Our Silver Belle Labrador~Athena has crossed the Rainbow Bridge

[WeLoveAthena]

Hello
SO grateful to have found this site. We just received news today of the results of our Lab's test for Cushings. She has been officially diagnosed with Cushings ( Pituitary dependent). We are so sad but trying to be hopeful for her. Let me give you some basic info and such.

Our Lab is a Silver Lab. Her name is Athena. She's precious, smart, protective, loyal and the happiest dog you will ever meet despite what she's going through. You couldn't ask for a better friend in her except her brothers and sisters ( We have 3 other doggies that she adores).

Athena is 4 1/2 years old

She started to show signs of being thirsty all the time, extremely hungry all the time, her coat was thinking but only in certain areas like along her back and part of her tail. She has little black spots on her belly/skin. In addition to this she has this barrel like belly and when standing she shifts her weight between her two back legs. She's overweight and we have tried everything under the sun to decrease her weight and nothing has worked. That is when we became very concerned and took her to the Vet. All our dog go to the vet for all their yearly appointments/shots, etc. They miss nothing and are well cared for. We thought maybe diabetes but it wasn't that.

We had the Cushings test on Friday. She was there all day. After we picked her up and came home. She couldn't drink enough water. We picked up the bowls so she wouldn't get sick but she did. She vomited everywhere twice. She was pacing back and forth and was so hot you could feel the heat come off her. We thought she was having a reaction to the Low Dex injection. Our vet uses an emergency service after hours. We call. They said to watch her close, to give her only a few ice chips hourly (which we did and we were up all night with her) and not let her drink freely from the water bowls. We had to move those to another part of the house for our other dogs.

She refused food which she never does. We tried a few times to feed her a little something because she's on tramadol but nothing.

The emergency vet said if she wasn't better by morning ( when we called it was around 8pm) to bring her in. The next morning she stopped the wanting of so much water. She started to slow down. She was walking a few steps then would sit down. She then just slept. She went out to potty and it was bright orange ( I'm thinking dehydration or the injection) but eventually she was willing to eat a small bowl of food but all day Saturday she slept and we just let her rest. We put her water bowl back out and she would drink a little then lay down.

Today is Monday. I was able to talk to our regular Vet when she called with the results but I had already called her in the morning to report what happened over the weekend. She said Athena did great at the office when she had her test but that she felt the stress of being there all day long and noise of other dogs could have just stressed her. She's used to just us and our other dogs and it's peaceful and fun here for her.

So the report today was as follows:

Her baseline was 4.8
the 4 hour test draw was 3.5
the 8 hour test draw was 10.0

She's a big lab, big boned lab and her weight is 115

Our vet is real good and explained everything. She wanted to start her on 120mgs of Vetoryl. She explained she felt that was safe. She told us we had to watch for diarrhea, vomiting, gastro upset and if that happens call her asap and bring her in.

She said if no side effects then she wants to see her in two weeks for a blood draw to check ACTH and Electrolytes. We have to be careful with the drug as to not give her an Addisons crisis.

We are very worried. Athena has proven to be sensitive about thing. She has fought 3 bacterial infections with no source known since we had her as a puppy. Not sure if this is a result of her compromised immune system due to this Cushings or what.

She tolerates her other meds well as in Tramadol for her sore hind legs. She always tolerated anitibiotics fairly well.

I asked if we could start her on 90mgs vs 120mg. I know she's the Vet but I'm anxious about this drug and the amount and wondered if it was better to start her at a lower amount initially and if she tolerates it well to up the dose. Any thoughts? I'm a Nurse (RN) and at home I always start with small doses for things and increase as needed vs a big whopping dose of something.

We are beside ourselves tonight because there is a minefield of info on the web and I'm cross eyed from reading and not sure what to believe about this drug. I know just as with humans everyone responds a certain way to a certain drug.

All our dogs are our life. We have no kids. Our dogs are the kiddos. Athena in particular has been a great source of love and healing for my Marine who was injured in combat a few years back in Afghanistan. She has been a wonderful member of our family and we want to do what is best for her.

This has been alot to take in as we have a 14 year old and 9 year old pitbull who are the picture of health even at those ages and our youngest is a 2 year old blue nose pitty. We are meticulous in how we care for them and give them plenty of love, play time, trip to the beach and mountains and where we go...they go..if they can't go..we don't go. They have never been boarded or anything.

Is there any other information I can give you to help? If so, please just ask away. Sorry to be long winded. Just very concerned. Depending on what you read and who you talk to you get a different story and finding this site I saw that it appears to be a rock solid place of good info and great people.

Does anyone have experience with the drug Vetoryl? Side effects? Effectiveness?

Are there any other treatment options out there? Anything else we can do to help her?

Thanks for your time...:o

[Harley PoMMom]

Hi and welcome to you and Athena!

First, I understand how frightful you are but I want you to know that Cushing's is not a death sentence for a dog, with proper treatment a dog can have a good quality of life and there is every reason to believe that they can live out their normal life span.

Thank you for the detailed information about your sweet girl, that helps us to provide our best feedback. But, of course, I still have a few more questions ;) Did Athena have a CBC/chemistry blood panel performed, and if so, could you post those values that are marked abnormal (H or L) with the normal reference ranges....as an example.....ALP 150 U/L (5-75)...thanks! Was an urinalysis done to rule out an UTI, and does Athena have diluted urine with a low specific gravity? Does Athena have an underlying illness that she is taking any herbs/supplements/medications for?

Those test results you posted are from a low-dose dexamethasone suppression (LDDS) test and do point to Cushing's, but to my knowledge are not indicative to the pituitary type of Cushing's. The criteria used to interpret the LDDS test:
Test interpretation. When interpreting LDDS test results, first evaluate the eight-hour post-dexamethasone administration cortisol concentration. If it is above the reference range, the dog probably has hyperadrenocorticism (false positive results may occur in dogs with nonadrenal illness). I

If the eight-hour post-dexamethasone administration cortisol concentration is above the reference range, then evaluate the baseline and four-hour postdexamethasone administration cortisol concentrations to see whether cortisol suppression occurred during the eight hours. If at least 50% cortisol concentration suppression is present at the four- or eight-hour time points, the definitive diagnosis is PDH and additional adrenal function tests are not needed.

http://veterinarymedicine.dvm360.com/clinquiz-interpreting-low-dose-dexamethasone-suppression-test-results

I am sorry that Athena had such a bad reaction to the dexamethasone, although not real common it can happen, sounds like this may have been a gut issue for Athena and I am glad to hear she is feeling more like herself.

The starting dose of Vetoryl that is recommended is 1 mg per pound of a dog's weight, so for Athena's weight of 115, that 120 mg is reasonable; however, seeing that she can be sensitive to certain medications I would opt to start her at a lower dose, maybe at 60 mg. Over a period of time larger dogs do seem to need smaller doses of Vetoryl to control their Cushing's.

Did the vet mention that the Vetoryl has to be given with a meal to be properly absorbed? And the timing of those monitoring ACTH stimulation tests are crucial ~ Dechra recommends that the ACTH stim tests be performed 4-6 hours after the Vetoryl is given. We have information regarding Vetoryl/Trilostane in our Resource Forum which I'll post a handy link to:http://www.k9cushings.com/forum/showthread.php?t=185

Athena, her brothers and sisters sure hit the jackpot with such loving pet parents as you are, they are a lucky bunch!

Cushing's sure can be a scary but when knowledge of the disease grows it does become less frightening, we are some of the best hand holders and are here for you, so lean on us, ok ;) If you have any questions please do ask them.

Hugs, Lori

[Joan2517]

Hello and welcome. This is a wonderful site and you will get lots of helpful information. I am new and can only say that it has helped me tremendously with my precious Lena and her diagnosis. I have gained a lot of information and so much support. I went nuts searching for information after we were told that Lena had Cushing's and I was panic stricken until I stumbled on this forum...they are all wonderful.

Joan

[WeLoveAthena]

Hi Lori

Hello Lori. Thanks so much! Yes, it's very overwhelming but trying to stay level headed although it's hard.

Quick?? Are you saying after the first dose they should draw her blood within hours? The Vet said she wanted to draw in 2 weeks from the first dose. Is that normal or waiting too long? I will be speaking with the Vet tomorrow so any info will help.

Here are the lab values of the bloodwork done two weeks prior to her cushings test and I will be able to post the actual numbers to her Cushings results tomorrow when I pick them up at the Vet with her meds.

The only things on her initial labwork that were out of range were the following


EOS Range 0.06-1.23 and her result was 1.45
ALKP Range 23-212 and her result was 459
TT4 Range 1.0-4.0 and her result was 1.3

as a RN I saw some of her values on the low side but they weren't marked as being bad because they were within range but I felt they were on the low side such as the following

BUN Range 7-27 Her result was 11
CGT Range 0-11 Her result was just 0 ( Vet didn't say anything about it)


I felt her T4 was of course within the range BUT it's what I think they call "Euthyroid Sick".

They didn't say a U/A was done but I will know when I pick up results in the morning but they have never done any U/A on her. Is that normal?


Athena takes Tramadol in the morning and at night ( 1 tablet) because she has soreness in her hind legs whether it's from this Cushings or what she limps and when she stands her legs shift alot. Her Xrays and MRI showed no damage as in an injury so they felt that her weight could be contributing to her being sore in her hind legs and put her on Tramadol and it seems to help her rest and do better.

They did mention that she must eat with her med and to give it in the morning.
They wanted her on 120mgs but I asked to start smaller. Just due to her being sensitive and what she just went through with the Cushings test.

There are no words that I could say that would ever properly explain how thankful I am for your posting and this site. THANKS!!!

We are both exhausted and worried about her.

[WeLoveAthena]

Thank you Joan. So grateful for your words and kindness.

[Joan2517]

I am still learning about this disease, but I don't need to learn how it feels...I already know, and it breaks my heart each time I hear that someone else is going through it too.

[molly muffin]

Welcome to the forum. We all came here terrified for our furry kids, so your in good company. I agree with Lori that I would mention starting a bit lower than the 120 just because of her reaction so maybe until you see how she does on the medication lower would be better for all of you.

14 (corrected from 24 UGH) days is the recommended time frame for the first five low up test which is an ACTH. On the test day you give the meds with her breakfast and 4-6 hours later she goes in for the test. I go st about 4.5 hours. They do a first draw. Baseline and then an hour after that they do the second blood draw after giving an injection that basically makes the adrenal glands dump the excess cortisol. The post tests how much excess the glands are making.
You are looking for a post ACTH result of under 5.0 ug it can be as high as 9.0 ug if symptoms are controlled.
Normally you don't want to withhold water in general as they need the water to stay hydrated because the kidneys work over time. I do understand the reasoning though as she was throwing up from drinking too fast and probably having an upset stomach too.
The high cortisol tends to cause ligaments and tendons to weaken and rear leg weakness is common in Cushing's dogs. The wreight probably doesn't help with that so maybe try supplementing when she is hungry with something low cal but filling like cooked green beans etc.
Another thought is to try water therapy to strenghen them.
We do see a lot of lower thyroid results in initially diagnosed Cushing's dogs so that might straighten up as the cortisol comes down.
They often go a UA to rule out a UTI and to see how she is concentrating her urine.
You will be surprised how fast you pick up the Cushing's info. It tends to become second nature almost.

This is a link to info on Cushing's and vetroyl from the manufacturer Dechra. I find the flow chart to be a very handy guide for ns I gating through what to do when.

http://www.dechra.us/Admin/Public/Download.aspx?file=Files%2FFiles%2FSupportMaterial Downloads%2Fus%2FUS-046-TEC.pdf

Again. Welcome.

[tank&kat]

Welcome!

It is a fact that some dogs over 100 pounds will achieve ideal control taking trilostane at an initial dose of 60 mg. It upsets me that the vet didn't hear your concern to start Athena at 90. Have you purchased the vetoryl yet? If not, you can ask her if starting at 60 mg BID could be an option. This will not only reduce the risk of over suppression but also keep her cortisol levels balanced evenly throughout the day since vetoryl has a short half life of 8-10 hours.

My dog also had trouble with his hind legs because of his weight. He weighed 83 pounds when diagnosed. He's been on vetoryl for 7 months now and has lost a total of 14 pounds which has helped him significantly. It took him 9 days post treatment for the PU/PD to resolve and about a month before his energy levels increased. I honestly thought he was just old and didn't want to walk or play as much. I can barely keep up with him now. This drug saved my dog. Athena is quite young. It's rare but this disease can occur in younger dogs. I truly hope you see improvements in symptoms soon. Keep in mind that response time is different for each dog. It can take anywhere from a few days to a month or two.

The link below is to help guide you with the timing of the ACT tests after a dog begins treatment with vetoryl.

http://www.dechra-us.com/therapy-areas/companion-animal/endocrinology/canine-hyperadrenocorticism/monitoring-cushings

~Katherine

[labblab]

Welcome from me, too!

I see that you've already gotten excellent advice, so I only have a couple of comments to add. First, I think that Sharlene's auto-spell might have run amok in her answer above :p, because I'm sure what she meant to say is that the "first followup" ACTH test should be run 10-14 days after you start giving the trilostane (not "24" days). So your vet's testing recommendation conforms with the recommended protocol.

Secondly, if you decided to dose twice daily rather than 90 mg. once daily, I would recommend giving 60 mg. in the morning and 30 mg. at night (if you are using brand name Vetoryl capsules). I would not exceed 90 mg. as the daily total, and might even start as low as 30 mg. twice daily. This is because studies have shown that dogs dosed twice daily often actually end up needing less total daily dosage than do dogs dosed only once daily. As Katherine says, I imagine this is because cortisol levels never elevate quite as highly at any time during the day when the med is given at twelve hour intervals.

Some specialists do indeed prefer twice daily dosing in order to keep cortisol suppressed more consistently throughout the day. However, many dogs seem to do fine in terms of overt symptom resolution on only once daily dosing, and here is a quote from noted endocrinologist, Dr. David Bruyette, who tells us that dogs being dosed twice daily actually may need to be monitored even more closely for the development of low cortisol or electrolyte imbalances.


With regards to once vs twice a day dosing if we look at all the studies throughout the world you will see that about 80% of dogs do well with once daily dosing. One huge advantage of once daily dosing is owner compliance which goes up substantially when owners only have to dose once a day. While twice a day dosing may result in a lower amount of trilostane being used pre day it will require closer monitoring as the ACTH stimulation tests tend to be lower so we have to look for both hypocortisolemia and electrolyte abnormalities.

Marianne

[labblab]

I also want to add one more note to stress what Lori has said above: Athena's LDDS results can be consistent with either the pituitary or adrenal form of Cushing's. So unless your vet has performed an ultrasound or other secondary diagnostic test to differentiate between the two forms of the disease, it remains a question mark. The reason why this is significant is because in the situation of an adrenal tumor, complete surgical cure is a possibility. Adrenal surgery is very expensive and also risky, so it is not a viable option for all owners. But given Athena's young age, I just want you to know that the option may exist for her, depending upon the outcome of additional diagnostics.

Marianne

[budindian]

I'm fairly new here and first of all welcome, you are in the best possible place for cushings and other things. You said your baby was sensitive and I can relate to that , my baby was started to high on the Vetoryl and it had a very bad effect on him. I stopped the Vetoryl immediately and called the vet, it was the information from this site that told me they started him to high so what I did is started him at the lowest dose possible and we worked our way up as he tolerated it. My vet told me my baby has a sensitive system.
I hope all goes well with your baby.

[lulusmom]

Hi and welcome to you and Athena.

I am sorry the reasons that brought you here and I'm glad you found us. The symptoms you list are certainly those associated with cushing's but with Athena's young age and so few lab abnormalities, I am wondering why your vet did not recommend an abdominal ultrasound to determine which form of the disease Athena has. My first cushdog was only three years old at diagnosis. She had every symptom in the proverbial book and her specialist was beyond comprehensive in confirming a cushing's diagnosis. She had an LDDS, ACTH stimulation test, abdominal ultrasound. which confirmed pituitary based disease, and because she was a nordic breed prone to sex hormone imbalances, she even had a full adrenal panel done by the University of Tennessee Knoxville. If my Lulu had an adrenal tumor, which is a lot more serious than PDH, I most certainly would have opted for surgery. While the minority of dogs with cushing's have an adrenal tumor, a lot of credible resources state that larger breeds seem to be more affected than smaller breeds and females are more affected than males. My own experience in following a lot of case studies over the years would support that statement which is why I am concerned that your vet has not done adequate testing.
Labrador Retrievers are also a breed listed as being more affected with pheochromocytomas than other breeds and symptoms for this specific adrenal tumor does have overlapping symptoms with cushing's. It is rare but some dogs actually have both types of tumors. The symptoms you describe seeing after Athena had the LDDS are symptoms associated with pheochromocytomas. There are recorded cases where humans with pheochromocytomas have gone into crisis after receiving dexamethasone but I believe at higher doses but because there have been no formal studies done, who knows how a dog with a pheo could be affected by a low dose of dexamethasone?

Pheochromocytoma crisis induced by glucocorticoids: a report of four cases and review of the literature
http://www.eje-online.org/content/158/3/423.full

If Athena were my dog, I would not start treatment without knowing for sure that she does not have an adrenal tumor of any kind. Dogs with pituitary dependent disease can live out their normal lifespan, with a very good quality of life, but the prognosis for a dog with a functional adrenal tumor that is not surgically addressed, is very guarded. My intent is not to scare you but to provide you with as much information as possible before starting treatment so that you are making an educated decision for Athena. If Athena has already had an abdominal ultrasound, I apologize for making you read all of this. If so, can you please share the radiologist's interpretation?

Adrenal gland tumours. Different clinical presentations
in three dogs: a case report
http://vri.cz/docs/vetmed/58-7-377.pdf

Glynda

[WeLoveAthena]

I wanted to post this info real quick to help answer some questions folks may have and this evening I'm going to go over each posting here and read everything and respond because it's very important to us to read everything you have all written and respond. You have all be so kind in giving us our time, guidance and reassurance and it's a priceless gift to us all just being hit with all this. Thank you. I'm sure people think I'm crazy but Ive been sick about this since it all went down. In tears but I don't show that to Athena. She's very sensitive if she see's anyone upset. She's such a jewel. Always the friend, listener, protector and caretaker. We want the best for her and we are so grateful we came across this site. No way could we do this without all of you. Thanks with all of our hearts.

Here is the info from what went down today so far.


Hello to all. Thank you so much for all the input and responses. We are beyond grateful to each and everyone of you. It's as if I don't even have to try and explain how we feel. Each of you truly "gets it". Thank you for that.

We started Athena on her medication today. The Vet agreed to the scale back. She offered to do 90mgs vs 120 and I asked if we could do 60. So that's what we will do but they had already filled the 90 ( which was a box of 60 and a box of 30mgs) so we have both. I'll keep the 30's on hand to maybe increase later.

I made Athena a little med flow sheet where I can write the time she was given her meal, meds and anything that we notice. I want to keep track and take it to her next appt in two weeks.

She ate her meal just fine and we gave her the meds. I won't lie. My heart was beating just giving her this med. How crazy right? :( I'm an RN and have been in emergency nursing forever but when it comes to our dogs I'm just a regular person trying to do the best for our dogs. I can handle just about any human emergency but with my dogs it's different. I can't stand for them to be sick or have to suffer in anyway. I honestly feel it. Sounds crazy but I'm sure the awesome people here totally get it.

So she took the med and nothing so far and it's been 6 hours. She has not been showing any signs of feeling sick. She was a bit hot but she's been that way since she got home from her Cushings test. Just that her head is so warm. Not sure if that is the steroid in her still or what that is. Vet said its nothing to be concerned about. :confused:

Meds were very $ but I'd pay whatever it costs to help our girl. I just didn't expect it to be that pricey. For both boxes it was $254.00. Is that the normal cost of this medication? I don't care what I have to do but we will always find a way to cover whatever our dogs need.

I also was given a copy of her Cushings Low Dex Test and this is how it reads:

Baseline Cort 4.8ug/dl
4 hour post low dose dex 3.5 ug.dl
8 hour post low dose dex >10.0 ug/dl

This is the info under these lab values. Will type just as it reads

Both 4 and 8 hour <1ug/dl- Normal

Both 4 and 8 hour =1-1.5 ug/dl - Inconclusive consider repeat test 8 weeks

Both 4 and 8 hour >1.5 ug/dl and 50% of baseline= Consistent with Cushings Syndrome; consider HDDST to rule out adrenal tumor

4 hour < 1.5 ug.dl or <50% of baseline and 8 hour> 1.5 ug.dl and 50% of baseline is consistent with PDH

4 hour < 1.5 ug/dl or <50% of baseline and 8 hour >1.5 ug/dl and <50% of baseline is consistent with PDH

4 hour > 1.5 ug/dl or >50% of baseline and 8 hour > 1.5 ug/dl and <50% of baseline is consistent with PDH

Tests were done by IDEXX Labratories


Thank you and will post again this evening. May you each have a beautiful day. ;)

[Joan2517]

Oh, we all know how you feel! I give Lena her pill at least an hour and a half before I go to work, just in case. And my hands still shake when I take it out of the case. And I still hesitate, wondering if this is the right thing to do. And then I watch....I hate leaving her and going to work. I wish I was able to just stay home and take care of her. The days drag.......

The minute I get to my front door, the first thing I do is look through the window to make sure she is there, and then I can really breath for the first time all day.

So, you are not alone....

Joan

[labblab]

You take all the time you need to read and process the info we've offered to you. We all understand only too well how overwhelming this diagnosis may feel as you are starting out.

I just want to reassure you about one thing, however. You can definitely purchase the Vetoryl for a much less expensive price. I quickly scanned a couple of reputable internet pharmacies and found a range of $120-140 for both boxes in total. Perhaps your own vet will be willing to price match. But if not, we can tell you how to search for credentialed pharmacies from whom to buy veterinary Rx's.

Marianne

[Renee]

I've been purchasing from California Pet Pharmacy for the last 2 years. Never had an issue, except when first switching, they had some trouble coordinating with my vet, but it's been smooth sailing since then. It's about half the price. :) And, free shipping!

[molly muffin]

There are several good online pharmacies to order from, they just need the prescription from your vet and they will ship to you. Most of our members, use something of this sort to keep prices in check.

[Lola]

I have been using California Pet Pharmacy as well. Used them for over a year and a half without any issues. I get Vetoryl at almost half what it would normally cost me at the vet's office. Very convenient and saved me a lot of money.

[labblab]

Baseline Cort 4.8ug/dl
4 hour post low dose dex 3.5 ug.dl
8 hour post low dose dex >10.0 ug/dl

This is the info under these lab values. Will type just as it reads.

Both 4 and 8 hour >1.5 ug/dl and 50% of baseline= Consistent with Cushings Syndrome; consider HDDST to rule out adrenal tumor

Just wanted to stop back to highlight the lab's interpretation that fits Athena's LDDS results. Her 8 hour result was greater than 1.5, and both her 4 and 8-hour results were greater than 50% of baseline. Therefore, an adrenal tumor, rather than PDH, is a possibility. Personally, though, I would put my money towards an ultrasound rather than a HDDST test. With an ultrasound, not only do you get important info about the adrenals, but also about other internal organs, as well. And if an adrenal tumor is present, the imaging will give specific info as to size and location.

Has the vet said anything at all about further diagnostics? I think Glynda's speculation about the possibility of a pheo is very interesting, given Athena's very odd response to the LDDS test.

Marianne

[budindian]

I just want to say if your crazy we are all crazy, I cried almost everyday last week because my precious little furbaby wouldn't eat.
When Bandit had a bad reaction to the Vetoryl the first time I didn't give my vet much choice in lowering the dose after I had gotten the information from this site. I always listen to what she has to say and then give her my opinion and what I think would work for him, after all I am the one that lives with him and knows him. I really like my vet she does take the time to listen to me even tho I am hysterical sometimes. Your just like everyone here, just wanting whats best for your loved one.

[WeLoveAthena]

Oh, we all know how you feel! I give Lena her pill at least an hour and a half before I go to work, just in case. And my hands still shake when I take it out of the case. And I still hesitate, wondering if this is the right thing to do. And then I watch....I hate leaving her and going to work. I wish I was able to just stay home and take care of her. The days drag.......

The minute I get to my front door, the first thing I do is look through the window to make sure she is there, and then I can really breath for the first time all day.

So, you are not alone....

Joan
Oh Joan.. You would like me with how I feel giving her this medication. Thankfully we can be home with her. My other half retired recently from the Marine Corps after being injured in combat ( which we have had a long few years with that as well) on top of that I was diagnosed with MS. So you can imagine....thankfully we both have level heads and are able to face everything thrown at us head on but when it comes to our dogs it's so different. We feel it's because they are just our world, they ask for so little, and they give so much and we have come across some cruddy people along the way that just made us so jaded when it comes to humans and the only bright light of the day are these beautiful dogs we've been blessed with. They have been lifesavers. It's so true when they say "who rescued who".

I just wanted you to know I appreciate your words. you have a good heart. I can tell and I would do the same thing if I had to give meds and leave. I'm an RN as well but I too, am home now but I'm taking care of alot here with my Marine and everything else. When I give her the meds ( it's day 2) we won't go anywhere. We stay put with her. About to post an update on that as well
Have a great day. Is that your little bandit in the pic? Sooooo cute!!

[WeLoveAthena]

Day 2 of Medication

Hello all. I intended on writing last night. I'm so sorry. I just crashed on the bed and couldn't do much more. I think the stress of all this and worry just got to me.

Athena is on day 2 of her medication. I'm so nervous giving to her. So strange considering I've been an RN for so many years and administered big drugs on doctors orders which all have risks but nothing ever made me nervous like this. Isn't that crazy. :confused:

We give her the medication after she eats. We actually wait about 15 mins or so for her food to settle. Then we give it to her. We don't leave the house at all. We stay close by just in case. So far day 2 and she has had nothing really happen. She seems her happy self again. We do notice one thing and not sure if this is related to this medication but she sleeps alot more than she used too. She will actually go off in the dog room where we have a queen size bed ( mattress and box spring but no frame so they don't have to jump) and she will get up there with all the soft blankets and just lay down and sleep. We notice she does that alot more. Not sure if the meds are making her sleepy. Before the med she would sleep but she was always up here and there. She's a lab that is always on alert for lack of better words. She is protective and the true guardian of this home.

However I wonder if the extra sleep is just because she was so stressed during that test, the reaction she had and the 2 days it took her to get over it all. Maybe she feels like I do... wiped out.


I'm reading and re-reading everything heere. So much to take in but with that I'm beyond grateful, we both are, for this priceless gift of everyones kind words, information and such compassion. I feel like I found this little dog family that "gets it".

As you know we started her on 60mgs vs the 120 they wanted us to give her. They gave me a box of 60 and 30 because they thought I may go for the 90mgs vs 120 but I'm not comfortable with that. Started her on 60 and if she does good for awhile I don't mind adding the 30 mgs. Not sure I ever want to do 120 but we'll see. Any thoughts on that?

I did call the vet about the possibily of adrenal tumor but she assured me there was nothing that indicated it could be that, or that Athena should be tested for that unless I really wanted to go that route but she didn't see the signs for that with Athena. Does that sound right? I love our Vet. She's cared for all our dogs and Athena since she was a puppy but I know vets are not perfect and all sort of have their opinion on things.

She's a hard working vet. She works long hours and I love how she is with the dogs. She's very kind. She's willing to listen to what you say and she's not one of those Vets that push $$$ things on you ever. She's very common sense.

I love all the pictures here of your doggies. So adorable each one and they are so lucky in having such awesome families caring for them :-)

I haven't slept good. I sleep but I'm up every few hours checking on her. I have this fear for some reason that I'll wake up and this med has done her in. I know. Pure paranoia. I promise I"m not crazy:p

Thanks to each of you. This has been so overwhelming....

[Joan2517]

That is indeed my precious! We have 3 others, a teacup chihuahua, a puggle and a lab mix. I love them all, but there is always that one, and that is Lena. I hardly sleep anymore as I am listening to her breathing, moving, anything.

I watch her so closely that the poor girl avoids eye contact most of the time and when she sees me with the camera she either closes her eyes or looks the other way. She knows what I'm doing...

I am dreading the day that she dies or I have to make that decision. I know she's going to be 15, she's had a great life and it's not fair that she got sick like this. She has never been sick, ever. Up until a few months ago she was a happy little girl, even though she had a lot of the symptoms, but they were subtle and just seemed to go with old age. Then it was like BOOM! And our lives changed...I cry all the time now.

And the only place where I can say all this is here, with people who understand and feel the same way about their furbabies. So, nothing you say sounds strange to anyone in this forum.

[Renee]

With all due respect to your vet -- you have nothing to lose by definitely ruling out (or ruling in) an adrenal tumor. I'm confused about why she would insist you not pursue finding out, regardless of whether or not she thinks there are definitive symptoms pointing one way or the other. For that matter, if your dog has cushings at all, then an adrenal tumor is always a possibility and there is no way to determine if the cushings is PDH or ADH based on symptoms alone. Given Athena's age, surgery could be a hugely viable option.

Great vets aren't always right. It's sad, but very true, that cushings is a complex disease that most vets just are not familiar with. Or, their education of the disease is outdated.

[labblab]

Hang in there, because you are doing a great job with all of this!! So much new info and so much worry to have to absorb all at once. But I am hopeful that things will start to settle down again soon, and you will be able to feel more peaceful about Athena's progress.

I have one quick comment about meals and administering the Vetoryl. I totally understand why you are thinking it is better to wait for a little while after her meal to give her the capsule. But I do believe that for maximal absorption, it may be better to give her the capsule simultaneously with her food rather than waiting even for just a little while. I could kick myself because I didn't bookmark an article that I recently saw that I think made this statement. But since I can't find it again right now, I've put in a call to Dechra, the manufacturer of Vetoryl, to see what their advice is in this regard. It may be a day or so before I hear back from them, but I'll report on what they tell me

Also, as far as an adrenal tumor...


I did call the vet about the possibily of adrenal tumor but she assured me there was nothing that indicated it could be that, or that Athena should be tested for that unless I really wanted to go that route but she didn't see the signs for that with Athena. Does that sound right? I love our Vet. She's cared for all our dogs and Athena since she was a puppy but I know vets are not perfect and all sort of have their opinion on things.

She's a hard working vet. She works long hours and I love how she is with the dogs. She's very kind. She's willing to listen to what you say and she's not one of those Vets that push $$$ things on you ever. She's very common sense.

Your vet sounds as though she's been a wonderful partner for you through the years, but the info she is giving you about the possibility of an adrenal tumor doesn't really sound accurate. In the absence of additional specialized blood testing or actual abdominal imaging, there is no way to know whether or not it is an adrenal tumor or a pituitary tumor that is causing Athena's Cushing's. Frequently, there is nothing different about the symptoms that are produced, or the outward appearance, or the general labwork of the dog.

It is a fact that adrenal surgery on a dog is very expensive and a risky undertaking. And if surgery is not an option, then treatment with Vetoryl is recommended for adrenal Cushing's as well as for pituitary Cushing's. Your vet may be hoping to save you the financial and emotional stress that might accompany further diagnostics, let alone the stress of contemplating surgery itself. In honesty, I don't know whether or not I would opt for adrenal surgery on a dog of my own. A lot of factors would go into that decision. But from what I can tell, there is nothing that we know about Athena's testing that would rule out adrenal Cushing's as a possibility. So if this is something that you want to know more about, I think you will need to push your vet a bit harder for more answers. This is not something you need to do today or tomorrow. But if surgery is something you'd consider, it is better to proceed sooner rather than later so as to remove the tumor before it expands even further and perhaps becomes inoperable. However, if you already know upfront that surgery would not be an option for your family, then your vet is correct and there is no need to stress further about the issue.

As an ER nurse, I'm betting you will agree with this thought: Just because a procedure is available does not mean that it is the "best" choice for every patient. So however you and your husband feel about further diagnostics and the possibility of surgery for Athena, we will understand and support you here.

OK, enough blabbing for now. As I say, I'll report back when I hear from Dechra.

Marianne

[WeLoveAthena]

Renee/Marianne Thanks. I'm calling her now for a more detailed explanation on her feelings on this. I'm glad you wrote this. Making the call now. Thanks! :-)

** Marianne. Thank you. I was thinking let her food settle and not upset her stomach but you're correct. It's better to do it the way you said. I'll give it to her with the meal. Thanks. I'm so overwhelmed right now with it all but that does make sense. Thanks for checking with Dechra for us. We are so grateful

[labblab]

I just got the call back from Dechra -- they were very prompt! -- and they did confirm that it is best to give the capsule simultaneously with food for maximal absorption.

[Renee]

This disease is very overwhelming, even for 'seasoned' veterans. You are doing amazingly well and being very thoughtful / thorough. :)

When my pug had her LDDS done, it was inconclusive for PDH / ADH. I opted to do a CT scan in the hopes she may have an adrenal tumor that could be surgically removed. Turned out that she has PDH, but I have never regretted finding out for certain which tumor she had and it provides more information to me now in terms of watching and assessing symptoms.

[molly muffin]

Vetroyl will continue to lower cortisol levels for usually at Least 30 days with no change in dosage.

So I would definitely not introduce the additional 30mg until you see how she is doing after a month on the 60mg. They test usually at 14 days and some vets now don't test till 3 weeks or 4 as long as there are no risk factors. Dechra the manufacturer still recommends the 10 - 14 and 30 day testing regime though.

If you can get an ultrasound at a reasonable price, then I personally think it is worth it and that is just me personally. I hate surprises when it comes to my molly. Not that the little diva doesn't throw a lot of surprises our way but they are usually of the more pleasant sort. LOL

[WeLoveAthena]

@ Marianne. Thank you!!! So thankful you made that call. How very sweet of you to do that for us. We will make sure it's done together with her food. Thanks again;)

Renee, thanks for prompting me to make that call to the Vet. She called and what I didn't know ( and she may have told me but I was so taken back by the whole thing of Athena having Cushings and such) is that the test she did on Athena is from IDEXX Labs. It tests for both with certain markers. The math turns out that because of Athena's numbers and her baseline being less than 50% that she is not in danger of having an Adrenal Tumor. Had her numbers been matched with her baseline being over 50% then she would have had us bring her in for an ultrasound and further testing.

I'm so sorry. Hope this makes sense. You'd think with my fancy Nursing degree I could get this straight but I'm taking this real hard about our girl Athena. Just so much happening at once which I've always been great handling but not lately :-(

So she said her baseline was 4.8

4 hour was 3.5
8 hour was 10.0


Hope that makes sense. I apologize for being all over the map right now. In a few days I may be able to explain this more clear but the vet said the old test they used to do ended up causing alot of dogs being misdiagnosed or having to go back in but this new test takes longer ( 9 hours) but it tells them whether or not it could be an adrenal tumor. She said she tried not to dump alot at once so she just wanted us to know what it was and how we would treat her and when we see her in two weeks we could go over more info but that there was nothing to be concerned about regarding a tumor in Athena.

I was able to tell her how Athena was doing on the meds so far and she was happy about that. She said in fact that she may do well just staying on 1/2 the original dose she had wanted her to be on. I pushed for the 60mgs vs 120mgs and it Athena's numbers look good in two weeks there is no reason to up the dose but if not we will have to up the dose.

I'm thankful Athena is tolerating the meds. I pray it helps her. We noticed today that she was playing with some of her toys. She hasn't touched those toys in a long time. We thought that was pretty funny. It may have nothing to do with being on this drug for 2 days but it was good to see her playing. Her brother and sisters were laying with her today. Very sweet. They didn't like that she was gone for a whole day. They missed her! We all did.

Thank you to all and thanks to you Renee. I feel better with that info now.

[WeLoveAthena]

Question: I've been told that Athena is actually pretty young to have this diagnosis and that Cushing is seen in older dogs moreso than young dogs. Is this accurate? Her parents were very healthy and are still alive. No issues. We know the people we got her from as a puppy and her mother/father are both fine. No issues at all. Wonder if this is something heredity in certain bloodlines or just happens. I have MS which is hereditary but not a soul in my family had MS or anything remotely like MS. I guess one never knows.

[molly muffin]

Usually we do see it in older dogs, but it has been known to happen in younger dogs too. We've had some diagnosed at I want to say 4 years old.
There is nothing so far that has shown that cushings is hereditary, although if the parents had it I'd be inclined to watch for it since there is nothing that says either way. Basically there is no Known proven cause for a cushings tumor for either pituitary or adrenal.

Remember what I said that cortisol will lower for 30 days on the same dose. Unless her cortisol numbers are Very high post ACTH at the mid way mark of 14 days, I probably wouldn't increase till after 30 days.

[molly muffin]

I just want to add one thing, you aren't at all abnormal in your worry and stress over this. I've been on the this forum for years and can throw out what to do, what things mean, at the drop of a hat and then my Molly has her test, and I become still, a basket case of what should I do, what shouldn't I do, even though I Know. I do know, but emotions just sort of flood you and rational thought goes out the window, either that or I analyse all the possibilities until I become practically inert. Thank god for the other members and the other admins here who have kept me sane and on track for the last 4 years.
So I think you are completely normal in your response to this diagnosis and what to do and what things mean and what questions to ask, etc. It's always harder in our own. Big hugs. I can say, it does it get better, but I couldn't be more thankful for a forum like this when the mind starts rolling.

[WeLoveAthena]

Sharlene. Thank you so much. Your words mean more than I can say. I appreciate the info on the cortisol and will defintely not make any changes until after 30 days if that. This site is an absolute godsend. I thank my lucky stars I stumbled on it.

After Athena ate tonight she just wanted to go lay down and sleep. That's not what she normally does but she's been more active today and the last 2 days. She used to try and go to everyone else's bowl to see if they left any food. We always have to pick up bowls or she will try to eat everyone's leftovers. The otehrs always have a bit leftover but she never does. The last two days however she will just eat her meal and go lay down until she wants to go outside. She's not looking for more food.

Thanks again for everything Sharlene. I really truly do appreciate it.

[molly muffin]

Okay that is good. One thing that might be causing the change in sleeping more laying around is that when the cortisol drops, some dogs feel yucky for a bit till they adapt to a lower level. Like taking all that feel good stuff that has been in excess away. We've seen that happen quite often. Normally is this is the cause then she will get back in sync and be better. Also aches and pains they didn't know they had can be uncovered. That she is already having a change in eating behaviour does signify that the cortisol is dropping.

[labblab]

I'm so sorry to be the squeaky wheel that keeps disrupting your peace :o, but I'm really afraid that your vet is misinterpreting the IDEXX test results.


Renee, thanks for prompting me to make that call to the Vet. She called and what I didn't know ( and she may have told me but I was so taken back by the whole thing of Athena having Cushings and such) is that the test she did on Athena is from IDEXX Labs. It tests for both with certain markers. The math turns out that because of Athena's numbers and her baseline being less than 50% that she is not in danger of having an Adrenal Tumor. Had her numbers been matched with her baseline being over 50% then she would have had us bring her in for an ultrasound and further testing...

So she said her baseline was 4.8

4 hour was 3.5
8 hour was 10.0
If those are truly Athena's results on IDEXX's LDDS test -- and in that order -- then your vet is interpreting things backwards. You do not check to see whether the baseline is less than 50% of the 8 hour result. You do the reverse, and check to see whether either the 4 or 8 hour results are less than 50% of the baseline. If not (and assuming the 8 hour result is greater than 1.5 which Athena's is), then this test result does not show whether the Cushing's is caused from a pituitary tumor or an adrenal tumor.

Here is a link to a pdf that gives you charts for all of IDEXX's Cushing's related tests. The LDDS is on Page 3 of the pdf, and Athena's results are consistent with the result "silo" that is the third from the left: the one in which both the 4 and 8 hour results are greater than 1.5, and both are also greater than 50% of the baseline. As you will see, that test result is consistent with Cushing's, but further testing is needed to determine which type of tumor is the cause.

https://www.idexx.com/resource-library/smallanimal/snap-cortisol-testing-guide-en.pdf

As I say, I am so sorry to be harping on this. But when you have the time to take a look at this chart, I think you will see how IDEXX would interpret Athena's result. And at that point, you can even print the chart out and once again talk this over with your vet if you choose to do so.

Marianne

[Renee]

Yikes, I was just typing up a response quite similar to Marianne's.

It's a lot of absorb at once, so hopefully you aren't getting overwhelmed by us.

Even if she does not have an adrenal tumor, there are many uses from doing high quality imaging. I opted not to do an ultrasound and went straight for a CT scan. Would you believe we have referred back to that scan numerous times the past 2 years for a number of reasons? Point is, you'll not only get to rule in or rule out ADH, but you'll get a good view of the surrounding organs and any other information the imaging can provide.

[tank&kat]

There is a lot of good advice on this thread. I just want to emphasize what others have said...to not increase the dose on the 14th day. Vetoryl can continue to lower cortisol for 30 days and it is recommended that any increases be made on the 30th day if necessary. I'm thrilled to hear the vet has heard your concern to start at a lower dose.

The first week my dog started taking vetoryl, I was a wreck. I didn't leave the house at all. Nothing you say can sound crazy to any of us :D Also, I remember my dog being tired in the very beginning of treatment and looking back I believe it was due to his cortisol dropping quickly. His post ACTH number went from 25 to 7 ug/dL in under 2 weeks. He got his energy back around the one month point and it was more energy then I have seen from him in a couple of years. I felt horrible when I realized this disease took so much out of him.


http://www.idexx.nl/pdf/en_ie/smallanimal/snap/cortisol/trilostane-dosing-monitoring.pdf

~Katherine

[Joan2517]

I wish I had known about the 30 days before I let my vet increase Lena's dose from 10 to 20 to 30. Next week is 30 days on 30mg...if I had found this forum first I would have fought it.

[tank&kat]

I just want to add one thing, you aren't at all abnormal in your worry and stress over this. I've been on the this forum for years and can throw out what to do, what things mean, at the drop of a hat and then my Molly has her test, and I become still, a basket case of what should I do, what shouldn't I do, even though I Know. I do know, but emotions just sort of flood you and rational thought goes out the window, either that or I analyse all the possibilities until I become practically inert. Thank god for the other members and the other admins here who have kept me sane and on track for the last 4 years.
So I think you are completely normal in your response to this diagnosis and what to do and what things mean and what questions to ask, etc. It's always harder in our own. Big hugs. I can say, it does it get better, but I couldn't be more thankful for a forum like this when the mind starts rolling.

Oh how I can relate! It's been 7 months and I have yet to find that perfect balance of sanity.

[WeLoveAthena]

Oh how I can relate! It's been 7 months and I have yet to find that perfect balance of sanity.

Everytime I read a posting here I break out in tears. People will think I'm crazy but it's just so comforting to find such a great group of people that understand. Sometimes I think I make no sense in my postings and yet everying "gets it". I'm so grateful beyond words.

How's your doggy doing?

Thank you for your kind words.

[WeLoveAthena]

Hello to all
It's day 4 of Athena being on her Vetoryl. No signs of anything bad. She sleeps more and I'm not sure if that is from the meds or that she's starting to feel better. She was pretty stressed during her Cushings test and in fact had the reaction to the low dex so not sure if this finally all caught up to her. When she's awake we notice she plays more with her toys and with her brother and sisters.

Just hoping and praying this goes well. It still hurts so much. When she's sleeping I go into the room that has the big queen size dog bed and just lay with her if she's in there alone. I just lay quiet with her. She loves when I do that. I just want her to know we are all in this together. She's such a wonderful dog.

Thanks to everyone of you angels for being here for us.

[WeLoveAthena]

Website ??

How can I edit the title of my posting to add Athena's name in the sentence. I thought I did it but it only changed it on one posting in the thread. Trying to change the main title. Thanks.

[mytil]

Hi, I have added her name to your thread title so you do not need to do anything :). Let me know if this is how you want it. BTW - she is a beautiful girl!

Terry

[Joan2517]

She surely is!!

[WeLoveAthena]

Thank you Joan :)

Yes Terry. Thank you for taking care of that for us ;)

We call her Pretty Girl all the time...thanks for the compliments about her. She said Woof as well ( her version of thanks)

[tank&kat]

Everytime I read a posting here I break out in tears. People will think I'm crazy but it's just so comforting to find such a great group of people that understand. Sometimes I think I make no sense in my postings and yet everying "gets it". I'm so grateful beyond words.

How's your doggy doing?

Thank you for your kind words.

My dog is doing ok. He has plenty of energy, loves his walks and seems happy which makes me happy. He still has some incontinence that's not related to Cushing's so I'm currently just trying to get that under control. It could be much worse. I'm thankful he is happy and as long as he is trying to chase cats and squirrels then I know he is good :D.

I do the same thing when my dog sleeps all day. I'll get a big pillow and plop right on the floor next to him. Same reason...I want him to know I am there with him. He doesn't do this much but does have some off days.

I just started opening up in this group and I'm realizing I should have done it a long time ago (7 months lol). I can't believe I went that long dealing with this by myself. Everyone here really does understand.

Glad to hear Athena is tolerating the drug well. We are all here if anything should happen. I am hoping for the best possible outcome for the both of you.

~Katherine

[WeLoveAthena]

Thanks Katherine. You are very kind. I was in such shock when Athena was diagnosed and on top of which she had a reaction to the low dex. We had a rough 48 hours with her after that. Not sure what I told myself could be wrong with her but was hoping it was something minor probably out of fear of losing her. Soon as we found out I stumbled onto this godsend of a site while researching Vetoryl. Like someone guided me here. I was so grateful to find this site. How much Vetoryl is your baby on if you don't mind me asking?

[tank&kat]

Thanks Katherine. You are very kind. I was in such shock when Athena was diagnosed and on top of which she had a reaction to the low dex. We had a rough 48 hours with her after that. Not sure what I told myself could be wrong with her but was hoping it was something minor probably out of fear of losing her. Soon as we found out I stumbled onto this godsend of a site while researching Vetoryl. Like someone guided me here. I was so grateful to find this site. How much Vetoryl is your baby on if you don't mind me asking?

Not at all. He is on 60 mg. He started at once a day but eventually ended up needing 30 mg twice a day. I can often tell when the drug wears off for him. He gets a bit anxious and starts to pant heavily.

[WeLoveAthena]

Thanks Katherine. Athena is also on 60mgs. Vet wanted her on 120mgs. She's a big Lab. We asked to start her on 1/2 that does. Was just concerned about the drug and side effects so vet agreed. We can revisit. Higher dose later down the road if Athena needs it. Don't know if she's getting enough but I wanted to gradually start her. Was worried about the warnings on gastric upset and all. She's had no issues with the meds. She sleeps more. That's all that we notice

[tank&kat]

There are dogs that weigh 100 pounds that are controlled on 60, even 30 mg. Every dog metabolizes the drug differently so you just never know how much will be enough or too much. Best to play it safe and start at the lower end, especially in this situation. I'm glad you took our advice. I'll be checking in so keep us all updated on her progress.

~Katherine

[WeLoveAthena]

Thanks so good to know Katherine. Athena is 115lbs but some of that weight is from her being sick so we hope it comes off. We had tried everything before that and it wouldn't budge. Now we know why poor girl.
Thanks for all your help. You are all such a gift to us.

PS: What is your doggy's name?

[WeLoveAthena]

Just a quick update on Athena.
She's had no side effects from the Vetoryl. Thankful for that.
We did notice today however she was very hungry. Her hunger had slowed down the last few days but today she finished her bowls and was hovering around the others just waiting for them to leave something behind. Not sure if this is just an off day or something to be concerned about.

Any thoughts?


We were told by a friend to start her on Vitamin A which will help her coat. Is this something that can be mixed with this medication? Is anyone's doggy on Vit A for their coats? They said it will help her coat come back and not be so thin which is a result of Cushings as we've been told.


Thanks for your help
T~

[Renee]

Hi T,

I would caution against adding anything new at the moment, even a supplement. You'll want to get good and comfortable with the vetoryl before you add anything else in the mix.

As for the drop in hunger and subsequent rebound, it's possible that during the first days of treatment, she was going through cortisol withdrawals, which could have lessened her appetite. As her body rebounds a bit, it's not a surprise that the hunger has come back. There can be a lot of ups and downs during the beginning of treatment, but most important is watching for over-suppression.

[WeLoveAthena]

Ah..makes sense. Thank you Renee. I'll hold off on the Vit A. I wasn't going to administer it until I got some feedback from all of you here ( Dog Angels) and was going to ask the Vet but yes, you are right. Makes perfect sense to wait. I was iffy about it to start. I guess it's just anxiety of wanting her better and being overloaded with everything.

I think I finally slept 5 hours last night for the first time in awhile.

I appreciated the quick response. I also wouldn't want anything affecting her lab draw on the 25th.

Also have alot on our minds with our oldest girl. She's a 14 year old Staffordshire Terrier. She's not doing so well. It's been a tough time in our little dog family the last month or so.

[WeLoveAthena]

UPDATE

Hello to all, Just an update on Athena. We are in week two of her meds. So far so good. No side effects to speak of. Friend stopped by last night and commented on her looking better. I thinks what I notice most is that her coat seems better, her skin has cleared up of that little breakout she had going ( we treated her previously with other meds and it would help short term), she rests good and she is playing more. It appears she has lost a little weight as well ( I'd say maybe 2-4 pounds). We see the Vet on the 25th for bloodwork to see where her numbers are. I'm thankful she appears to be tolerating the meds okay. She's on tramadol as well and there is no problems taking both. I do give her the Vetoryl while she's eating as opposed to before I was waiting about 15 mins post meal thanks to an Angel here that called the drug company for us to confirm best way to administer the drug. We do wait on the tramadol just a little while. Didn't want to mix them together so we just space the tramadol out about 30 mins. This site has been a lifesaver and I'l so grateful to all. We love Athena with all our hearts. We love all our doggies. We want what is best for them and this has been a tough time for us dealing with the reality of Cushings in Athena. Just don't want her to suffer at all. Just want her to be a healthy happy girl. Thanks to each of you for your support and help. T~

I forgot to ask. Has anyone seen their dogs improve within a week? I was told it would take months from the Vet. Thanks!

[labblab]

I'm so glad to hear how Athena's doing! Yes, it is possible to see improvement in symptoms such as excessive thirst, urination, hunger, panting, and energy level as quickly as 1-2 weeks after starting treatment. My own boy showed a reduction in thirst within the first 3 days of starting on trilostane! Usually skin, coat, and muscle weakness take a longer time to resolve, though: several months as opposed to just a couple of weeks. So I'm not sure exactly how to account for what seems to be such quick improvement in Athena's coat. Maybe the fact that she's more active and seems to be feeling better is just making her look better to you, overall.

Marianne

[WeLoveAthena]

Thanks Labblab.. Love that name!

Did you see weight come off your baby over time?

[labblab]

My baby was one of the odd ones, in that he actually lost weight prior to his diagnosis rather than gaining it. His appetite was ravenous so his weight loss was puzzling and worrisome to us. We were always really careful about not giving him any extra treats, though, even when he begged. So I have to figure that the elevated steroids were just affecting his metabolism in such a way that he was losing actual pounds in addition to muscle mass. His weight did stabilize after we started treating him. But it just goes to show that individual Cushpups can present differently, even at the same time that many core symptoms may be shared.

[WeLoveAthena]

We are finding out how truly different each case of Cushings is. It's not straight across the board. Hoping this helps her weight come off too. At first I thought she was back to eating like crazy or wanting to eat everyone's leftovers. She did that for a day but now she's back to eating only her food and not being concerned with the other bowls. All 3 of our other dogs seem to leave a little behind and Athena used to run to each bowl we couldn't even pick them up fast enough but now she only eats her bowl and she's content...which is a good thing.

[tank&kat]

My boy's name is Tank, which fits him perfectly :D. I'm sorry to hear about your girl being sick. What's her name? Has she been diagnosed with anything or is her sickness acute in nature?

Vets tell pet owners that improvements with vetoryl can take a few months because they don't want to raise their hopes up to quickly. In some dogs, it can take months before improvements are seen. Others only a few days. My dog started drinking less on the 9th day of treatment and had more energy between the 3rd and 4th week. I was at the lakefront (his favorite place) with him during that time. A man stopped me and couldn't get over how good Tank looked for his age. This came as quite a shock as that is not the usual response I get when people see him. After talking with him for a minute, he tells me he is a vet. He said that Tank looked like the happiest dog he had ever seen! That's really the first time I recognized the meds were doing something internally and not just clinically.

It's also a good sign that Athena has lost a few pounds. Tank has lost a total of 14 pounds in the last 7 months. Most of the weight loss occurring the first 4 months after starting vetoryl. He's been at a steady 69 pounds since. I'll be checking in from time to time. I hope she continues to do well. So glad you haven't seen any adverse reactions. Give her lots of hugs from me and Tank tonight.

~Katherine

[WeLoveAthena]

Hello to all.
Just a quick update on our girl Athena.

She is going into week three of her Vetoryl treatment. So far no side effects to speak of. We do notice she seems to feel better. Her coat looks much better. That appears to have happened within a week. We feel that she is stabilizing and we hope we are right about this.

She goes in on the 25 of Feb for some blood work to check and see where she is. We pray this medication continues to help her and we see her continue to improve. I'm still edgy every time I give her one of these pills but I remind myself this is place to help her.

Something else noticeable is her skin. It seems to have cleared up. No more dry spots of skin which she had before. She also kept having this thing happen between two of her toes that was like a fungus that would swell up and she would lick to death. We had to treat it with antibiotics/for bacteria infections to clear it up and sometimes wrap it with meds to stop her from the licking nonstop.
Her toe is completely healed as if she never had an issue. That was pretty amazing. Not sure if that was pert of this whole Cushing's ordeal or what but we are so thankful. We battled that toe for awhile and it felt like it was never ending.

That's our update so far. We hope/pray all is well with all the Cush Pups here and we are still and always will be forever grateful for each of you...

Thank you

[WeLoveAthena]

Hello Katherine. Hope that Tank is doing good. Please update us when you can. I love that name!!! He's such a handsome boy :-)

Thanks for writing to us. Have a great week.

[molly muffin]

It's great to hear that she is doing so well and seems to be making great improvements already. Yay!
You'll definitely know after the test to check out her levels as to how she is doing. But attitude and how they appear to be doing in their daily life is also a big part of it. So this is a good thing to hear.

[WeLoveAthena]

Thank you so much Sharlene and Molly Muffin. We are so thankful for your note and kind words. Will post after her test later this week.

[tank&kat]

Great news that Athena is feeling better. I hope the results from today's test come back ok. How is your other girl, the terrier? I was worried when you mentioned you had another sick one at home.

~Katherine

[WeLoveAthena]

Great news that Athena is feeling better. I hope the results from today's test come back ok. How is your other girl, the terrier? I was worried when you mentioned you had another sick one at home.

~Katherine
Hello Kat and Tank,
Thanks for checking on us. Athena's appt was moved to Monday @ 1600. That puts her at actually a full 3 weeks on the meds. Vet office called to change appt due to an emergency they had. It's only a few more days and she seems to be doing well so far. So grateful and hoping the lab results look better. I know it takes some time to really work but so far so good.

How sweet of you to ask about our oldest girl. She's a Stafffordshire Terrier. She's 14 and she went through a few bad days but she bounced back. Still, we are keeping our eye on her. We won't let her suffer. She's been a wonderful loyal girl. She gets around good except her back legs are a bit slow due to arthritis on one side ( She's on meds daily and nightly for that which really help) and everything else she's doing good with per the Vet. It makes the decision harder but I just don't want her to fall and break a leg or hip so we are watching her. She does good going down 3 steps on the deck to use the bathroom but sometimes needs help back up and carry her. Other times she acts like she's 5 years old again. It's hit or miss. The vet said she will let us know when it's time. I hope because I would not be able to live with myself if she ever suffered because I missed something. She's always been a tough little girl. She no longer sleeps on the comfy chair or couch and we don't let her on the bed for fear she could fall. She feels best in her little bed she can get too and we have a double padded egg crate that we made up with plush blankets on top in the living room. She loves to sleep on that as well. She eats great too.

It's so hard. I know she's just getting older and older and I can't imagine being without her but reality is...well you know..

Hope Tank is doing well. So good to hear from you. T~

[tank&kat]

That's wonderful news! She sounds like Tank. When he goes in the backyard, he actually prefers to jump down instead of using the ramp I built but when coming back up he has a harder time. He is doing really well. I'm questioning his actual age (since it is an estimate). He does not act like a 15 year old dog. More like 12. Good to hear from you.

~Katherine

[WeLoveAthena]

UPDATE

Hello K9 Cushing friends,

Her is our update on Athena
We saw the Vet yesterday after 2 reschedules. Not a good day. We arrived and Athena was in major panic mode. She has NEVER done that. We couldn't get her out of the truck. Finally we managed to get her out. We walked her around to try and calm her. She seems to have remembered her all day stay there. We felt so badly for her but tried to keep her calm. She had been dosed at 1030 am and her appt was at 230 pm. We get into the room and a brand new Vet Tech we never met came in . After she weight her, and looked at her she left the room and came back in saying that they weren't going to test her because she hadn't lost weight and didn't seem to be displaying any signs she was doing better on top of which the Vet Tech stated "You've only been giving her 60mgs a day and that's only 1/2 amount she needed" I told her that I discussed with our Vet that we were only comfortable starting her on 60 mgs and she agreed. Our Vet had wanted 90 mgs but we said we preferred 30mgs. She then said "Well you picked up 90 mgs tablets". I said, Nope. We picked up a box of 60mgs CAPSULES and the box of 30 mgs was done in error because the vet wanted her started on at least 90mgs but I wasn't comfortable with that and since it was already filled we purchased it in the event she goes up to 90 since there are no 90mgs capsules. She said well the Vet said that she needs 90 now before we can test her.

I asked where our Vet was. She was in the middle of an emergency. I understood but I also didn't see why we couldn't test her since we had came in with her. She said she wanted her on 90mgs for a few weeks then test her ( 2 weeks). I don't think that's enough time on 90mgs but we will see. On the way out I saw my Vet. It was clear the Vet Tech wasn't being truthful. Vet spoke to me and said that yes I only wanted 60 mgs initially to see how she tolerated the drug but since the Vet Tech didn't see any noticable changes ( are we suppose to see "noticable" changes) she preferred to save us money and wait and see how she does on 90mgs. I told her the Vet Tech told me it was a waste of time giving her 60 but I disagreed. At least she has the medication in her and increasing it may not be such a big shock to her system. Vet agreed. You could see she wasn't happy with the Vet Tech! Before I forget. I told the Vet Tech plenty of Labs that are the same size as Athena have been on 60 and done well. Obviously she needs more but it wasn't a waste in my opinion. Her coat does look better. Her skin seems better. I wish our Vet would have at least examined her. Needless to say I'm not too happy.

So... since we already had the 30mg box at home unopened we got a box of 60mgs to go with it. Price went way up on that drug as well. Not that I care because money means nothing when it comes to our dogs.

SO......today Athena started the 90mgs. I fed her and as she was eating dosed her ( per the advice here). She finished eating and then right away laid down. She wouldn't move. Even if we called her which is HIGHLY unlike her. We watched her close. She seemed to be breathing ok. Not in any distress but just very lethargic. An hour later she was up and just her normal silly and happy self. Not sure what that was all about. Had it went on longer I would have take her into the Vet.

I have always loved our Vet. She's always been great. Lately it's been hit or miss because her practice is so busy but I feel like when you get to her she's really good. We were not very happy with how yesterday went down.

So we have to wait a few more weeks and see how she does on 90mgs.

Any thoughts? Please ask any ?? I'm still a big upset about all this and on top of which our oldest doggy isn't doing well so lots happening.

I'm feeling lousy. Vet was on board with the 60mg initially. I thought I was doing good by trying that first to make sure she could tolerate...and now I'm thinking did I goof up and my poor girl wasted a whole month? I didn't want to think it was a waste because at least we tried it...much easier to add meds than take away a larger dose in her. I don't know. Not very happy right now

Thanks for your time as always.

[labblab]

I am so sorry that you've had such a rotten day, and especially sorry to hear that your older girl is not doing so well. With so much going on right now, it's no wonder that you're upset.

First and foremost, even if Athena does end up needing that dosage increase, you've done no harm by first starting her off with the lower dose of 60 mg. Experience has shown that when cortisol levels are lowered rapidly, many dogs exhibit unwanted side effects even when their cortisol has not technically dropped too low. So lowering the level more gradually can allow the dog's body to adjust with less discomfort. You are right in your thinking about this.

Secondly, on your behalf, I am furious with that vet tech! It sounds as though she took it upon herself to make an evaluation which should have been left to your vet. And what was her evaluation based upon, anyway -- largely just the fact that Athena hasn't lost any weight yet?? You've reported to us that Athena's skin and coat look better, her hunger has normalized somewhat, and she has been playing and interacting more with your other dogs. These are all positive changes that should not have been overlooked, and are part of the overall assessment. You've not mentioned her thirst and urination, so I don't know whether you've seen improvement there. But regardless, it was not the tech's place to make these judgements and it was certainly not her place to criticize your dosing decision.

On your behalf, I am very disappointed that the ACTH testing did not proceed, especially since Athena went through the stress of the office visit for essentially nothing. It's entirely possible that she will indeed benefit from a dosing increase, but today's ACTH results would have been a guidepost as to the appropriate size of any increase. Given Athena's weight, I do understand that 90 mg. does not seem like an excessively high dose. But there was no reason not to proceed with the testing today. You would have had actual numbers to guide the dosing decision, and not just the vet tech's snotty pronouncement as to what you should or should not be doing. GRRRRRRRR!!!

But we are where we are. As long as you don't see any adverse effects, it is probably OK to go ahead and continue with the 90 mg. But I am concerned by hearing you say that you will be waiting for "a few weeks" before retesting. I would wait no longer than two more weeks to perform the ACTH and also to check Athena's basic blood chemistries. By that time, Athena will have been taking Vetoryl of one dose or another for five weeks. I do not think it's safe to wait any longer than that to have some actual numbers in hand. And certainly, if Athena starts acting "off," I would drop back to the 60 mg. and insist that the ACTH be performed even sooner.

Please keep us updated as to how you all are doing, OK? I really hope your older girl is able to hang in there. :o

Marianne

[molly muffin]

Omg. How very unacceptable. A vet tech is not a vet and should not be doing an evaluation or determining what test should be done. They are there to do the test as ordered by the vet. End of story. If they want to act the part of a vet. Then head their sorry butts back to school and become one. I am like Marianne. Furuious on your behalf. It's hard enough going through illness with a beloved dog. You have the added stress of others with problems too and just don't need that. Shame on your vet for allowing that.

Just watch very closely as to how she acts on an increased dose. What if the 60mg was the perfect dose. Idiot tech shouldn't be out in the real world.

[judymaggie]

Hi! I read your post last night but wasn't able to reply so am very glad that Marianne and Sharlene were able to do so. I even woke up in the middle of the night thinking about Athena and the terrible treatment you received at the vet's office. They owe you a serious apology! :mad:

I realize that you respect and like your vet but he doesn't seem very familiar with the proper testing protocols to be used when administering Vetoryl. You might want to consider taking in a copy of Dechra's flow chart (Sharlene had given you the link earlier) and discussing it with him.

I second the importance of watching how Athena does with the increased dose, especially since you mentioned lethargy after the first dose.

[WeLoveAthena]

I am so sorry that you've had such a rotten day, and especially sorry to hear that your older girl is not doing so well. With so much going on right now, it's no wonder that you're upset.

First and foremost, even if Athena does end up needing that dosage increase, you've done no harm by first starting her off with the lower dose of 60 mg. Experience has shown that when cortisol levels are lowered rapidly, many dogs exhibit unwanted side effects even when their cortisol has not technically dropped too low. So lowering the level more gradually can allow the dog's body to adjust with less discomfort. You are right in your thinking about this.

Secondly, on your behalf, I am furious with that vet tech! It sounds as though she took it upon herself to make an evaluation which should have been left to your vet. And what was her evaluation based upon, anyway -- largely just the fact that Athena hasn't lost any weight yet?? You've reported to us that Athena's skin and coat look better, her hunger has normalized somewhat, and she has been playing and interacting more with your other dogs. These are all positive changes that should not have been overlooked, and are part of the overall assessment. You've not mentioned her thirst and urination, so I don't know whether you've seen improvement there. But regardless, it was not the tech's place to make these judgements and it was certainly not her place to criticize your dosing decision.

On your behalf, I am very disappointed that the ACTH testing did not proceed, especially since Athena went through the stress of the office visit for essentially nothing. It's entirely possible that she will indeed benefit from a dosing increase, but today's ACTH results would have been a guidepost as to the appropriate size of any increase. Given Athena's weight, I do understand that 90 mg. does not seem like an excessively high dose. But there was no reason not to proceed with the testing today. You would have had actual numbers to guide the dosing decision, and not just the vet tech's snotty pronouncement as to what you should or should not be doing. GRRRRRRRR!!!

But we are where we are. As long as you don't see any adverse effects, it is probably OK to go ahead and continue with the 90 mg. But I am concerned by hearing you say that you will be waiting for "a few weeks" before retesting. I would wait no longer than two more weeks to perform the ACTH and also to check Athena's basic blood chemistries. By that time, Athena will have been taking Vetoryl of one dose or another for five weeks. I do not think it's safe to wait any longer than that to have some actual numbers in hand. And certainly, if Athena starts acting "off," I would drop back to the 60 mg. and insist that the ACTH be performed even sooner.

Please keep us updated as to how you all are doing, OK? I really hope your older girl is able to hang in there. :o

Marianne


Hi Marianne,
Yes, that was my exact thinking. What harm have I done?? If anything I've been looking out for her. I know my Lab and I know she has to be gradually given stuff, not just given a full dose and better to be safe then sorry is my view.
We are not happy to say the least with how things transpired.
I ended up having to call her because the 30mg capsules are exactly the same as the 60mg capsules. Same color, markings..etc. I asked her about this. Our Lab quickly came to the phone. Hard to ever get her on the phone. I explained the meds and she went back to check the boxes and came back saying in fact, they were the same, all the same, and she wondered why the pharmaceutical company didn't change color to distinguish the difference. Granted the boxes say what they are as do the foil inserts but the pills are identical. Same shape, size, color, markings.
She assured me it was fine.
Today we gave her her 90mgs ( day 2) and she seems to do ok. Nothing like yesterday so many that was something unrelated, not sure. I'm just still upset that we were treated that way after being with that Vet for over 5 years.
You are correct in that I felt that her coat, her eyes, her skin, everything seemed to be getting better so I thought maybe more time on 60 would start to really kick in after she had more time on the meds at that level. Apparently I didn't know what I was talking about. :mad::confused: What upsets me is I told her that we are the ones with Athena day in and day out, we are the ones that know our dog and I think my being an RN qualifies me for knowing something about medication and how to administer it safely. Granted I'm not a Vet but....I think I at least know my dog.

Thanks for your support. More soon.

[WeLoveAthena]

Omg. How very unacceptable. A vet tech is not a vet and should not be doing an evaluation or determining what test should be done. They are there to do the test as ordered by the vet. End of story. If they want to act the part of a vet. Then head their sorry butts back to school and become one. I am like Marianne. Furuious on your behalf. It's hard enough going through illness with a beloved dog. You have the added stress of others with problems too and just don't need that. Shame on your vet for allowing that.

Just watch very closely as to how she acts on an increased dose. What if the 60mg was the perfect dose. Idiot tech shouldn't be out in the real world.


Thanks for your support. I knew I wasn't crazy but I have been feeling bad all weekend about this. Did I delay Athena getting better and all that stuff swirls around but others here seem to agree that it didn't hurt Athena to be on 60mgs. She was doing better in several areas. I know she didn't lose any weight yet but maybe that is coming. Very frustrating! I would have liked to see that even if on 60mgs were there any changes in her levels. Now we won't know for a few more weeks ( 2 weeks to be exact). I plan to talk to my Vet about this. When I schedule Athena's appt on Monday I will tell the scheduler that I want the VET there, not the Vet tech again. I may even have them come out to the truck to draw her blood and do that ( they have done it for some dogs in the past is what I've been told) because I don't want to try and stress Athena out more getting her out of the truck into that office like last time. She NEVER acts that way but after that all day test she flat out refused to go in there. It took all we had to get her out of the truck and I felt horrible for her.

Thanks for your support. I'm so grateful!

[WeLoveAthena]

Hi! I read your post last night but wasn't able to reply so am very glad that Marianne and Sharlene were able to do so. I even woke up in the middle of the night thinking about Athena and the terrible treatment you received at the vet's office. They owe you a serious apology! :mad:

I realize that you respect and like your vet but he doesn't seem very familiar with the proper testing protocols to be used when administering Vetoryl. You might want to consider taking in a copy of Dechra's flow chart (Sharlene had given you the link earlier) and discussing it with him.

I second the importance of watching how Athena does with the increased dose, especially since you mentioned lethargy after the first dose.

Hi Judy. Thanks so much for your supportive words. You will never know what this wonderful godsend of a site means to us. Athena tolerated her 90mgs today pretty good. So we are just watching her. On top of this we have our oldest girl that is not doing well so the stress is tough and we try not to show it around the dogs because as you know they pick that stuff up from how we act.

Going to look for that flow chart that was posted in this thread. That will be MOST helpful. I brought it my own flow sheets that I made up where I marked her daily dose, anything I noticed good or bad post dosing, etc. I did that for everyday that she has been on the meds and had that with me but the Vet never saw it. I know I sound OCD but it's the Nurse in me. :rolleyes:

Thanks again for everything. I truly appreciate each of you

[judymaggie]

Hi! Here is the link to Dechra's technical brochure -- the flow chart is on page 11:

http://www.dechrace.com/pdfs/vetoryl/VETORYLTechnicalBrochure.pdf

One of the administrators will actually move over your new thread to join this one -- that way all your information will be in one place. I did want to let you know that you can call Dechra (the manufacturer of Vetoryl) yourself and ask them about the packaging of the 60 mg. and 30 mg. capsules. Their technical support phone number is 866/933-2472. I had called them with questions about Vetoryl as my vet had never used it before and they were very helpful. I set up a file for my dog and gave them my vet's name. Then I asked my vet to call them and he did. Dechra will only give limited information to pet owners and prefers to discuss more detailed issues directly with vets but I think they would be the best ones to answer your questions about the packaging.

I am glad to read that Athena did well with this morning's dose. Keep up the good work, Mom!

[WeLoveAthena]

Hi! Here is the link to Dechra's technical brochure -- the flow chart is on page 11:

http://www.dechrace.com/pdfs/vetoryl/VETORYLTechnicalBrochure.pdf

One of the administrators will actually move over your new thread to join this one -- that way all your information will be in one place. I did want to let you know that you can call Dechra (the manufacturer of Vetoryl) yourself and ask them about the packaging of the 60 mg. and 30 mg. capsules. Their technical support phone number is 866/933-2472. I had called them with questions about Vetoryl as my vet had never used it before and they were very helpful. I set up a file for my dog and gave them my vet's name. Then I asked my vet to call them and he did. Dechra will only give limited information to pet owners and prefers to discuss more detailed issues directly with vets but I think they would be the best ones to answer your questions about the packaging.

I am glad to read that Athena did well with this morning's dose. Keep up the good work, Mom!

You ROCK Judy!!! Thank you so much. Just got it. Printed it and taking it with me to the Vet. I'll call them Dechra on Monday as I'm sure no one is there on the weekends. Thanks a bunch for everything!!
Athena thanks you as well ( Woof!)

[judymaggie]

Hello again -- you can also e-mail Dechra at:

support@dechra.com

You could e-mail them this weekend with your question and perhaps have an answer by Monday. On the flow chart pay special attention to the monitoring schedule or, should I say, have your vet pay attention to this! ;)

[tank&kat]

Wanted to check up on Athena. Has she had her 2 week ACTH test since the increase to 90 mg? I have to add that I'm so disappointed in the vet for saying 60 mg was a waste. It is a fact that some dogs are controlled at <1 mg/lb. You didn't cause a delay in her treatment by starting on a low dose. Cushing's progresses at a snail's pace. 2-4 weeks of trial and error would not caused any harm.

~Katherine

[molly muffin]

Hi, just want to check in and say Happy Easter and ask how Athena is doing :)

[WeLoveAthena]

Thanks Sharlene and Molly/ and Tank and Kat.... Getting ready to post an update. I appreciate the note. Sorry it's been a bit crazy around here but thanks for checking on us.

[WeLoveAthena]

UPDATE
******

Hello K9 Cush Pup Friends,
Sorry it's been awhile since my last posting. In the middle of a move, caring for my husband
( combat wounded Marine) and our older pup has been ill on top of our Cush Pup but hanging in there and doing the best we can as always.

Athena's follow up labs were delayed twice. However it finally happened today. This is after we went in for her test and they didn't do it due to the dosage I was giving her but I refused to go above 90. Initially I did only 60mgs and then agreed to the 90 to give that a shot but we never agreed to giving her the 120 off the bat. That didn't make them too happy but we stuck to our guns. We know our dog and thank GOD we did.....

Because the last time we went in Athena was so ballistic (ever since she was there for the 8 hour stay and initial Cushings test) and became so upset that she was panting like a wild dog we told then this next visit they had to come out to the truck to draw her blood/give her the injection. We were not going to stress her out again and if she is that stressed out then how can a cortisol test come back accurate since cortisol is a stress hormone and getting her stressed wouldn't be good. They agreed.

So the two techs came out to the truck. Tried twice to draw her blood. No luck. Hubs was about to come unglued but we kept ourselves in check. She's not a hard to stick. Being an RN I wanted to grab it and draw it myself but I know that isn't permitted. SO they went and got the Vet. She drew it with no issues at all.

One thing I was shocked at was this visit was twice the amount of the 8 hour test she had completed. They said because the injection of the synthetic hormone is way more expensive then the steroids they did on the 8 hour test. Okie Dokie. I wasn't prepared for that amount BUT we paid it as we'd never let our dogs go without something they need.

We left and came back an hour later for her post draw. We had taken her for a walk, and to help her relax some. She hates going to the vet something fierce.

So after her post draw....we left. We expected the results in a day or so but she just called me and these were the results

Resting draw 2.5
1 hour post draw 3.3

Normal Range 1.8 - 7.2

She said that was good and to keep her on 90mgs. She also told me it was a good thing I didn't go with the 120 because she did great on the 60mgs and the added 30 after a month of 60 was just what she needed.

WOW.....so I guess I DO know my dog afterall. She said 120 would have made her sick...

Thank GOD I was so adamant about not putting her on that dose off the bat. She is to remain on 90 and have a recheck in 6 mos. Course we will be with a new Vet then as we are moving to the mountains to our perm home BUT can you imagine if I went with the 120 right off the bat.

I feel I did the best thing for her by starting her for a month on the 60 then adding the 30mgs

Whew....

Overall Athena has lost some weight, and her coat is really looking so beautiful now. She's slowly getting better. She tolerates the drug with no issues that goodness and we are very happy we fought for our doggy and the dosage ordeal. She doesn't drink tons of water any longer or pee 100 times a day :-) She sleeps good and is just doing so much better. So happy for our girl


Of course without this site I don't know what we would have done. The love and support here is amazing. This is by far the BEST site on the entire net!! I love how friendships are formed here as a result of our dogs but they go outside the issues of our dogs. Just a great group of people and we are both grateful for you all. Athena is as well.

:-)


Any thoughts?

[Harley PoMMom]

OMGoodness, what a roller coaster ride you have been on :eek: Are you all moved in and is hubby doing ok, and how is the older dog? I sure hope things will settle down for you.

Athena's ACTH stim numbers are perfect! And I take it that all Athena's Cushing's symptoms are controlled, right? Kudos to you for sticking to your guns about starting her out at a lower dose!! And yes, it's a good thing that you did, I agree that she may have had trouble on that higher Vetoryl dose.

Those ACTH stimulation tests are costly. :mad: Most vets use Cortrosyn as the stimulating agent and we call it liquid gold because that's what drives the ridiculous price. They are very expensive but very necessary.

So happy that Athena is doing so well...Great job Mom!!!

Hugs, Lori

[molly muffin]

Whooo hoooo! those are wonderful numbers and she's been on 90mg for right at one month tomorrow or today right? So that is good, they Shouldn't go any lower, but as always keep that vigil. :)

Oh man, what a time you've had. So hard when the dogs get older. Poor babies.
I hope your move goes good and smoothly. The mountains, what a lovely idea.
(for the summer) hahahahaha

[WeLoveAthena]

Hi Sharlene
She was on 60 for a month and after that 90mgs for another month. I flat out refused to put her on the dose they originally wanted her on of 120mgs and now as they found out..that would have been way to much
I agree to an extra 30 mgs but that was it. They made me feel terrible about only having her on 60 and got on me about only giving her 1/2 the main dose she needed but I was apprehensive about the full dose and wanted to gradually introduce her system to this drug. Turns out it worked out best because 120 surely would have made her sick....even though the chart says that's the dose for her weight I didn't trust giving her that big dose.
Hope that makes sense. :-)

[molly muffin]

Yea that makes perfect s nose to me. I was just trying to remember when you had started her on the 90 and though it was first part of March. :).
Cortisol can and usually does drop for 30 days or so and then l levels out. So hopefully she stays right where she is at now

[WeLoveAthena]

Hi Lori
We are still in the midst of the move, and our older girl ( staffordshire sweetie) is okay but she's 14 and really starting to slow down. Very concerned. She lost her hearing now so we have to be extra careful. She gets around pretty good but she's become very frail in the last few weeks so.....we have that weighing on us. I don't want her to hurt herself..etc..
Hubby is hanging in there. Surgery number 1 million coming up soon and yes it's been a rollar coaster to say the least
Athena would have become ill on the 120. The Vet said so as well as the other vet. Although she's a big dog...she ended up doing great on the low dose then just one increase to 90. So for all the making me feel bad about starting her out low and wasting time....and all....just gets me. I think that Vets should listen to pet owners like doctors should listen to their patients. I mean...we know our dogs...
I'm thrilled for Athena!
Her all day test of 8 hours only cost about 200 dollars. The meds are very $$
but today's test was 400 dollars. It threw me off but....it's done now and the results were good and we are happy with that. Just didn't understand that price...UGH...but they are worth every penny
Hugs back to you
T~

[WeLoveAthena]

Yep..she did 30 mgs for a month and then we went to 90 after that one fiasco of an appt where they wouldn't even draw her blood or check anything until she was on a higher dose so I agreed to 90 but not 120. So thankful that we didn't go higher. Vet said she should be stable now and we will recheck in 6 mos but we will have a new Vet by then as we are moving to the mountains 8 hours away. Hope to find a great Vet up there. Our realtor has dogs and is as bad as we are in spoiling them so I'm sure she can refer us to a great Vet

I'm just so thankful for the outcome today. Meds will still be about 250 a month but it is what it is...and so long as our girl is doing great then we are happy

We have to get two boxes of meds because there isn't a 90mgs capsule. We have to get a box of 60 and 30. Both pills are identical in color and size. VERY confusing if you aren't careful. We have to carefully double check the box we are pulling them from. The only thing different ( even the boxes are identical in color and size) is the foil behind the pill packs.

You think they would at least make it a different color...UGH

[tank&kat]

I'm so happy to hear this news! Those are some lucky dogs to have you take such good care of them. And yes, she most likely would have gotten sick if started vetoryl at 120 mg. You have done an amazing job so far.

The ACTH testing agent is cortosyn which is very expensive. It's $350 where I am. You can save $100 a month if you purchase the vetoryl from an online pharmacy. I use valley vet. It is the same drug you get from the vet, brand name vetoryl, not compound. I will post the link below.

I am in the process of moving also. I can't imagine doing that plus monitoring my dog in the first month or two of treatment and having another sick dog. You have been a busy lady.

https://www.valleyvet.com/ct_detail.html?pgguid=057ae20c-efea-490b-b89e-562663425dfe

~Kat

[labblab]

So after her post draw....we left. We expected the results in a day or so but she just called me and these were the results

Resting draw 2.5
1 hour post draw 3.3
So great to see you guys back here, and especially to get such a good report on Athena! :)

I do want to add one cautionary note, though :o, and that is to say that an ACTH retest probably ought to be performed sooner than six months from now. I know that darn test is awfully expensive, but the recommended monitoring interval (assuming the dog is outwardly doing well) is every three months. It is very common for dogs to need dosage adjustments even after they've been taking the medication for awhile. Athena's current result is excellent, but for safety's sake, you want to make sure that it doesn't go a whole lot lower than this. Since she's only had one monitoring ACTH test thus far, I personally would not feel comfortable waiting a full six months before rechecking once again. And of course, if she acts unwell in any way (either signs of overdosing or a return of Cushing's symptoms), you would want to proceed with retesting regardless of how much time has passed.

I definitely don't want to spoil your relief at how well she is doing right now. But you want to keep her on a safe and effective amount of medication, and unfortunately, that involves rechecking her cortisol level and blood chemistries at regular intervals. ;)

Marianne

[tank&kat]

I agree with Marianne! Every 3 months for a while. :)

[WeLoveAthena]

Hi Marianne
I agree with you and hubby and I had actually discussed doing it in 3 mos vs 6 mos. We want the best for her
I'm just so glad we stuck to our guns on her dosage...can you imagine if she had been put on that 120 off the bat
Good to hear from you as always :-)

[WeLoveAthena]

Edit: I found that I did post her levels.



The area where she was dosed/injection is still patchy and funny looking. Called the Vet but they didn't seem worried about it. It's just odd. Could the medication have leaked and done that? The Vet tech also missed her blood twice. The Vet had to draw it and the arm where the Vet tech missed is still not right. SO not happy lately with the clinic. We move very soon and we've been referred ( by a friend) to an outstanding Vet where we are headed. Hoping for better luck. Never had complaints before but lately it's just a bit much. Vet has been preg back to back 3 pregnancies. Not saying that's the reason but.............

Still watching Athena closely and so far so good but not happy with the last appt in terms of them missing her blood twice and if the Vet couldn't get it we were taking her home and to another Vet..but she did...and then being blindsided with the cost. We'd pay it in a minute but it helps to know a bit in advance.....

and I'm still upset about how we were treated when we were not agreeing with sticking her on 120mgs off the bat....I think we know our dogs and being a Nurse I'm careful about any medicine that I take, my husband takes and even more so with our doggies.

UGH.. sorry for the vent..

Thank you to each of you lovely folks for all your help/support/encouragement and information. Without this site we would have never been able to deal with this so well....

[molly muffin]

It's okay to vent. We all do it. The great thing is having a safe place to vent and have people understand what you mean. Which we All do.
I've had moments of major irritation, which usually passes but you do tend to "remember". You know that old saying, "You might forgive but not forget".
I hope your new vet at your new home is truly outstanding. :)

[WeLoveAthena]

UPDATE
Sorry it's been so long. Have been through a lot and just had to put our oldest girl to sleep (Staffordshire Terrier). She was 14. Worst part is that our regular Vet was on maternity leave and the Vet in her place really messed up. 2 weeks later we lost our girl. It has been a very emotional few weeks as she was declining the last few months and we knew the day was coming but sadly thanks to a crappy Vet it was made worse and our very own clinic wasn't there for us after years of being loyal to them and trusting them with our dogs, which are our kids. The only positive thing is that we ended up at the Emergency Vet that evening we lost our girl. My husband was in the truck with her and I was standing in the parking lot waiting for the emergency vet to open. They open at 6pm after all other vets close and I stood there bawling knowing that we were losing our girl. The most precious staffy ever. Out of nowhere comes this lady and hugs me and asks me "Is your dog injured or is it time". I barely could get the words out "it's time". She asked about our regular Vet and I explained all they put us through that day ( long story) and she was disgusted and told me not to worry. Everything was going to be okay. We would not be alone in this and she was there for us however long it took even if it took all night to let her go. It didn't as we didn't want her to suffer but it helped so much having a loving Vet. My husband carried her in her blanket into the emergency clinic. He didn't want anyone carrying her and we laid her in the room. They kept the lights low and made her very comfortable and out of pain until it was time. Our hearts broken in half in that moment we heard her last heart beat. We had spent time with her and talked with her and even took her to Mc Dees for her fave ice cream cone and plain hamburger and a few minutes at the ocean. She wasn't in pain because we had pain meds on board for her already
Just like that...she was gone....My hubs is a combat wounded Marine and tough as they come and this brought him to his knees. She was our best buddy, the matriarch of the family and our oldest. A sweet soul if ever there was one. Because we are in the midst of a perm move to our final home we couldn't bury her and had to opt for cremation and we found the most awesome place at 10pm at night. The man that runs it is a former Marine and people come from out of state to see him because he only does on dog, cat or animal of any kind at a time and has nothing to hide. The most honest guy ever. We drove to his house straight from the emergency vet with our girl and that night is still a bit of a blur but he took such good care of her. I believe God kept us away from our Vet Clinic and showed us their true colors that day for a reason and gave us this group of special angels that night.
We came home to the other dogs, including Athena....all looking for their sister. It was difficult to hold it all in so as to not upset them. We have since picked up all their records and left them after 6 years ( our vet hospital) and found a new one doctor vet that seems to be very good. We interviewed her. This left us not trusting anyone with our dogs without being I interviewed to see if they were good enough to care for our dogs. The betrayal we felt after what our Vets office did to us can't be put into words and they know they did wrong because they tried hard to cover their butts but failed to do so. They have been reported

As for Athena: She just had a retest today to see where her levels are at. She's still on the Vetroyl 90mgs but she started acting sick again and what we found out is that she is severely hypothyroid and our old Vet knew this, tested her, and NEVER informed us of this diagnosis. We found it in her records today when we went through them. We were disgusted beyond words

So now we will be treating her for both Thyroid and Cushing's. She had hypothyroid for 2 years without us ever knowing that she was sick with it. Our old Vet told us she was fine and no thyroid issues.

Today we are trying to get some X-rays on two of our dogs and first they said yes, then they said "HIPAA laws prevent us from giving you your X-rays". Give me a break. They just handed us all their records last week. We suspect those X-rays were never done even though we were charged because nothing in their records shows they were done.

We really thought we had a great Vet.She appeared to be so great with the exception of one or two little things but we were sadly mistaken. They are a factory Vet. They get as many people in for appts and it's always crowded and you wait forever. It's evident it's all about $$$$ for them and that things are missed and we are just two of the many people this has happened too.

We are now in good hands
Waiting for results for Athena. One thing is Athena hated our old vet office. They'd keep her all day for one thing. This new Vet let us stay with Athena as they did the retest, one hour post and everything so she was never stressed. They treated her great and us great as well.

We learned a hard lesson with our old Vet. I should have asked for all those records before and I would have caught it and what they did.

Thanks for listening. For now we are hoping Athena will be okay soon. The other two are doing great except for we all miss our girl that passed so badly....the world isn't the same without her in it.

[DoxieMama]

Ohhh, I am so so sorry to hear of the loss of your Staffordshire Terrier. What was her name? I'm SO glad you had a compassionate and loving experience at the Emergency Vet, and that you have found a new vet for Athena and the rest of your family that you can trust. Let us know how she is doing - and you!

Many hugs and prayers your way.

[molly muffin]

oh my goodness!!! I'm happy to see you again.

But oh my gawd, what a horrible mess with your old vet. It is awful that during this terrible time of losing your baby, that they would not be there for you and then to find out later that you weren't told crucial information. Well I can't even begin to imagine how you feel.

I'm glad though that you found out about Althena's thyroid so that you can treat that. Monitor that periodically too.

It does sound like you have now found a good vet, for which I know we are all very happy.

Indeed what angels to come to your rescue that evening when they were most needed.

[WeLoveAthena]

Started a new thread. Not sure how to combine them but here is our update.
Really need some input and help here. We are baffled
So after a year of Athena being on Vetoryl ( 90 mgs). This is her 3rd follow up. 2nd F/U her levels were stabilized but I called our new Vet ( got rid of our old vet long story) and I was concerned as she was back to drinking tons of water, going out to pee tons of times, and her weight was going back up despite dietary changes. We had he retested and Vet just called. Athena no longer has Cushing's based on her results. They say she now has Addisons!!! WHAT?? I'm beyond confused.
Her results were as follows

Normal Range is 1.5 - 6.0 for lab they use. IDEXX
Her Pre result was .6. ( Low)
Her post result was .5
She was dosed within the 4-6 hours before her testing

We also found out she was hypothyroid something our previous vet told us she tested normal for but not true. When we obtained her records we found she indeed was found to be hypothyroid and they never told us for 2 years ( that's how old that particular test was).

So new vet states that Athena is the opposite of Cushing's now having Addisons and that her 90mgs of Vetoryl is too much. We have to cut her to 60mgs for a month with another restest to see where she's at wth that amount. She wants to do this before treating her for straight Addissons. Also, they want to hold off treating her with medication for hypothyroid as they don't want to overload her. She's on tramadol for joint pain due to her hind legs being sore ( she's young) but her weight is back on and also it's left over joint issues because when we got her as a puppy we didn't know she had been bitten by a Lyme Tick and she tested postitive on her first puppy visit. She was treated for that and tested negative since the for Lyme.

Has anyone heard of a dog going from Cushing's to Addissons and how serious is this now? I couldn't think of any ?? To ask the Vet as I was stunned and we just lost our oldest dog, our staffy, age 14 ( Spyndal) who we had to put down on November 11th so it's been a tough month and now this. Not what I expected in her results since last time she stabilized on the meds but we were worried when she started all over with the excessive water drinking, pee'ing a lot and also her weight coming back on

Any food recoomendations for Athena. They told us to try Hills Metabolic/Weight Management and gave us a sample We mixed a bit in her current food and she loved it but is this the best one. We want the best for her. When it comes to our dogs no expense is spared. They are our world.....

Any thoughts????

Thank you so much!!!!

[WeLoveAthena]

Ohhh, I am so so sorry to hear of the loss of your Staffordshire Terrier. What was her name? I'm SO glad you had a compassionate and loving experience at the Emergency Vet, and that you have found a new vet for Athena and the rest of your family that you can trust. Let us know how she is doing - and you!

Many hugs and prayers your way.

Hi DoxieMama. Thank you so much. Her name was Spyndal. Sorry my message was so all over the place. Tough month and today we got an update on Athena's recent test. Just posted it. More confusion. Your note was so kind. We really appreciate it.

[labblab]

You'll see that I've gone ahead and merged your new thread into your original thread. This way, all the info about Athena will be consolidated in one place. I will try to edit your thread title in such a way that better reflects your current situation, though.

The risk of cortisol falling too low (going Addisonian) is always present when you are treating a Cushpup with either trilostane (Vetoryl) or Lysodren. So it is not an unusual situation, but it can be a very dangerous situation if the proper recovery steps are not taken. Athena's cortisol levels are quite low. In a situation such as this, there can also be life-threatening imbalances in sodium and potassium levels because the adrenal hormone that controls those balances, aldosterone, can also fall too low if a dog is overdosed on trilostane or Lysodren. Did your vet also check basic blood chemistries at the time this ACTH was performed? Were the potassium and sodium levels normal? If so, then it is really the cortisol alone that is the issue.

I am very concerned that the vet is instructing you to continue giving more trilostane, at any dose, while her cortisol level is so low. This is totally contrary to the instructions of both the maker of Vetoryl and also testing laboratories. At a minimum, no more trilostane should be given at all until cortisol levels have rebounded to a more acceptable range. And some dogs may even require supplemental prednisone as a bridge between the period of overdose and the time that the dog's natural adrenal production has rebounded. Since Athena is not suffering from symptoms such symptoms as vomiting, diarrhea, or extreme lethargy, she probably does not need the supplemental prednisone. But she should not be started back on the trilostane yet. I will try to come back later this evening and give you some related links, OK?

Marianne

[WeLoveAthena]

You'll see that I've gone ahead and merged your new thread into your original thread. This way, all the info about Athena will be consolidated in one place. I will try to edit your thread title in such a way that better reflects your current situation, though.

The risk of cortisol falling too low (going Addisonian) is always present when you are treating a Cushpup with either trilostane (Vetoryl) or Lysodren. So it is not an unusual situation, but it can be a very dangerous situation if the proper recovery steps are not taken. Athena's cortisol levels are quite low. In a situation such as this, there can also be life-threatening imbalances in sodium and potassium levels because the adrenal hormone that controls those balances, aldosterone, can also fall too low if a dog is overdosed on trilostane or Lysodren. Did your vet also check basic blood chemistries at the time this ACTH was performed? Were the potassium and sodium levels normal? If so, then it is really the cortisol alone that is the issue.

I am very concerned that the vet is instructing you to continue giving more trilostane, at any dose, while her cortisol level is so low. This is totally contrary to the instructions of both the maker of Vetoryl and also testing laboratories. At a minimum, no more trilostane should be given at all until cortisol levels have rebounded to a more acceptable range. And some dogs may even require supplemental prednisone as a bridge between the period of overdose and the time that the dog's natural adrenal production has rebounded. Since Athena is not suffering from symptoms such symptoms as vomiting, diarrhea, or extreme lethargy, she probably does not need the supplemental prednisone. But she should not be started back on the trilostane yet. I will try to come back later this evening and give you some related links, OK?

Marianne

Marianne. THANK YOU. Please post anything I can print and take to my vet in the morning. I plan to go and take the info right to the new Vet. Very concerned for my dog. Our vet we trusted for 6 years just betrayed us beyond comprehension with our staffy that we just had to put down so before we allowed this new Vet we interviewed her to make sure she could take care of our dogs properly. If she doesn't know that it's dangerous to have her on this then why say continue but at a lower dose. They didn't do basic blood work but they still have her vial so I will request they run it ASAP in the morning. At this point we have zero trust with Vets due to stuff with our old Vet who we thought was the best but we were sadly mistaken. Now this Vet seemed good and consults with other vets if she needs more info but I agree why put her on this med again at a lower dose if these are her results. I'm very apprehensive. I can't lose Athena...we just lost our staffy and right now I'm beside myself.
Anything you have please let me know. I'm very very worried about Athena. She's not acting sick except drinking a lot, pee'ing and her weight is back on a bit more. She's not acting like all the other symptoms listed for Addisons or Cushing's other than those two except her hind legs bother her which is why she's on tramadol.
I want to trust this new Vet badly but we are very gun shy right now....why wouldn't she know this info that you know. That must be a red flag
Thanks for anything you can give me tonight. We will go there tomorrow armed with this info.
Now can you cold turkey stop Vetroyl or do we have to ween her off it if we choose to take her off the med.
Our lab is young. Barely 5. This is very concerning to us both.
Thanks for helping us..... Thanks very very much

[labblab]

Here's the relevant warning/instruction from the insert that Dechra includes in boxes of Vetoryl :


If the ACTH stimulation test is < 1.45 μg/dL (< 40 nmol/L) and/or if electrolyte imbalances characteristic of hypoadrenocorticism (hyperkalemia and hyponatremia) are found, VETORYL Capsules should be temporarily discontinued until recurrence of clinical signs consistent with hyperadrenocorticism and ACTH stimulation test results return to normal (1.45-9.1 μg/dL or 40-250 nmol/L). VETORYL Capsules may then be re-introduced at a lower dose.

http://www.dechra-us.com/Admin/Public/Download.aspx?file=Files%2fFiles%2fProductDownload s%2fus%2fvetoryl-5mg-pack-insert.pdf

If your vet has questions about this, he/she can definitely call Dechra directly. They have technical reps on staff who can explain the reasoning beyond this recommendation.

Marianne

[WeLoveAthena]

Here's the relevant warning/instruction from the insert that Dechra includes in boxes of Vetoryl :



http://www.dechra-us.com/Admin/Public/Download.aspx?file=Files%2fFiles%2fProductDownload s%2fus%2fvetoryl-5mg-pack-insert.pdf

If your vet has questions about this, he/she can definitely call Dechra directly. They have technical reps on staff who can explain the reasoning beyond this recommendation.

Marianne


Thanks! I'm withholding her meds in the morning and taking this over to the new Vet. Is there a phone # to Dechra? That print is so small on the leaflet. Trying to locate one that I can give her so she can call directly. Thanks a bunch!!!!!! We really appreciate your help!

[labblab]

Yes, here's a link to the phone number and contact page for Dechra's U.S. Office:

http://www.dechra-us.com/contact/technical-support

Also, here's a lengthier treatment brochure that may be easier for you to read. You'll see it includes a Treatment/Monitoring Flowchart that again advises that Vetoryl be discontinued at least temporarily when low cortisol readings are obtained. If a dog otherwise seems to be clinically well, the recommendation is to stop for at least a week before restarting at a lower dose. But if a dog is not doing well, more investigation needs to be done before restarting. I am not sure what to make of Athena's increased thirst/urination in this situation. They can be symptoms of low cortisol as well as high cortisol, but there may be something else going on with her, as well. So I do think it would be helpful for your vet to discuss her case with a Dechra technical rep.

http://www.dechrace.com/pdfs/vetoryl/VETORYLTechnicalBrochure.pdf

Marianne

[WeLoveAthena]

Yes, here's a link to the phone number and contact page for Dechra's U.S. Office:

http://www.dechra-us.com/contact/technical-support

Also, here's a lengthier treatment brochure that may be easier for you to read. You'll see it includes a Treatment/Monitoring Flowchart that again advises that Vetoryl be discontinued at least temporarily when low cortisol readings are obtained. If a dog otherwise seems to be clinically well, the recommendation is to stop for at least a week before restarting at a lower dose. But if a dog is not doing well, more investigation needs to be done before restarting. I am not sure what to make of Athena's increased thirst/urination in this situation. They can be symptoms of low cortisol as well as high cortisol, but there may be something else going on with her, as well. So I do think it would be helpful for your vet to discuss her case with a Dechra technical rep.

http://www.dechrace.com/pdfs/vetoryl/VETORYLTechnicalBrochure.pdf

Marianne

Hi Marianne. Brought everything to our new Vet. She's a one vet practice and very good but hasn't treated a lot of dogs with this condition that being said she is still very open to research things and talk to whomever we ask her to talk too. She consults with others as well and she's just a good solid vet compared to our big vet practice we were at that really took us for a ride ( long story). So we held Athena's dose today, brought our vet all the info you sent us and she read everything and was very grateful we brought it to her attention. She called Dechra and then called us and the plan is to withhold the med for 14 days to get Athena stabilized. We are waiting on results of a potassium/sodium test ( they still had her blood from the other day and the lab said it's still good) and at the end of 14 days we will test her and start her on the lower dose of 60mgs vs 90mgs. Dechra and our Vets plan. So thanks to. YOU...we have a great plan in place and we are all thrilled that together we came to a good plan and agreement on it. Athena is doing good today. Nothing stands out except the things I mentioned before but for example today she's drinking normal amounts of water..but later she may start drinking a lot. So we are going to do some more blood work as well to check a few things but right now we are just so happy that it all came to a good plan in motion and it's thanks to YOU and this godsend of a site. We will keep you posted. We also started Athena ( started to slowly mix the new with current food)a new food that is good for metabolic issues and weight management. She likes it so we are just cutting back a bit on her normal food and adding some of this new one to see if that also helps her. Thank you with ALL our hearts!!!!! Have a great afternoon. PS: We like this vet a lot because she is open to hearing things and also working with pet parents. Our old Vet was one that "knew it all" and we had to fight them on things as well as the time they wanted to start Athena on the max dose and we said NO and only wanted to start her out small. We got our way and in the end they ended up thanking us for fighting them because the higher dose would have proven to be fatal for Athena but then a bunch of other stuff happened and we got our records and left. 6 years of loyalty to them and enough chances. Our dogs are our life and we were not going to jeapordize their care. The things we found out when we got their records..well suffice to say we are still reeling from it in the midst of grieving our oldest girl that had to go off to the Rainbow Bridge so it's been a tough month or so.

[DoxieMama]

I'm so glad that Marianne was able to provide you with the recommendations from Dechra - and even more glad that your vet is willing to be open and discuss things with you, and them! I think I would be inclined to like her, too! She sounds great.

Spyndal is an honorary k9c angel. I hope she found my baby boy Visuddha. Those two old pups have had all their ills healed and are romping in the green meadows happy and care free, until we join them.

Much love,
Shana

[labblab]

Oh I'm so glad your vet visit turned out so well! And Shana is absolutely right -- Spyndal is now an honorary member of our K9C angel family. If you will tell me the date of her passing, it will be our privilege to add her to our special memorial thread of honor. We can also talk later about adding a photo link, as well.

http://www.k9cushings.com/forum/showthread.php?t=7676

Definitely do keep us updated as to how you all are doing. After all your family has been through, I am so hopeful that things will quickly straighten out for sweet Athena!

Marianne

[WeLoveAthena]

I'm so glad that Marianne was able to provide you with the recommendations from Dechra - and even more glad that your vet is willing to be open and discuss things with you, and them! I think I would be inclined to like her, too! She sounds great.

Spyndal is an honorary k9c angel. I hope she found my baby boy Visuddha. Those two old pups have had all their ills healed and are romping in the green meadows happy and care free, until we join them.

Much love,
Shana

Hi Shana. So sorry for your loss. Today makes 3 weeks for us and we are so heartbroken but I bet you anything that Visuddha was there to greet our girl Spyndal and give her the grand tour. Together they are enjoying their brand new bodies, legs and yes, those beautiful green meadows, treat lined streets and so much more and we will see them again. You can rest asssured we will. :-). If I may ask how long as your boy been gone? We have had a very hard three weeks. We have our other babies that keep us going but she was the queen of everyone and the matriarch and it's been so hard not to see her sweet face. I have to keep telling me myself as does my husband we did the right thing letting her go. It was just so hard and we gave her our word she would never suffer when the time came that her battle was done. We kept our word but it broke our hearts. She went so peaceful and we are grateful for that and the emergency vet we had with us who is an ANGEL ( our vet of 6 years really let us down and we left their practice and have a new vet now). So in the end things happened in a way we know God planned for us and we are grateful he kept our old vet practice away from us through it all.
XOXOXOXO

[DoxieMama]

Thank you. It has been 4 weeks today since my baby boy crossed the Rainbow Bridge. He was 14 years and 4 days old. Some days are better than others.
Hugs.

[WeLoveAthena]

Thank you. It has been 4 weeks today since my baby boy crossed the Rainbow Bridge. He was 14 years and 4 days old. Some days are better than others.
Hugs.


Oh Shana. It's 3 weeks today for our girl. She passed at sunset. She was 14 too. A staffordshire terrier/pittie. For certain they are pals up there ;)

[WeLoveAthena]

Oh I'm so glad your vet visit turned out so well! And Shana is absolutely right -- Spyndal is now an honorary member of our K9C angel family. If you will tell me the date of her passing, it will be our privilege to add her to our special memorial thread of honor. We can also talk later about adding a photo link, as well.

http://www.k9cushings.com/forum/showthread.php?t=7676

Definitely do keep us updated as to how you all are doing. After all your family has been through, I am so hopeful that things will quickly straighten out for sweet Athena!

Marianne

How sweet. Athena sure does miss her sister Spyndal. We also have two others. Our boy Axle ( American Bulldog-Brindle) and the baby, Luckie-blue nose blue brindle pitbull. They are keeping us going after such a devastating loss of our oldest girl Spyndal. Thank you so much for making Spyndal an honorary member. She would be blushing. She was such a quiet humble sweet soul. We miss her terribly. It's three weeks today that at sunset she went off to the Rainbow Bridge....
I will get a pic to you when you are ready to post it. Thanks Marianne. Everyone here is the BEST. Shana also lost a doggy a week before we did so we both are going through the loss of our precious pups.
FYI: does it make that big of a difference if a dose is missed or the meds are stopped. Athena is okay except she's sleeping a lot today. We are going to get her test results tomorrow for the potassium/sodium but wasn't sure if they feel different without the meds given she's been on it awhile now. She's to be off it for 14 days before we test and resume. Thanks!!

[Squirt's Mom]

One of the good things about Vetoryl is that you can stop and restart, even skip a dose, with minimal setback if any - especially when the cortisol has gone as low as it has for Athena. ;) I would just enjoy the med vacation while I could and watch her for returning signs indicating the cortisol is elevated again.

[WeLoveAthena]

Site Moderator please merge this post with our original post. I can't locate it. Sorry and thanks for your help

Update

As everyone knows Athena was moved to 60mgs of Veteroyl (spelling, sorry my mind is on overload tonight)

So we just took her into the Vet for some blood work. We have a new Vet now due to some issues with our old vet.

Athena's blood test results were as follows:

Pre: 1. ( Range 1.5-6)

Post 2.2. ( Range being 1.5- 6)

So the new Vet called the Lab director and also consulted with an internal medicine vet she knows ( didn't even know that existed) but that vet isn't in our location.

Both said a good plan would be to
A. Recheck her blood work in a month leaving her at 60mgs with a.m. Feeding

B. Go to 30mgs a.m. And 30 mgs p.m.

They both stated the drug only stays in their system 8 hours and is gone. I had no idea but you learn something new and this journey with Cushing's has been tough. We also didn't know Athena had a thyroid issue as our old vet failed to disclose some irregular results that came back on her in the past. We only found out when we got a copy of her records.

So since Athena has only been on 60mgs for about 2 months we wanted to give her a least another month which will become 3 months Mar 2. We scheduled an appt for her on that date for another blood test.
At that time the determination will be made to put her on 30 twice a day vs 60 once a day

Anyone hear of this or have any input please chime in as we are grateful for anything you can share. Her weight has slowly come down but not enough regardless what we do. We even weened her to a new food that was suppose to be for weight issues prescribed by the vet...nothing. She doesn't like it even though initially she ate it fairly well but now won't eat much of it and we are about to cease that because the poor dog needs to eat and it's not like she's losing weight on that food so she was better off on her old food which she would at least eat. We are happy she's no longer wolfing down her food like before but that has nothing to do with the new food. She had already stopped eating her food in 3 minutes and looking for more awhile back on her old food.

We really need to get that weight off her and get this under control. Thank GOD I fought so hard with the old vet and refused that max dose they wanted her on. She could have died from 120mg dose!!

We like our new Vet. She is humble enough to consult and ask for help if she doesn't have answers and we appreciate that vs the vets that know everything or think they do and won't even make calls to gather more info.

Thanks everyone for your help and time. Sorry haven't posted in awhile as you know we lost our oldest doggy. We had to let her go and it's been tough since losing her and trying to help Athena as well as a ton more. LIFE! The good news is Athena plays well with her brother and sister. She loves to go outside but she does poop out pretty quick. She has also started to snore loud and dream a lot. Not sure if that's the meds.

Thank you again....

PS. CBC was normal for the most part except a bit of an elevation in her sodium and alkphos.
We also had her off her meds for two weeks per the vet when we went from 90 to 60mgs. This is all with new vet. Old vet was the one that wanted her on 120 and I fought to get it down to 90mgs and thank god we did. We would have lost our dog had we let the old vet have her way

[labblab]

I'm so glad you've returned to update us, and also happy to merge your two threads ;). I will try to come back later on in order to add a more substantive reply, but wanted to at least take care of the merge right now. Before leaving, I'm going to add a Visitor's Message to your profile page that contains a link to this thread. That way, if you ever have trouble finding your original thread again, you can just go to your profile page and click on that link which will bring you back here. :)

Marianne

[Harley PoMMom]

Although her ACTH stim numbers are within Dechra's guidelines it bothers me a bit that her appetite is off. As you know a loss of appetite is a sign that cortisol is too low and it just may be that Athena needs her cortisol to run a bit higher. I would carefully monitor her for any other adverse symptoms such as: diarrhea, vomiting, lethargy, or she is just acting off. If she would start showing any one of these withholding the Vetoryl is needed along with an ACTH stimulation test. Also, why is the vet contemplating on dosing her twice a day? Is Athena on thyroid medication now?

She is getting her Vetoryl with food, right? And her ACTH stimulation test was performed 4-6 hours post pill?

I am so glad you dug your heels in when the vet wanted to start her out at 120 mg, good job Mom!!!

Hugs, Lori

[Squirt's Mom]

Don't have anything to offer RE the Vetoryl treatment but do want to give you a HUGE "attagirl Mom" for fighting and advocating like a pro for your girl with the old vet! :cool::cool::cool: You done good, Mom!!

Hugs,
Leslie and the gang

[WeLoveAthena]

Although her ACTH stim numbers are within Dechra's guidelines it bothers me a bit that her appetite is off. As you know a loss of appetite is a sign that cortisol is too low and it just may be that Athena needs her cortisol to run a bit higher. I would carefully monitor her for any other adverse symptoms such as: diarrhea, vomiting, lethargy, or she is just acting off. If she would start showing any one of these withholding the Vetoryl is needed along with an ACTH stimulation test. Also, why is the vet contemplating on dosing her twice a day? Is Athena on thyroid medication now?

She is getting her Vetoryl with food, right? And her ACTH stimulation test was performed 4-6 hours post pill?

I am so glad you dug your heels in when the vet wanted to start her out at 120 mg, good job Mom!!!

Hugs, Lori

Hi Lori
Thanks for writing. New vet consulted with a few folks (lab that did the test, drug co and dog internal med). They all felt Athena would benefit more from a split dose 30/30 so that drug is in her system longer
We are also waiting on a repeat thyroid test as she was low last time but had improved from her old test from previous vet (that we were never told of).
We think her eating being off is she hates the new special food. She will eat her old food but this other one they wanted to try her on (metabolic weight management) is one she's not a fan of. At first she ate it but we did the mix to ween her as you know you never stop one food and start a new food so we gradually mixed. She started to only pick out her old food and left her new food in the bowl

We do see some improvements such as her coat is full now and skin cleared up but she needs her weight to come off more. It's frustrating and we are trying so hard for her

Thanks for posting :-)

[WeLoveAthena]

Don't have anything to offer RE the Vetoryl treatment but do want to give you a HUGE "attagirl Mom" for fighting and advocating like a pro for your girl with the old vet! :cool::cool::cool: You done good, Mom!!

Hugs,
Leslie and the gang

Hugs and thanks to you Leslie and your sweet pups ;)

[WeLoveAthena]

I'm so glad you've returned to update us, and also happy to merge your two threads ;). I will try to come back later on in order to add a more substantive reply, but wanted to at least take care of the merge right now. Before leaving, I'm going to add a Visitor's Message to your profile page that contains a link to this thread. That way, if you ever have trouble finding your original thread again, you can just go to your profile page and click on that link which will bring you back here. :)

Marianne

Thanks Marianne as always you are a gem and such a huge help. Looking forward to hearing from you when time permits 🐶

[labblab]

Oh, you are so welcome, and now I'm back again to add a few more thoughts. First of all, I'm so glad you've found a vet that sounds like a much better partner for family. I'm also really glad that, generally, Athena seems to be doing better. Since it seems as though your biggest question right now is about the possibility of shifting to twice daily dosing, that's what I want to talk about.

I believe you've read another discussion about this on another member's thread where I talked about the fact that many clinicians favor twice-daily dosing because the effects of the Vetoryl typically do not extend for a full 24 hours. However, there are some practical reasons why once-daily dosing may have benefits for certain dogs and also their owners' lifestyles. The first is purely financial: one box of 60 mg. capsules will likely cost less than two boxes of 30 mg. capsules. And if you end up needing to adjust Athena's dose further via a combination of capsules, twice-daily dosing can be significantly more expensive unless you shift to using a custom-compounded dose of trilostane as opposed to brandname Vetoryl.

In that vein, I want to mention that experience and research have shown that dogs who are dosed twice-daily tend to require a lower overall daily total of medication. In other words, it is likely that Athena's cortisol level may drop even lower if she takes two 30 mg. capsules -- one each in the morning end evening -- as opposed to 60 mg. in the morning alone. However, she is already at the low end of the acceptable cortisol range, and as a result, I would worry about her dropping any lower. So if her cortisol remains this low at her March test, I would be cautious and retest again within a month if you do make the switch to twice-daily dosing. Her overall dose may need downward readjustment at that time.

Also, bear in mind that Vetoryl must be given with a full meal to be metabolized properly. So if you make the switch, she must be fed dinner as well as breakfast.

Finally, some dogs seem to feel better when their cortisol is allowed to increase somewhat throughout a 24-hour period, while others do better when the cortisol remains more consistently "flat." There is individual variation in exactly how quickly each dog metabolizes the drug throughout the course of a day. Per the U.S. Product Insert for Vetoryl:


Trilostane absorption is enhanced by administration with food. In healthy dogs, maximal plasma levels of trilostane occur within 1.5 hours, returning to baseline levels within twelve hours, although large inter-dog variation occurs. There is no accumulation of trilostane or its metabolites over time.

For this reason, I think that both once- and twice-daily dosing can be acceptable options, depending upon each individual dog's rate of metabolism and overall health condition. I do realize that many clinicians believe there may be systemic health benefits to twice-daily dosing. But just from my "real-life" experience following dogs on this forum throughout the years, I've come to think that once-daily dosing is often the cheaper and easier regimen to maintain as long as overt symptoms have resolved and as long as the dog is not diabetic or suffering from a health condition that has been proven to benefit from more consistent cortisol control. Just my two cents worth to factor in next month!

Marianne

[WeLoveAthena]

Oh, you are so welcome, and now I'm back again to add a few more thoughts. First of all, I'm so glad you've found a vet that sounds like a much better partner for family. I'm also really glad that, generally, Athena seems to be doing better. Since it seems as though your biggest question right now is about the possibility of shifting to twice daily dosing, that's what I want to talk about.

I believe you've read another discussion about this on another member's thread where I talked about the fact that many clinicians favor twice-daily dosing because the effects of the Vetoryl typically do not extend for a full 24 hours. However, there are some practical reasons why once-daily dosing may have benefits for certain dogs and also their owners' lifestyles. The first is purely financial: one box of 60 mg. capsules will likely cost less than two boxes of 30 mg. capsules. And if you end up needing to adjust Athena's dose further via a combination of capsules, twice-daily dosing can be significantly more expensive unless you shift to using a custom-compounded dose of trilostane as opposed to brandname Vetoryl.

In that vein, I want to mention that experience and research have shown that dogs who are dosed twice-daily tend to require a lower overall daily total of medication. In other words, it is likely that Athena's cortisol level may drop even lower if she takes two 30 mg. capsules morning end evening, as opposed to 60 mg. in the morning alone. However, she is already at the low end of the acceptable cortisol range, and as a result, I would worry about her dropping any lower. So if her cortisol remains this low at her March test, I would be cautious and retest again within a month if you do make the switch to twice-daily dosing. Her overall dose may need downward readjustment at that time.

Also, bear in mind that Vetoryl must be given with a full meal to be metabolized properly. So if you make the switch, she must be fed dinner as well as breakfast.

Finally, some dogs seem to feel better when their cortisol is allowed to increase somewhat throughout a 24-hour period, while others do better when the cortisol remains more consistently "flat." For this reason, I think that both once- and twice-daily dosing can be acceptable options, depending upon each individual dog's rate of metabolism and overall health condition. I do realize that many clinicians believe there may be systemic health benefits to twice-daily dosing. But just from my "real-life" experience following dogs on this forum throughout the years, I've come to think that once-daily dosing is often the cheaper and easier regimen to maintain as long as overt symptoms have resolved and as long as the dog is not diabetic or suffering from a health condition that has been proven to benefit from more consistent cortisol control. Just my two cents worth to factor in next month!

Marianne

Hi again

Sorry. Just to clarify. Athena takes 60mgs with morning meal. They want to give her 30mgs am and 30pm. Our dogs eat two times a day so she would eat twice

We don't overload their bowls. They get the right amount so we know Athena isn't per se over eating but no matter what we do she has lost very little weight which she needs to do badly

Any suggestions on her weight? She's plays outside some but poops out and walking her isn't easy with her joint pain due to weight. It breaks our hearts. We are trying everything and spent a fortune which the money doesn't matter. We'd go into hawk for our doggies.

Thanks so much Marianne 🐶🐾

[labblab]

No, you wrote clearly -- sorry I did not. I'll go now and edit my reply to make that clearer myself. However, I did understand what you meant -- that you'd possibly be shifting to giving one 30 mg. capsule in the a.m. and one in the p.m. So everything I wrote above was still based on that assumption, including the likelihood that Athena's cortisol may drop lower when taking 30 m.g. morning and evening, as opposed to taking all 60 m.g. in the a.m. I did understand that she would still be taking a daily total of 60 m.g. either way.

Marianne

[WeLoveAthena]

No, you wrote clearly -- sorry I did not. I'll go now and edit my reply to make that clearer myself. However, I did understand what you meant -- that you'd possibly be shifting to giving one 30 mg. capsule in the a.m. and one in the p.m. So everything I wrote above was still based on that assumption, including the likelihood that Athena's cortisol may drop lower when taking 30 m.g. morning and evening, as opposed to taking all 60 m.g. in the a.m. I did understand that she would still be taking a daily total of 60 m.g. either way.

Marianne

Oh good. Sometimes I confuse my own self. This has been tough to deal with. We had first seen progress now not so much. Would you consider the split dose for your dog? I hate feeling more confusion and we go back and forth as to what to do. We just lost our oldest doggy in November (old age and it was time to let go as she let us know) and it's been so hard. We can't lose Athena too. Very scary thought.

[labblab]

When you say that you're no longer seeing as much progress, can you tell us more specifically what you mean? You've mentioned lack of energy and excessive weight -- how about other Cushing's symptoms that you saw earlier? If anything, it sounds as though Athena is now picky about eating as opposed to her original ravenous appetite? How about thirst, urination, skin and coat?

The reason why I ask is because a switch to twice-daily dosing is indeed recommended when overt symptoms don't resolve or rebound later in the day even when cortisol levels are optimal 4-6 hours after dosing. But in Athena's case, I'm not sure whether you are in that situation or not. Especially because lack of energy and a picky appetite could actually result from a cortisol level that is a bit too low to keep her comfortable. So that's why I'm wanting to know more about the whole picture of her symptom progression or resolution.

As far as my own dog, our personal experience does indeed color my attitude about all this. At my own urging, we started out with twice-daily dosing right from the get-go, and in retrospect I always wished we had begun with morning dosing only. We encountered quite a few bumps along his treatment journey that probably weren't related to dosing at all, but juggling/adjusting the two doses didn't make things any easier and I'm not convinced that keeping his cortisol level so consistently flat all day did him any favors. When we finally shifted to just dosing him in the morning, he seemed to gain some energy back. But this was also years ago when the overall dosing recommendations were much higher. Had we been giving him less medication overall, our experience might have been very different.

We do have many members here who dose twice daily with great success, and as I say, I do realize it is the preference of many clinicians. But we also have many dogs who seem to do equally well (at least outwardly) with morning dosing. For that reason, when folks come to us and ask about switching, I'm always curious about the basis for making the switch. Is the dog actually not doing well on the once daily dose, or is it because of theoretical assumptions that twice-daily may be better? In the case of the former, I'd definitely switch. In the case of the latter, I'd want to also factor in my dog's actual symptom presentation, and also the expense and convenience of making the switch, as well.

I realize that Athena is quite young, and for that reason alone, the vets may feel that twice-daily dosing may be the better route for long-term control of systemic cortisol-related issues. Since I am not a vet, I can't argue with that possibility. But going full circle in this discussion, you don't want Athena's cortisol to drop any lower than it is right now. So if you do make the switch, I think you'll want to retest her levels before too much time passes in order to make sure her cortisol remains stable.

Marianne

[molly muffin]

Hi there. With her ACTH being currently 1.0 and post 2.2 and Athena having arthritis, I am wondering if a lowering over all of medication might be of benefit. Sometimes when the cortisol is lowered, they feel those aches and pains more and so can be less active. It's a delicate balance, so what if her post cortisol level was allowed to come up to say 4.0 - 5.0 (ish) it can go up to 9.0 if overall cushing symptoms are controlled.
so whether you stick with once daily or go to twice daily, that is probably what I'd talk to the vet about.

[WeLoveAthena]

Hello to all
Sorry things have been a bit hectic
As for Athena after her last appt she's been reduced to30mgs once a day. She seemed to be doing ok but still struggling to get her weight down more
Today she's not been herself. Lethargic and having trouble getting up. Like she's sore. We keep tramadol and gave her some but she's just not herself again. We are so frustrated and feel so badly for her. We want to help her and now it's the weekend
Our new Vet is open on Saturday so calling her in the morning but just so upset that she seemed to be doing ok then backslided some then back to good and now here we go again
Frustrated with not being able to get more weight off her but can't reduce her good anymore or she will go hungry which makes her anxious
She's a young Labrador and should be enjoy being a dog. It's upsetting.
She's the sweetest girl ever
Venting and also seeking suggestions

Thank you


Mods: if you can connect this to original thread please do I can't find it. Sorry

[labblab]

Hello and welcome back to you and Athena, although I am sorry she's not doing too well right now. The first question I need to ask is whether you had an ACTH stimulation test performed at the time Athena was lowered back to the 30 mg. daily. Also, what was the date of that last appointment/dosing change?

I know I'm sounding like a broken record :o, but we've had continuing concerns about low cortisol all along, it seems. And once again, her current behavior is consistent with that issue. So before discussing other possibilities, I'm really anxious to learn more about any recent testing of her cortisol level.

Thanks so much,
Marianne

[WeLoveAthena]

Hi Marianne
You always come to the rescue :-)
Just letting you know I'll post the info here shortly. In the process of a move soon to permhouse and vet records are boxed. Called out Vet tech for info and will post here shortly

You're the best :D

[WeLoveAthena]

Here is the lab. Removed all private info like names address
Ok. Never mind. Attachment won't work
Numbers and date of visit
3/17/2017

Pre 1.3. Range 2-6
Post 1.9. Range 6-18

Vet says. An be up to 6

Hope this helps

[Harley PoMMom]

Those stim numbers are too low for my comfort and if she is still feeling unwell she may need some prednisone to help get that cortisol back up. One of the top veterinary endocrinologist, Dr. Peterson, recommends that the post number never drop lower than 2 ug/dl.

Also, the therapeutic ranges for Trilostane are 1.5 ug/dl - 5.4 ug/dl and if clinical symptoms are controlled that post number can be as high as 9.1 ug/dl.

Lori

[Squirt's Mom]

That range of 6-18 (ug/dl I am assuming) is for a dog who either does not have Cushing's or is not yet on treatment. The normal or optimal ranges for a dog on treatment depends on which drug the dog is on. Lori gave you the ranges for a dog on Vetoryl. ;)

[WeLoveAthena]

That range of 6-18 (ug/dl I am assuming) is for a dog who either does not have Cushing's or is not yet on treatment. The normal or optimal ranges for a dog on treatment depends on which drug the dog is on. Lori gave you the ranges for a dog on Vetoryl. ;)

Athena is on Vetoryl 30mgs QD. It's too low for us too. So the next lowest dose is 10 or I wonder if a break from the medication is in order
Our vet took her off it for a month not long ago
This is mind boggling. We just want our girl well :-(

[WeLoveAthena]

Those stim numbers are too low for my comfort and if she is still feeling unwell she may need some prednisone to help get that cortisol back up. One of the top veterinary endocrinologist, Dr. Peterson, recommends that the post number never drop lower than 2 ug/dl.

Also, the therapeutic ranges for Trilostane are 1.5 ug/dl - 5.4 ug/dl and if clinical symptoms are controlled that post number can be as high as 9.1 ug/dl.

Lori

Thanks Lori. It's too low for us too. She's on 30mgs of Vetoryl
Next lower dose is 10mgs. She's a big lab. Just really want our girl well
Beyond frustrated. Called Vet today. She wants to run another test
It's real hard to get Athena there. She won't even come out of the truck anymore going to the Vet. They come to the truck :-(

[Harley PoMMom]

Recently Dechra (the makers of Vetoryl) started to manufacture 5 mg capsules so an option could be to add a 5 mg capsule along with the 10 mg for a total of 15 mg.

If this were me, I would probably stop the Vetoryl and have an ACTH stimulation test performed. I know that this isn't an easy task to accomplish, poor Athena, I'm glad that they are willing to come out to the truck....sending comforting hugs for you both.

[molly muffin]

I actually wouldn't restart vet royal until she shows symptoms again. Then restart lower than 30. 20 15. 10.

[WeLoveAthena]

Recently Dechra (the makers of Vetoryl) started to manufacture 5 mg capsules so an option could be to add a 5 mg capsule along with the 10 mg for a total of 15 mg.

If this were me, I would probably stop the Vetoryl and have an ACTH stimulation test performed. I know that this isn't an easy task to accomplish, poor Athena, I'm glad that they are willing to come out to the truck....sending comforting hugs for you both.

You're so sweet. Thanks
We"re calling Monday and getting her tested again.
We will stop Med but will have to dose her day if test. They ask us to dose her 4-6 hours

[WeLoveAthena]

I actually wouldn't restart vet royal until she shows symptoms again. Then restart lower than 30. 20 15. 10.

Thanks Stephanie.
Sorry to sound so frustrated :-(

[labblab]

I'm going to be a bit of a contrarian here and suggest continuing with the Vetoryl until you get her tested tomorrow -- and then stop it, at least until you get the results back. If you don't give her any med today or tomorrow morning, you won't get an honest assessment of her cortisol on this dose of the drug. Of course, all bets are off if she worsens even more today or if you have to wait longer than Monday or Tuesday to test. But otherwise, I'd try to stick to the regular schedule for another 24 hours.

Marianne

[WeLoveAthena]

I'm going to be a bit of a contrarian here and suggest continuing with the Vetoryl until you get her tested tomorrow -- and then stop it, at least until you get the results back. If you don't give her any med today or tomorrow morning, you won't get an honest assessment of her cortisol on this dose of the drug. Of course, all bets are off if she worsens even more today or if you have to wait longer than Monday or Tuesday to test. But otherwise, I'd try to stick to the regular schedule for another 24 hours.

Marianne

Hi Marianne. I agree. I meant to say that we'd have to give it to her to rest it so unless she worsens then going forward so we get an accurate test
We hate seeing her like this.
I believe our first vet that created a nightmare for us with our oldest doggy that crossed the bridge in Nov is responsible for a lot wrong with Athena. They withheld info from us and more but new vet now and the past is gone
Thanks for your help

[WeLoveAthena]

So sorry for being out of touch for so long. I won’t go into everything about that it would be too long winded I have apologize because everyone here was so good to us when we first arrived with 1 million questions about Athena our lab
Athena had her birthday last week 8/26
It’s been quite a ordeal dealing with this Cushing’s she will do you good for a while and then she doesn’t they’ve given her a couple breaks off out of the medication Veteroyl because of her levels but also because we started noticing that she was doing worse on the medication then off of it Then out of nowhere she started up all over again with the excessive peeing drinking water all the time hungry every five minutes and losing her hair again As much as we hate the medication we agreed to put her back on a low-dose Of 30mg
I don’t know if everyone remembers the first vet that we had was terrible and nearly killed her. We since had switched over to a great new vet
Well this evening she started acting very strange. She always acts like she’s spooked by something for lack of better words
She won’t rest. She has been pacing about and panting and her eyes look a bit dilated she’s on medication for pain tramadol and Rimadyl but we are careful with the rimadyl (liver). She tolerates both well. Our vet is open on Saturday morning at 08 and we plan to call her soon as she opens up. The fat practice we go to is one doctor and it’s basically a vet hospital they can do all the testing on the premises to include labs x-ray ultrasound and so forthIt’s 3 AM where we are right now and we’ve been up with her all night if she gets worse we will take her to the vet ER but in the last 10 minutes she finally laid down and is resting a bit, her eyes are normal again and pain meds finally kicked in.
We are not sure what to think she is at the three-year mark since her diagnosis we don’t know if this means something bad or if this is normal or she’s just progressing and we do not want her to suffer at all
Cushings sucks! She was overall healthy with everything else at her last vet visit last month but we can tell she still having a hard time with this Cushing’s no matter what we do we can’t can’t weight off of her we’ve tried everything but can’t starve the poor girl she has to eat something
She’s hyper thyroid too but that was stable on her last results last month

We just hope that there isn’t something going on because of Cushing’s as I’ve been told all the nightmare outcomes of this awful disease We promised her we would never let her suffer we promised our dogs that

Can anybody think of anything or does this sound familiar

I have always been able to trust the solid compassionate advice we’ve been given here so here I am at 3 o’clock in the morning we don’t want to lose her but we don’t want her to suffer either

We love our sweet girl so much ♥️��

[Harley PoMMom]

Hi and first off....Happy belated Birthday, Athena!!!!!

You will see that I have merged your post into Athena’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thank you for the update although I am sorry that Athena is having some difficulty right now. Could you do us a favor and post the results of her ACTH stimulation tests and the dosage of Vetoryl she was taking when the monitoring tests were done? Were her electrolytes checked recently? Also, I see she is taking pain medication, is this for arthritis or something else? When did Athena restart the 30 mg of Vetoryl? Was her cortisol checked before restarting the Vetoryl?

For reasons that are not yet fully understood, it also seems that larger dogs may need lower doses of Trilostane per pound than smaller dogs to control clinical symptoms, on the forum we have witnessed this too. So, it just may be that Athena is one of those dogs that needs their cortisol to be in the higher normal therapeutic ranges to feel her best. Is her appetite good? Is she drinking/urinating normally?

Sending you and Athena tons of loving hugs, Lori

[WeLoveAthena]

Hi and first off....Happy belated Birthday, Athena!!!!!

You will see that I have merged your post into Athena’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thank you for the update although I am sorry that Athena is having some difficulty right now. Could you do us a favor and post the results of her ACTH stimulation tests and the dosage of Vetoryl she was taking when the monitoring tests were done? Were her electrolytes checked recently? Also, I see she is taking pain medication, is this for arthritis or something else? When did Athena restart the 30 mg of Vetoryl? Was her cortisol checked before restarting the Vetoryl?

For reasons that are not yet fully understood, it also seems that larger dogs may need lower doses of Trilostane per pound than smaller dogs to control clinical symptoms, on the forum we have witnessed this too. So, it just may be that Athena is one of those dogs that needs their cortisol to be in the higher normal therapeutic ranges to feel her best. Is her appetite good? Is she drinking/urinating normally?

Sending you and Athena tons of loving hugs, Lori

Thanks Lori. For your comments and relocating my post I appreciate it
I’ll get all the test results posted tonight as we are spending our time staying close to her right now. We ended up having to take her to the ER vet because she got worse. She is home with us now but I will post an update for everyone later if you could just keep us all in your prayers and thoughts we’ve had a rough 24 hours for now I can say she’s been taken off of the Cushing’s medication Veteroyl that’s a separate issue from them suspecting that she may have ingested something toxic out in the yard and we have some suspicions of what may have happened but I’ll have to explain more later We still can’t get over how she was acting. Scariest thing ever
She is on pain medication and has been for a while because when she was a puppy she was bitten by a lyme tick that we didn’t know until later the people we got her from never told us so she developed some sort of arthritic issue and her back legs are often stiff and sore and the medication really helps her so that she could walk easy and even run at times the Vets Have kept her on that medication to help her because her back legs Plus she’s carrying around weight that we can’t get rid of them matter what we do and we tried everything under the sun

We will post more tonight we thank everybody for their thoughts and prayers ��

[Harley PoMMom]

Keeping you and sweet Athena in my thoughts and prayers, sending healing energy along with tons of loving hugs.

[DoxieMama]

I haven't been around for a while myself, but just popped on and remember your girl. Sorry to hear she's had some issues recently. Sending more healing hugs and prayers your way.

Shana

[WeLoveAthena]

Hello to all
So sorry we have been out of touch we have had many things that have kept us away But we have often thought about each and everyone of you that have helped us so much along the way with Athena
As you know we have two other dogs we lost our oldest one two years ago she crossed over the rainbow bridge in November 2016 and right before Christmas our oldest of the three left our only boy Axle crossed over the rainbow bridge. It was very difficult his last night before we took him to the vet in the morning we all slept in the doggy bed with him we knew it was coming and he let us know (He had basically been placed in a hospice dog status for just a couple weeks he was completely out of pain due to being on extra pain med but the vet was trying to see if maybe the issues he was having would resolve if we just kept him on extra pain medicine and muscle relaxers but Axle et us know it was time and we had already come to the conclusion that it was coming in as we promised him from puppyhood we would give him a great life and when his time came we would allow him to go with love and dignity and we had an appointment first thing on Saturday morning but we laid in the bed with him and we talked to him and thanked him for all the years he gave us 12 beautiful years and we read to him and for some reason the song that kept playing in the background was baby itÂ’s cold outside on a little radio that we kept in that room we always kept the radio on for the dogs and their favorite room to sleep in Which if I knew how to post a picture inside this post I would because a year ago I took a picture of him and Athena together at the back door and I put it in one of these frames on the phone app and it was a winter frame and it said baby itÂ’s cold outside
Anyhow around 4 oÂ’clock in the morning he needed to go out so we took him outside at that point he was still walking fairly well but not the best but has he tried to go to the bathroom he fell backwards and that was it we knew it so our appointment was not a minute too soon. We carry them up the stairs mind you he was a nearly 90 pound American bulldog but had started losing weight and muscle tone. We brought them inside and for the last couple hours we just wrapped them up in blankets and kept him comfortable
Athena and our other dog Lucky had been with us all night as well tending to him mostly Athena since she is our resident nursemaid. She was extremely close to him and sheÂ’s the one thatÂ’s always near anyone who is not feeling well The day before when we needed him to eat a little bit of food which he didnÂ’t want to in order to give him his pain meds it was Athena that got him to eat we would give her a couple pieces and then he would eat out of our hands after she licked in the face as if to tell him it was OK to have some food
As we left the home to go to the vet when morning came our hearts are breaking the doggies said their “till we meet again” licks
We got to the vet and of course our vet and the staff was amazing they gave us all the time we needed although we already had all the time we needed the night before and we didnÂ’t want him to suffer any longer but we did spend some time with him they sedated him and then a little while later they came in and we said our final till we meet agains we laid our heads on his chest held his paws and heard his very last heartbeat.
When he was gone they left us so that we could have some time we were taking him with us to our local Sacred Paws. We wrapped him in his blanket that he had been laying around that we brought with us And they let us leave out the back door and we carefully placed him in our truck and I stayed with him until we reached our destination
The sweet soul of a man that runs Sacred Paws here is amazing He only does one dog at a time youÂ’re welcome to stay as he has nothing to hide and people come from out of state because of the level of integrity and care that he gives
Of course thereÂ’s no way we could watch that process and we had already trusted him with our girl two years ago and they were absolutely amazing
So we went again had a chance to see him off and we wrap them in a beautiful soft blanket thatÂ’s the dogs leave pop prints in your heart and we put his favorite toy and stuffed animal and some treats wrapped in a gold ribbon to take to his sister who we knew was waiting for him at the bridge. We kissed him goodbye one more time
We walked away brokenhearted bawling our eyes out but we knew that we had done right by our boy and kept our promise and we knew where he was going
My husband has a very strong Marine who is injured and come back and has been through a lot we both have but we cried all the way home holding hands knowing we did the right thing but knowing that our our boy was really gone
Axle had a host of medical issues starting with pancreatitis and started losing the use of his hind legs slowly although he kept trying to be a strong boy we knew he was only doing it for us and we couldnÂ’t let him go on and injure himself or continue to suffer in anyway. Even though we kept them on the best medication for his medical issues for paying for anything he was 12 years old and we realized that there was no way we were gonna let him go on like this he did have an area of his leg they thought maybe cancerous and would require surgery and we said no way not at his age he wasnÂ’t going out that way and in the end and our awesome vet completely agreed with us and said she wish more people thought that way instead of letting an animal go through so much at an older age and suffer
The outcome of the surgery wasnÂ’t going to change anything because we would never allow him to go through chemo there was no way we would put that beautiful boy through all of that
This is our new vet and you recall our previous vet wasnÂ’t very good and thatÂ’s how we ended up going back-and-forth because with Athena after spending a ton Of money and having no resolution we had to find a new vet
Anyway the next morning we were able to pick up Axel‘s ashes and bring him home His beautiful errands it’s right next to his sisters and they gave us paw prints and so many other things and I carry a locket which hasn’t left me since we lost our girl that has ashes in it from her and they added some of axles ashes in it as well. It was something that my husband picked out for me when we lost our girl. She was a Staffordshire terrier that made it to 14 1/2

Our vet staff said if they ever come back reincarnated they want to come back and be one of our dogs ♥️

Now as for Athena
As soon as we got home Athena knew immediately knew he was gone
At first she searched for him
Then it all sunk and then he was gone and never have we seen a dog grieve as fiercely and she has been grieving
We have done everything we can to help her but also being careful because they said they can develop separation anxiety but we are all trying to get through this loss together
Going in the week three I kept getting a feeling that something wasnÂ’t right with Athena although she has CushingÂ’s I just didnÂ’t know what was going on it just seem like something different. I was wondering if she was just having another crisis with CushingÂ’s if the stress of losing a Axle was just too much for her either way I booked an appointment to see the vet Our vet was going to be going out of town for a week and we wouldÂ’ve had to use an emergency vet or a back up so I did everything I could to get her in and we were able to take her first thing Saturday morning as the first appointment so that she could be seen before our vet left town for a week
Athena had lost 8 pounds And we had to told our vet that she had not been eating
She had pretty much ceased eating except for a few scoops enough to give her her medication since losing a Axle. Anyone that has a lab knows that that is very rare they would eat the kitchen sink if you want them
So we told our vet that we wanted her to have a complete work up the money didnÂ’t matter we were just very concerned that this was something more than just a grieving dog and maybe something outside of CushingÂ’s but we didnÂ’t know what it could be because the only symptoms were that she really wasnÂ’t eating and doing her usual Cushing stuff
We brought in a UA sample just in case because heÂ’s generally too nervous at the vet to do one And we thought she might be getting a start of a UTI which she has had in the past
They drew her blood and they were testing it and the UA. Our vet was doing an exam on her because she had a spot under her arm we were worried about but a quick little punk of it and we found out it was just a little fatty area nothing to be concerned about
She also had one on her hind leg that weÂ’ve always been concerned About but our old vet that told us it was nothing to worry about that she had checked it and it was fine but nothing could be farther from the truth this vet said it was a very concerning spot so while we were discussing the probability of having it surgically removed She checked it and then said she wanted to run and see if the labs were completed because they were shortstaffed that day they didnÂ’t have another vet tech to help so she left the room and two minutes later came flying into the room top speed
The news was devastating on top of CushingÂ’s Athena has been officially diagnosed with diabetes requiring to insulin shots per day 12 hours apart
Her number is 534 and it was even in her urine
She did have a very mild UTI which we jumped on with antibiotics but this new vet we had went into full speed ahead printing off everything we needed writing our prescriptions out for the insulin getting us everything set up I am going over the new food we would have to put them on and slowly switch her to
And actually sheÂ’s on 14 units every 12 hours we are going to watch that for week and see how she does her out for track meet or will be here by mail tomorrow along with her special food that we will slowly introduce into her current holistic food that she eats and was doing well on
To say that we were stunned is nothing short of an understatement we kept wondering how did this happen what did we miss but our vet assured us that we missed nothing but the greatest thing we did was follow our gut feeling and insist on getting her in before she went out of town because the symptoms can often mimic CushingÂ’s we would not of been able to pick up on her being diabetic
This vet is extremely reasonable compared to our old vet that charged us a mountain of money for nothing
Are all the vet was so extremely overpriced but at the time we didnÂ’t care we would do anything to help our girl feel better but in reality she did nothing and didnÂ’t really care about our dog
So two hours later because they devoted so much time to help us and Athena we left the vet office to go pick up her insulin first we took her home and my husband stayed with her because she was just spent from that appointment Plus we had our other doggy at home and didnÂ’t wanna leave her alone any longer I went off to get the insulin at one of our local small pharmacies who did their very best to help us with the price as opposed to the larger chain pharmacies which wouldÂ’ve been almost double but it really wouldnÂ’t of mattered we have always said we would move the moon and the stars for our dogs but considering everything we went through that day and just losing a Axle a few weeks ago it was nice To have not only our vet but our pharmacist help us with the cost as this was going to be overwhelming on top of the CushingÂ’s

So we are day two of the insulin shots and already we are noticing that Athena is perking up and starting to feel somewhat better we wonÂ’t know her levels and tell her glucometer arrives tomorrow
Today was the first day she actually ate everything in her bowl

We bought a logbook so we are locking everything up thing every time we give her her insulin shot and her meds weÂ’ve always done that with our dogs but now particularly since we are giving her injections
We keep a close eye on her post injection just to make sure and watch for any signs to make sure sheÂ’s OK and they may adjust her insulin level depending how she does over the next few weeks

Needless to say we had a tough year in 2018 and a rough start to 2019 but we are all each other has and weÂ’re going to get through this The two of us and our doggies but I just thought I would update everybody on what was going on and if anybody is in a similar situation and you can offer any opinions thoughts advice please feel free to


The one good thing is Athena is great with her injections my hub sits in front of her and talks to her and I give you injections being that I am a nurse they are over so quickly she really doesnÂ’t pay attention but she does very well with everything

We just feel so badly for her the whole time we just thought it was her CushingÂ’s and her grieving but then something started bothering my gut and I just kept getting a feeling something wasnÂ’t right this was more than just CushingÂ’s and grieving but I wouldÂ’ve never thought it wouldÂ’ve been diabetes

This poor sweet lab has had a rough that start from day one Of her being a puppy but just like the others we promise to take care of her for better for worse through everything and thatÂ’s exactly what weÂ’re doing

SheÂ’s an amazing girl and just like our others who have crossed over the bridge and the last two years we are so honored that she is part of our lives as well as her little sister

Thank you to all for listening and so sorry that IÂ’ve been away from this website I have thought of you all very often life just got very crazy for a while

Sorry for any typos my phone has a mind of its own and does this crazy spellcheck thing adding words that I wouldn’t put it but I don’t know how to do a spellcheck on this website so I apologize for anything that may not make sense

[WeLoveAthena]

double post. Trying to edit my original post and correct typos but I’m having a difficult time on my side tonight sorry

[Squirt's Mom]

Hi and welcome back! I am so sorry to hear about your precious boy, Axel. There is no question he left this life knowing he was very much loved. My deepest sympathy for your loss.

As for Athena, the most important thing I can share with you is to go NOW and join K9Diabetes, our sister site. They are the experts on canine diabetes and are well acquainted with the concurrent conditions of diabetes and Cushing's. They will be able to help you immensely in dealing with her diabetes. Here is the website - http://www.k9diabetes.com/forum/

Let us know how she is doing. Just because you join our sister site doesn't mean you get to forget about updating us here! ;) We want to hear about her.

Hugs,
Leslie

[lulusmom]

Hi and welcome back. I am so incredibly sorry to hear of Axle's passing. My heart broke and tears fell as I read about your final moments with your precious boy.

I see that back in September, you took Athena off of medication for cushing's. Did you restart treatment since then? If not and if her cortisol is high, getting her blood sugar regulated is going to be very difficult until you get her cortisol back down. I didn't have time to go back through your thread to see if she was on once a day or twice day dosing and if on once a day, you should talk to your vet about switching to twice day dosing. The reason for this is that Vetoryl (trilostane) has a short half life and it's effects start to wear off after 8 hours. This may be long enough for most dogs to see complete resolution of symptoms but a dog with diabetes needs maximum control throughout the day. If you did restart treatment, when was the last acth stimulation test done and can you share those results. Athena is lucky that her mom is a nurse and is an expert at giving injections. You should also be pretty good at doing home testing curves. I second Leslie's recommendation to join our sister site, k9diabetes.com. The folks there are amazing and I may be a bit biased but so are we when it comes to cushing's so you will have the best of both worlds. Please keep us posted on Athena's progress.

Again, I am so sorry for your loss and I hope we can be of help in getting Athena on the right path to a continued great quality of life with both conditions well controlled.

Glynda

[WeLoveAthena]

Will update soon

[labblab]

Welcome back to you and Athena! I’ve gone ahead and merged your note into your original thread right now, and we’ll definitely be watching for your continued updates.

Marianne

[WeLoveAthena]

I had a long post typed here and removed it. I should have shortened it but I started to type and it all came out. I'll try to keep it short as I can.
Athena, as everyone know was diagnosed very young with Cushings
When we got her as a puppy we didn't know she had been bitten by a Lyme Tick. The people we got her from never told us ( but they later told us they knew. They were afraid we wouldn't take the puppy. That would have never happened. She was ours lock stock and barrel good or bad).
Our first Vet found out after some testing and then shortly there after came the Cushings Diagnosis For Lyme she was treated with a big antibiotic and did well and then had a negative test afterwards.
Fast forward to her going through treatment with Vetroyl and it nearly killing her twice using two different dosages. We took her off and just winged her treatment best we could to keep her going and happy. It was very frustrating but she was just not well at all on the me.
Fast forward to Dec 15, 2018. We had to put our beloved boy Axle down. Athena and Axle were very close. We never saw any dog ever grieve the loss of a dog the way she grieved Axle. We were all heartbroken but we had to let him go because we loved him so much and promised all our dogs a wonderful life and when it was time..no suffering...just a peaceful journey to the rainbow bridge.
Suddenly Athena started doing the same thing again. Drinking gallons of water, unable to get any weight off, etc. All signs of that nasty Cushings. We took her into the Vet two weeks after losing Axle because she wouldn't eat and it took all we could to get her to eat enough to take her pain med for the damage/arthritis to her rear leg joints due to the Cushings/Lyme. So there we were in the vet office ( we have a new vet after the first vet was horrendous. We've had this new vet for a few years now)
They did all sorts of blood work, exams, etc..nothing over the top just a good overall exam.
As we were discussing her Cushings history and all with the Vet Tech. The Vet came back in quickly and said "Athena is Diabetic".... I felt weak in my knees. All I could think was HOW MUCH MORE CAN THIS BEAUTIFUL CREATURE TAKE... Her numbers were off the charts. How did we miss this? The Vet said we didn't. The symptoms are much like Cushings except the weight loss but we thought that was due to her not wanting to eat after losing Axle. So... They immediately set her up with Humlin NPH insulin. We started out low. She must have this particular insulin and we get it from the pharmacy. Very costly but we don't care. She can't have the generic kind or the one people get at Walmart for 25 bucks. Her's is 170 a vile and she needs two a month because now she's up to two viles a month ( 30 units twice a day). We had to work up to that amount. Athena was very resistant to the insulin and her number were awful. The first few months were touch and go then suddenly after awful curve test results and all she started to come around. Since she couldn't d be on Veteroyl-we actually tried the lowest dose and she's a big dog but it nearly killed her again and we refused anymore of it. We were very apprehensive about starting that stuff again but they tried the lowest dose possible and same thing. She nearly died. ( the vet wanted her Cushings dealt with again because otherwise her Diabetes wouldn't get under control) We had to place her on a compound version of the drug from a pharmacy in Arizona. She actually responded to that one for whatever reason. Finally after so many touch and go moments trying to stabilize her she turned the corner and once again Athena was acting like a young dog, she lost more weight that she needed to lose, she played like a 6 mos old puppy, she was running despite her rear legs not being the greatest but it was amazing to watch.

All the hard work, keeping a logbook, never missing a dose of anything, her special food ( she's on RC Glycobalance which has been the only food to work for her) she was like a new Lab... I get tears thinking about it because she just became this vibrant lab again.

Then out of nowhere 4 days ago she lost her vision. OVERNIGHT. GONE. just like that. We knew there was a high chance of it ( 80% of dogs in the first 9 mos ) but we hoped she would FINALLY catch a break and fall into the 20 % category after everything.
No such luck.

We couldn't believe it. I know that people will say dogs without their vision do well, they don't use their eyes like humans do and more so use their nose but to watch it was horrible. She bumped into things, she had to learn to navigate ( we helped her) and she has been very anxious and confused. She's very sensitive now to sound. The worst has been watching her missteps and trying to make sure she doesn't hurt herself. Her back legs are not the greatest which is our concern. If she had a stronger set of legs it wouldn't be so bad.

Watching her look around but not really looking at anything is tough. I know we are to not feel bad for her. People say she doesn't feel bad for herself but I'm sorry I see her confused, anxious and no matter how calm we stay and encourage her it's been tough. We are using all the things to help her with small treats to navigate and scents and anything she needs.

There isn't a thing we wouldn't do for our dogs. Our Vet and her techs told us many times that if there is such thing as reincarnation they want to come back as one of our dogs.

I'm trying to keep my emotions in check but I'm so heartbroken inside. This girl has been dealt one bad hand after another ( like me with serious medical issues which is why I'm so bonded with Athena) and it's like another big punch in the gut.

We've done everything right so far and moved nothing and she's been adjusting here and there but it's so tough. My concern is hear back legs and if she falls and breaks a leg. It's over. Athena is not a candidate for surgery at all, not for cataracts, not for any injury because while she's doing better with things her diabetes is not totally stable but it's the best we're going to get for all she has going on. Other than this loss of vision she's been so happy and doing great. She actually found her toy last night and was playing with it. It was sweet to see but when I look at her eyes I see that strange color now and it's gut wrenching.

They want to do a tonometer test on her eyes but they want to give it another week so that she's not as anxious or the result will not be accurate. Her being anxious at all and this being new but I'm thinking no matter what she will be anxious because she will still not realize where she's at and she's always anxious at the vet even when she can see. She just hates going ( she's never forgotten her bad experience with our old vet when she was spayed and had her nails cut. Long story)


We just don't know what to do? Are we doing the right thing just going with the flow? This is affecting her quality of life to some degree. Is it right to keep going? We don't know what to do. She played that one time with her toy but now for the most part she sleeps. She always with me. I can't stand people saying "don't feel bad for her, she doesn't feel bad". While I don't show her I do feel bad. I don't believe she doesn't feel bad. I know her the best and I see her personality has changed. I want her to be safe. I don't want her to go out because she fell and broke a leg.

Also, if she can't have surgery....does this mean she will develop awful painful glaucoma because I can't have this beautiful girl suffer with the pain they say that causes. How do you even know if it's that or cataracts. We don't see the Vet till next week. Reading the stuff on these two things ( Cataracts vs Glaucoma) is confusing at best.

Any input is appreciated. Thank you. Sorry for sounding like a crazy person. I just wish this beautiful girl could have been given one stinking break!!!! Even though she is currently anxious and confused she still a strong beautiful girl and an amazing dog. I just wish she could’ve been given one stinking break

Thank you


We aren’t even sure at this point what she can see your can’t see

Thank you for listening I tried to make it short but didn’t work out that way


Her meds are as follows twice a day every 12 hours.

1/3 tablet of Compound Cushings Med
1 Carprofen
30 units insulin
Tramadol in between as needed
RC Glycobalance food A mixed bag of wet and dry every 12 hours with her insulin
Her treats are diabetic friendly treats along with homemade ones

[labblab]

Our Vet and her techs told us many times that if there is such thing as reincarnation they want to come back as one of our dogs.
I couldn’t agree more! You are such good and loving parents — no dog could ask for a better home. I’m so sorry about your loss of Axle, and now these added worries about Athena. Life is not fair, that is for sure. But first and foremost, it sounds to me as though you are doing all that’s within your power to provide the best situation possible for Athena. Some things are just out of our hands, though, and that’s the really hard part. I do think you’re doing the right thing by giving Athena (and yourselves) some time to adjust to your new challenges before making any big decisions. You may find that things settle down even more once a bit more time has passed, and that’s a good goal to hope for. I’m going to send a message to one of our staffers here who’s lived quite happily and successfully with blind babies. If she’s able to stop by, I know she’ll have some welcome words of support for you. I think it’s probably safe to say that Athena *is* bothered/affected by her vision loss right now, but it’s amazing how readily dogs can readapt to even the most challenging circumstances. So I’m hoping there’s more improvement yet in store for you.

Medically, it sounds as though you have all the bases covered right now. In terms of the vision loss, the cause of the blindness may already be quite obvious to your vet — cataracts or glaucoma, as you have suggested. But there is one other thing I can mention. There is a very rare and poorly understood cause of blindness in dogs named SARDS (“Sudden Acquired Retinal Degeneration Syndrome”). We are familiar with it here, because it appears to be associated with some of the same hormonal imbalances and bloodwork abnormalities as Cushing’s. It can literally strike overnight, so that’s one similarity that struck me about Athena. Unfortunately, the condition is irreversible. So in that sense, it doesn’t restore vision by identifying that diagnosis. But I did want to mention it to you as a possibility in the event that Athena’s eye exam doesn’t turn out to be consistent with the more common problems. A doggie ophthalmologist can diagnose SARDS for certain.

In the meantime, I’m so glad you’ve returned to update us, even though you have sad and difficult news to share. We’ll stay right here to talk things over with you, and to send our healing wishes to your sweet girl.

Marianne

[WeLoveAthena]

I couldn’t agree more! You are such good and loving parents — no dog could ask for a better home. I’m so sorry about your loss of Axle, and now these added worries about Athena. Life is not fair, that is for sure. But first and foremost, it sounds to me as though you are doing all that’s within your power to provide the best situation possible for Athena. Some things are just out of our hands, though, and that’s the really hard part. I do think you’re doing the right thing by giving Athena (and yourselves) some time to adjust to your new challenges before making any big decisions. You may find that things settle down even more once a bit more time has passed, and that’s a good goal to hope for. I’m going to send a message to one of our staffers here who’s lived quite happily and successfully with blind babies. If she’s able to stop by, I know she’ll have some welcome words of support for you. I think it’s probably safe to say that Athena *is* bothered/affected by her vision loss right now, but it’s amazing how readily dogs can readapt to even the most challenging circumstances. So I’m hoping there’s more improvement yet in store for you.

Medically, it sounds as though you have all the bases covered right now. In terms of the vision loss, the cause of the blindness may already be quite obvious to your vet — cataracts or glaucoma, as you have suggested. But there is one other thing I can mention. There is a very rare and poorly understood cause of blindness in dogs named SARDS (“Sudden Acquired Retinal Degeneration Syndrome”). We are familiar with it here, because it appears to be associated with some of the same hormonal imbalances and bloodwork abnormalities as Cushing’s. It can literally strike overnight, so that’s one similarity that struck me about Athena. Unfortunately, the condition is irreversible. So in that sense, it doesn’t restore vision by identifying that diagnosis. But I did want to mention it to you as a possibility in the event that Athena’s eye exam doesn’t turn out to be consistent with the more common problems. A doggie ophthalmologist can diagnose SARDS for certain.

In the meantime, I’m so glad you’ve returned to update us, even though you have sad and difficult news to share. We’ll stay right here to talk things over with you, and to send our healing wishes to your sweet girl.

Marianne


Thanks ♥️🐾 Marianne. How do we know if this is causing her any pain she doesn’t seem to display it but Athena is a very strong girl and doesn’t always let you know when she’s hurting even though we can pretty much figure it out but I just want to make sure she’s not having any pain in her eyes are her head how do we know that

We’ve always been able to tell when our dogs want to go and cross the rainbow bridge but Athena is a tough cookie And I just can’t imagine letting her go right now and she still seems to have alot life in her and still plays even though she’s trying to adjust to this nightmare

Do any of these things cause them pain ?

Thanks 🙏

[labblab]

I don’t believe that either SARDS or cataracts cause any pain — it’s just the adjustment to the loss of vision that’s involved. I don’t know as much about glaucoma, but I’m guessing it is more likely to cause headaches or actual eye pain. In that event, though, I’d probably expect the discomfort to be more readily noticeable in terms of rubbing the head or eye against things, and painkillers could be prescribed. Hopefully, your vet will be able to give you some good answers after the next exam.

It does seem totally reasonable to me to give sweet Athena some more time to get used to things. Fingers crossed that she’ll bounce back even more after she has the chance to get more adjusted!

[WeLoveAthena]

I don’t believe that either SARDS or cataracts cause any pain — it’s just the adjustment to the loss of vision that’s involved. I don’t know as much about glaucoma, but I’m guessing it is more likely to cause headaches or actual eye pain. In that event, though, I’d probably expect the discomfort to be more readily noticeable in terms of rubbing the head or eye against things, and painkillers could be prescribed. Hopefully, your vet will be able to give you some good answers after the next exam.

It does seem totally reasonable to me to give sweet Athena some more time to get used to things. Fingers crossed that she’ll bounce back even more after she has the chance to get more adjusted!

Thanks Marianne ( with are most favorite screen name ever )
Today she’s doing fairly well she was actually playing which was very good to see


I have a call into our vet I read up on SARDS and it blew me away. Athena normally drinks a lot of water that’s because of the Cushing’s and diabetes even though it is somewhat stabilized but we did notice in the last week that she was drinking a ton more water and we could not figure out why
We see it’s one of the symptoms before SARDS hits. We had no idea because we just chalked it up to her Cushing’s and diabetes

Really at a crossroads it’s really hard to see her like this but we are just trying to stay positive and encourage her and help her anyway we can. She has the strongest girl and most amazing Lab ever!


Thanks sooooooo much. We know it still may be the Diabetes but since she’s had Cushings since she was 2 and it’s advanced it very well could be SARDS

[labblab]

Yep, I don’t know that it is SARDS in Athena’s case, but just thought I’d mention it. Also, In advance of our staffer, Leslie, being able to stop by here herself, I’m copying a couple of replies that she posted to another member in February. There are so many helpful tips in what she’s written — I hope some of the suggestions may make things easier for Athena.


Losing eyesight is never a good thing but our babies adjust much better than we do much of the time. I have had a dog who was both deaf and blind, dogs that were only blind, and one currently that is blind in one eye. To help your sweet Pebbles adapt there are some thing you can do. One, find where you want your furniture to be and leave it - do not move things around. Two, watch her and see if she reacts more to sound or touch or scent to find her way around then accommodate that. One of my blind babies operated by touch - he could figure out where he was by what his feet felt. So I used rugs with differing textures at the doorways of each room. That way he knew when he felt that stiffness of artificial turf he was going into the back bedroom, the soft rug meant the kitchen and so on. He also used hearing to help him navigate so TVs stayed on at both ends of the house to help him get from one end to the other. He went at top speed fearlessly everywhere he went and was prone to crashing into things so my house became the bubble wrap castle. All the hard surfaces like table and chair legs were covered in bubble wrap. I got pipe insulation, slit it, and put it on the corners of walls, etc. Good Housekeeping would have fainted had they ever visited! :D I could have cared less and would gladly do it all again to have him back.

Another baby had sonar like a bat, I swear! She seemed to know where things were and would turn away or go around just as if she saw them....but she didn't even have eyeballs so that was impossible. She amazed everyone who ever met her when they watched her maneuver thru her dark world. I did my best to teach them both how to go and down steps but neither one could over come the fear of going down...but that was alright too; I had built a ramp for them to gain access to the yard and back to the front door again. Both learned how to find that ramp and used it like pros.

Both these babies were itty bitty babies but the one who was deaf and blind was a Great Dane. She was born with her condition and had learned to navigate fairly well as a stray - how she survived on the streets I'll never know. When I adopted her SHE taught ME how to communicate with her. After supper I would fill the dishwasher and turn it on then take her out for the night since she never got the hang of house training. In a very short time, I noticed that when the dishwasher started she would stand up and go to the back door....it finally dawned on me she was feeling the vibrations in the floor and knew what that meant. So I started working with her by hitting the floor for certain cues - 1 slap or stomp on the floor by her meant it was time to eat, 2 meant it was time to go for a walk, and so on. To play, I would stomp around then take an old blanket she like to lay on and drag in around the yard. She would put her nose to the ground and follow me by following the scent.

Pebbles will help you learn how to help her, too. I believe this. Just pay attention to her, watch her carefully to see how she operates, and don't baby her too much - you want her to learn to be as independent as she can. The more independent she can be in her home and yard the happier she will be....and you, too. So cry for her loss today but tomorrow start working to learn how the two of you can manage together - and I know you can!

There used to be some good online forums for blind dogs but I haven't checked on them lately. I'll do a bit of looking and post links if I find anything that would be good.

Hugs,
Leslie


Blind Dog Support
http://www.blinddogsupport.com/

And if you are on FB, here is their FB group (just be careful about opinions VS facts)
https://www.facebook.com/BlindDogSupport/

Here is a site that offers other tips you can try to help Pebbles adjust. I did use the scents on the rugs when my itty bitty man first came to live with me but soon he didn't need that at all.
https://www.blinddogrescue.org/dog-blindness/tips-for-owners/

More tips from BestFriends
https://bestfriends.org/resources/blind-dog-and-cat-faqs

And again if you are on FB, here is what a search on that site found -
https://www.facebook.com/search/groups/?q=blind%20dogs&epa=SERP_TAB

[Squirt's Mom]

Hi,

I'm sorry it has taken me so long to get back to you on this but Marianne has kindly found one of my posts concerning blindness in dogs that covers everything I can think of telling you. ;):D:cool: The main thing right now for me would be to determine WHY she lost her vision so suddenly. It is my understanding that in diabetes the loss of vision is a longer process, giving signs along the way. With SARDS it is very very fast tho - seemingly overnight like you described. But our babies don't always give us clues like a human who is losing their sight would so it may be that she has been experiencing chanced and simply gave no indication until just now when things had already gotten so bad. Not that knowing why will change how you approach this new world with your girl but it may give you some peace of mind and help settle this nagging Cushing's diagnosis issue. With SARDS often those cush sign disappear so no treatment for Cushing's is needed because Cushing's was never in play in the first place - it was the SARDS causing those confusing signs. If it is cataracts causing this issue there is the possibility they can be removed...but again I doubt the loss would have come on suddenly with cataracts. Like Marianne I don't think SARDS nor cataracts cause pain however glaucoma DOES cause pain. This condition is caused by a build up of pressure in the eyes and without treatment the eyes begin to enlarge and become very painful. My little Trinket, the who had the sonar like a bat, suffered with this before she came to me. Her previous owners neglected it and it cost her both her eyes but the pain was gone with the eyeballs and she carried on with life like the champ she was til her final day. I will add...if you don't like where your furniture is sitting today move it quickly then plan to leave it in place as long as Athena is navigating her way thru your house. They learn quickly for the most part what paths are clear so it is up to us to make sure things stay where they belong at all times.

Again I urge you to listen and watch Athena - she will help you learn how to best help her. All my blind babies taught me something by the way the handled their dark, and in Dinah's case also silent, worlds. And if you feel the need to grieve for her loss, do. But know she will be alright in time, usually sooner than we are. :)

I am so sorry for your loss of Axle. It is never easy to lose them nor to watch the surviving baby grieve because we understand the pain they feel and know there is nothing we can do to take it away. Only time can help and it will help, not heal, but yes help.

Hugs,
Leslie

[WeLoveAthena]

Hi Leslie and Marianne
Thanks for all the insight
The last week has been rough. Athena has done well navigating through the house but outside (even with a great fenced in yard)is bad. Initially she was doing ok with it to a point but the vet said that he may have still been able to see around her cataracts. Now however she has taken a turn for the worse when it comes to going up the stairs and there are only three stairs on the deck She’s had a few missteps going down and has fallen three times which is the last thing she needed and thankfully we are there with her or she would have really hurt herself because she has weakened hind legs from having been bit by lyme tick as a puppy and having Cushing’s so young. She had the Lyme before we got her but they didn’t tell us about it so we found out when we had her tested for having these really crazy symptoms. Then a year later she ended up with Cushing’s. Just this past January was her diabetes diagnosis. The vet said that they actually can lose their site from diabetes anywhere from six months to a year given Athena has been a challenge from day one and her diabetes has never really been stabilized like most dogs have it...that presented us with the possibility of her being hit early with blindness we had
hoped she wouldn’t have to go down that road. We have her on insulin and her medications for pain control what she does well on but we’ve never been able to get her numbers below 350 she has been resistant to insulin the entire time initially we couldn’t get her below the 500 and even 600 so where she’s at now is this good as it’s going to get for Athena with her diabetes. Except in the beginning when she was very ill until her numbers started coming down ( and we got her off that poison Veteroyl) we got her the best we can get her in terms of being stabilized then she started acting like a puppy again playing and running and just really having a great time and a super good quality a life despite what she had been hit with

Her Cushing compound med helped stabilize her diabetes to where it is now. She lost the weight that she had from Cushing’s which was a plus and she does great on her food that she eats which is RC Glycobalance.

Now we are just struggling with her coming up the stairs when she goes outside she does three to four circles around the yard to try to come up them we try to give her space so as to not make her feel crowded but we are there just in case of anything

The last two days she has flat out refused to go up the stairs she won’t lay down on the ground or she will stand there and bark at the stairs

It’s all I can do not to lose it but I try to keep everything in check it does feel like we are grieving the loss of her eyesight which I know sounds crazy but that’s what it feels like I know they say dogs that lose their sight they donwell but if I have one more person tell me how she doesn’t feel sorry for herself and not to feel bad for her I will slug them we have every right to feel bad the way we do. It’s gut wrenching to watch. We both do. In addition we don’t see her walking around not feeling sorry for herself she seems tired and edgy. We are keeping a positive tone of voice and encouraging her and doing everything in our power to help her. She does wag her tail super fast when she hears our voices and when she finally does make it up to us she is extremely happy

Our concern is the weakness in her back legs if she falls and breaks a leg or something she will not be able to have surgery not that we would ever put her through that but she is not a candidate for surgery for anything, not even her eyes which after seeing how they do the cataract stuff I don’t think we would let her go through that even if she could that is a horrible surgery with a long recovery and at her age given her health I don’t think it would be a kind thing to do for her I think it would be the opposite

She has been a trooper from day one she has always had one thing after another but has taken it in stride being a happy lab but you can see that it’s catching up to her she has been fighting and overcoming for a long time

Sadly the people that we got her from and we didn’t find this out until recently never performed a true health certificate on her it was fraudulent and they no longer do anything with labradors. We found so many things which of course would not have made us do anything different in terms of keeping her but it would’ve helped the treat her early on before things piled up

I remember when she was first getting sick as a puppy with vicious allergies breakouts on her skin and then we found out about the lyme bite We called them and all they would tell us that we could bring her back and switch her for another puppy we were upset. We said under no circumstances will we be bringing her back but we just need to know what was wrong so we knew how to treat her did her parents have any of these issues (we saw her parents). He replied know that nothing was wrong and they were very sorry but they could offer no insight

We would also come to find out later that her parents were brother/sister. All of our dogs have always been rescues except Athena we just did not believe it that they weren’t honest with us either way we wouldn’t have traded having her in our lives for the world

Right now we just don’t know what to do :-(. Our Vets say we’re doing great but it doesn’t feel like it
I’m going to be calling the vet in the morning to let them know how this weekend transpired with her for hauling and not wanting to come up the deck stairs no matter what I mean it literally takes at least 20 minutes where she finally will take the chance and do it

We would love to put a ramp here but this is not our permanent home we are moving at the end of July to our permanent home where we will have ramps (for dogs and us-with our human medical stuff). We were only here for a medical board for my husband has a combat wounded marine. He’s finally completed his board and officially retired and off we go soon

Athena will have to learn a whole new place. This could not of hit or at a worse time at least if we were already moved in and settled into the new place it wouldn’t be so bad but at this point she still has these wonderful moments where she grabs her stuffed animal after finding it and playing. She makes us laugh so much. She’s a jewel! in our lives but we don’t want her to suffer or be afraid or injure herself. Three Vets have already said she is definitely not a candidate for any surgery and we would never put her through it anyway we don’t believe in putting an older dog through all this awful stuff we rather they just have the best life for as long as they can, be kept pain free (Which she is on great pain medicine just like our older two were till the crosses the bridge ) and on a great note with dignity-peace-Love. We never could be able to stand watching her go through surgery even if she could and trying to recover from something so awful it’s just not fair at her age. On top of all this poor girl had a bad experience being spayed by a vet everyone claimed was the best but that shouldn’t even have a license but that’s a story that is over with. We got her through it and quickly found another vet.

Athena has never caught a break since being a puppy except for landing with us in our lives had anyone else had her I’m almost certain they would’ve given up on her. We have spent and are spending a fortune to treat her but she’s worth every penny and we will gladly go without to make sure she has the best of everything:-)

We should mention her we are legs have weakness from a few things disease related but she also has sort of a bow legged stance which we know is probably a result of the bad breeding

Leslie....Are you saying if it was from SARDS that she may have not had Cushing’s I’m a little confused on that one

Vets are saying it’s from Diabetes But is there something I should look into further and what would be the difference in treatment or anything?

Thank you for saying that it’s OK for us to grieve the loss of her vision I have always love the site because people really get it


At a loss......

[Joan2517]

Wow, the poor girl...there are removable ramps you might be able to try and then take it with you.

When I realized Lena was deaf, I cried for a week and I know no one else understood, but it was so sad to me that she couldn't hear me, and probably hadn't for a while. I was so afraid that she thought I didn't love her anymore. I didn't understand why she hadn't been coming to me when I called her. It took a while, but we came up with a new language between us: sign, making sure she was looking at me when I wanted her attention, stomping on the floor so she knew I was coming or that I wanted her to look around to see me, and touching her gently when she was sound asleep so she didn't get startled.

Athena needs you to teach her how to get around, and she'll learn, she sounds like a smart girl. it is so sad when you can't explain it to them, but she will follow your lead and you will become closer. When Lee realized that I wasn't ignoring her, and we worked on new communication methods, I sometimes forgot that she couldn't hear me anymore. The night she died at the ER the doctor called me to see if I wanted to try to get there before they put her to sleep, I asked her to put the phone to Lena's ear and I told her over and over how much I loved her and to please stay with me, but she was suffering and I couldn't let her wait 45 - 60 minutes. It wasn't until the next day that I remembered that she was deaf and couldn't have heard me anyway. But maybe she did hear me...

You and Athena will find another way, and it will work out....

[WeLoveAthena]

Wow, the poor girl...there are removable ramps you might be able to try and then take it with you.

When I realized Lena was deaf, I cried for a week and I know no one else understood, but it was so sad to me that she couldn't hear me, and probably hadn't for a while. I was so afraid that she thought I didn't love her anymore. I didn't understand why she hadn't been coming to me when I called her. It took a while, but we came up with a new language between us: sign, making sure she was looking at me when I wanted her attention, stomping on the floor so she knew I was coming or that I wanted her to look around to see me, and touching her gently when she was sound asleep so she didn't get startled.

Athena needs you to teach her how to get around, and she'll learn, she sounds like a smart girl. it is so sad when you can't explain it to them, but she will follow your lead and you will become closer. When Lee realized that I wasn't ignoring her, and we worked on new communication methods, I sometimes forgot that she couldn't hear me anymore. The night she died at the ER the doctor called me to see if I wanted to try to get there before they put her to sleep, I asked her to put the phone to Lena's ear and I told her over and over how much I loved her and to please stay with me, but she was suffering and I couldn't let her wait 45 - 60 minutes. It wasn't until the next day that I remembered that she was deaf and couldn't have heard me anyway. But maybe she did hear me...

You and Athena will find another way, and it will work out....


Hi Joan
Thank you so much for your kind words and sharing your story. I had tears in my eyes. I believe well Lena couldn’t hear you that you were both connected in your hearts. After I just wrote that one post and having a terrible week tonight things got a little better we started using the word “wait” and slightly touching her nose to help her not run into things. She actually navigated the steps better tonight than she has been doing. They are amazing creatures!

It’s just so heartbreaking to us and we are doing everything to keep our emotions in check but it’s just hard to see her like that. Athena has always been this super strong girl and mighty spirit and overcome so much. We had just hoped she would cut a break and not lose their eyesight after everything else that’s happened but it wasn’t to be. We’re going to look at some sort of temporary ramps here that we can use until we move just to make it safer for her the problem is her hind legs are weak Unless professionally built (Like at our new perm house ) we’re concerned about her getting down them safely. The ones we looked at tonight just didn’t seem to be very strong.

She did better on the steps tonight but in the house she had a few run ins because she got a little too ahead of herself which she can sometimes do with that’s when we start utilizing “wait” and slightly touching her nose which seem to start helping. She has the most amazing girl and I really just hope that this works out

Lena sounds like she was a wonderful doggy. Very sorry for your loss

[labblab]

How I wish I could just reach out and give you guys a big hug!!! At least I hope you can “sense” my arms around you from a distance!

I’m so glad to hear that things seem a little bit brighter this morning, and I sure hope that continues. I do have one suggestion as far as a temporary ramp. My 75-lb. Lab girl who passed away three years ago suffered from severe mobility issues at the end, and we were able to help her maneuver our steps with a ramp from this company:

https://store.petsafe.net/deluxe-telescoping-pet-ramp

Unlike lots of ramps that fold, this ramp “telescopes” and I think that may make it sturdier. Plus you can adjust the length, and thus the steepness, to fit a variety of heights. You’ll see the ramp comes in two sizes, so that also offers additional flexibility. Hopefully you might find it in a store so you could actually eyeball it in person. If you like it, you can then search for the best price on the internet — multiple sites offer it. I’m sure there are other good choices out there, too, but I just wanted to mention this ramp since we’ve had personal experience with it for a big dog.

As far as the SARDS, no, I don’t think it makes any big difference for you to pursue a definite diagnosis now since it couldn’t be reversed even if it was the cause. Also, since Athena’s Cushing’s was diagnosed so long ago, I wouldn’t question whether or not she truly has Cushing’s. That question comes up for us when newbies arrive here with questions about dogs who have just very recently lost their vision and also simultaneously first started to exhibit Cushing’s-like symptoms. In some cases, dogs with SARDS do also get diagnosed with Cushing’s, too. In other instances, sometimes all the symptoms except for the vision loss begin to ease after a couple of months, so the possibility arises that some other hormonal imbalance is at play. But in Athena’s case, she was legitimately diagnosed with Cushing’s a long time ago, so I don’t think there’s really any value in pursuing the SARDS diagnosis further now.

OK, continued best wishes to you and all your family — and especially sweet Athena!
Marianne

P.S. I just checked the dimensions of our ramp, and it’s the “Medium” which is the smaller and less expensive of the two sizes. It worked fine for us because we only had a couple of steps to deal with, plus Peg had her vision so she could easily see the sides. It might be all you’d need for Athena, too, but it’s good that the “Extra Large” is also an option for folks to consider if they’re interested in this brand of ramp.

[WeLoveAthena]

Athena has taken a turn for the worse. Every time we hope and it gets a little better
BOOM
Just returned from Vet. Getting her settled
Update to follow. Happened in a matter of an hour
:-(

[labblab]

Oh no! :-(((((((((((((((

We’re right here alongside you, awaiting word whenever you have the chance to post more.

Holding you all in my heart,
Marianne

[Squirt's Mom]

Here with you all the way.

Hugs,
Leslie

[WeLoveAthena]

**UPDATE**

July 1st I had a medical appt. My hubby stayed with Athena. They were laying together when I left. She was fine. I even snapped a pic of her. For some reason I didn't want to go to my appt but I had to and so I went on. J assured me they would be fine. He hadn't slept well most of the night before ( combat wounded Marine- long lasting effects of injuries) so he was going to lay with Athena and just grab a nap while I ran to my doc appt. Athena had been fed, had insulin and her pain meds. No doubt she would drift off and nap with him. She loves that.

I wasn't gone no more than 90 mins. I noticed I had a missed call from J and when I tried to call him back there was no answer. Of course I was worried but got right home
J said that Athena woke him up pressing her nose in his arm. She does that at times when she want's to go out but he said he noticed her right eye didn't seem right. She couldn't open it and her left eye was showing the third eyelid. Soon as I got there I saw it. We thought maybe she got up, walked around and injured herself while J had been sleeping near her. She was walking with her head at an odd angle and not wanting to open her eyes. We scooped her up and I ran her to the vet.

Our regular vet who is awesome wasn't there so we had to see the other vet ( not much of a fan but it's all we had). Brought her in and she didn't really even look at her and said that she is just going through 'the normal progression of the disease of Cushings/Diabetes". I said "Yes I know but something is wrong with her can we test her eyes to see if she has any injury to them". So they did a stain ( I had to ask for it). Nothing came up. No injury. She placed her on an eye drop antibiotic ( wasn't aware she had an infection) and said that if we wanted a 2nd opinion we could come back the next day to see our regular vet. I wanted to have a meltdown!! Our regular vet is amazing and would have done much more. I left after not being able to get this vet to comprehend something was not right. So I raced home with Athena who by now was not well at all. It was hot out, and no amount of AC was helping her. Got her home ( J had stayed home with our other dog and I ran her to the Vet). I got home and he got her out of the truck. She will not get into and out of the truck. We have to lift her to get her in due to her hind legs being weakened and now with no eyesight it's worse.

We were both very upset between me feeling bad for going to that appt, J falling asleep with her and he felt like he should have stayed up but who could have known this would happen. So our next move was to call a hospice vet we know very well. She's always been good to us and she was the one that helped our oldest dog cross the rainbow bridge 3 years ago.

Explained everything to her, sent her pictures, etc. She promptly responded by calling
She said this is something she's seen in dogs with Cushings and Diabetes. It has to do with the effects of the nerves as they do generate deposits of calcification like material on the nerves. It's neurological decompensation She thinks she had like a mini stroke or a small clot but while we were waiting for her to call poor Athena seemed miserable. We fed her by hand in order to give her some pain meds which seems to help her very much but we noticed each time we tried to feed her she would do this involuntary head tilt to the left several times in a row. As if when she attempted to open her mouth her head would tilt to the left. Her eyes looked horrible.

The hospice vet was talking us through a few things and we had pretty much done them all. She was going to head over in a few hours ( she lives about an hour from here and the emergency vet here isn't open until after 6pm you have to utilize your vet before that and we had zero luck with that other vet).

Within 30 mins from that phone call with the hospice vet Athena suddenly returned to normal. Just her normal eyes that can't see, no more head tilts, she had her personality back and we were stunned. She was tired and slept most of the day but when she was awake to go out and also when fed her and did meds she was good.

Called the hospice vet back and she said that was VERY good. We sent her a new picture to show her the difference. She has always known Athena to be a tough cookie and so amazing. Athena bounced right back ah inch the hospice vet said was really good because sometimes it can take a few days and sometime they don't return to their normal self.

Since then we've not seen her do anything like whatever that was....We did talk to our normal vet the very next day as well and she is seeing Athena tomorrow for an exam.

We really thought that was it...that we were going to lose her...and had to prepare for that...it was heartbreaking and shocking all at once however like in true Athena form she bounced back as if nothing happened.

The hospice vet is gone for 5 days but will call when she returns. At that point she had told us she supported us if we felt it was time to let Athena go and anytime we do because sadly Athena will just progress and nothing is reversible. This we know all too well. Right now however it's not the time and she agreed that since she bounced back Athena is not ready and so we are enjoy, as always, every minute with her.

We are always with her and this one time that this happened so fast one of us was asleep and I was at an appt. You can't imagine how awful we feel but right now we have to focus on Athena and getting her through....the reality of losing her hit so hard especially after just losing our beloved boy in December. It was so overwhelming. I laid on her bed with her all night last night.

Our reg vet said this may be a few things and she feels we can safely treat Athena to prevent another one of these episodes.( once we verify what this is exactly) but it could happen again. We are just concerned because we don't want her going out of this world in a bad way. We want her to go with the grace and dignity she's always carried in herself and her strong beautiful ways.

She's doing good on the deck stairs ( we are near her of course) and we notice by the evening are when she has a few missteps due to being tired or sore which it's generally when it's time to dose her and feed her.

We are using our voice and a few commands we taught her that she basically learned overnight...such a smart cookie. She always comes to my voice when it's time to come up the 3 deck stairs. She's so funny. J loves how her ears become very alert, she wags her tail and follows my voice. We always encourage her when she gets to the top. There have been a few times J had to pick her up- and she's a big lab but it's when she's just not wanting to get up the deck stairs. We will be moving soon to our perm home. It's concerning as if she makes it that far she will have to learn everything again. We hate that for her but we were only here temporarily. This will be our perm home with ramps and all ( because even J and I need them. Yes, we are mess but we make a beautiful little family and have overcome so much we've been through in war and all and our dogs are everything to us)

I don't know how to post pics in a thread to show you what we're talking about with how she was that day but maybe the description is enough.

We never used the eye antibiotics. She didn't need them. So since then Athena has been playing, eating well, taking her meds, happy and doing well but we don't know for how long that will last as this thing came out of nowhere and we're both so upset neither of us saw the onset.

I watched her and J in the yard last night. Those are the moments that cause the tears to fall. Seeing them walk together. How he helps steer her if she's headed too close to a tree or something. She has always been our faithful friend, protector and just an amazing girl. We know she's never really been the same after losing our boy in December. They were very close. Our other doggy is the wild child and she can't be around Athena much especially now but they are amazing creatures that we feel so lucky to have in our lives. Once of us is always with one of the dogs. It sounds crazy to most but it's our life and we love it.

The reality of losing her is hitting hard. We know it's coming. I just feel it. It goes so fast....we knew she'd never be that 12 year old lab but she's still young and that's the hard part but she's packed a ton of life in those years..
I don't let her see me upset. Neither does J because she's so in tune to us and we don't want her to be worried. She's the resident Nurse too. Always checking on everyone else.

Sorry I'm rambling again. Just wish we knew what did this but hopefully tomorrow brings some more answers...when the time comes to let her go our hospice vet will come to the house. Athena hates going to the vet hospital ( bad experience at our old vet changed her) and although she loves our vet now with Athena we will bring the hospice vet to the house where she's comfortable then off to the awesome place that took care of our two older doggies but we hope we don't have to for awhile.... Lately Athena has been laying right next to their urns.

As far as what happened has anyone heard of anything like this before?

Any thoughts?

[labblab]

I’m so sorry for my delay in having a chance to reply, but I’ve now read everything you’ve described. Once again, I’m so deeply touched by your devotion to your dogs, and especially by your tender attention to Athena in her hour of need. I’m afraid that, otherwise, my posting here will be short because I truly don’t know what might have been going on with that very weird episode. I just hope it was a “one-off” and won’t ever happen again!!

Otherwise, it sounds as though you guys are doing an exceptional job of helping her adjust to her new routine — and of surrounding her with love. That has to be the best medicine of all. So I’ll keep my fingers crossed that everything remains stable for now, and please do continue to keep us updated.

Marianne

[WeLoveAthena]

Note to Mod: How do I change the heading on my old thread if you merge this one with it? Thanks :)


UPDATE

Hello to all on the K9 Site
So....we took Athena into her regular Vet on Friday for an appointment. Normally she's very stressed at the vet but she did great. She was calm and didn't mind a puppy coming up to her to lick her in the face. It was so sweet. Everyone in the waiting room swooned over Athena. It was truly sweet to see. Not many see a Silver Lab in person.
Anyway...we went back and saw our regular vet who has been treating Athena. By now Athena was past her crisis and so the vet did an extensive and detailed exam of her whole body and eyes. Her right eye is all the way blind but her left eye still has some sight left in it. There are cataracts but she can see around the one in the left but she did great on her exam. She has pretty awful stifle in her left rear leg which we knew about but it seems worse. This is due to a bad vet who diagnosed her as a puppy as having a "muscle strain" when we brought her in thinking she injured her leg playing but they insisted it was nothing to worry about even after an X-ray. It didn't get better and we brought her back and saw their lead vet ( this again was our old useless vet hospital we used to go to) and he said the same thing..muscle strain.. WRONG... Years later with our new vet in place we find out Athena more than like blew her ACL and you can't imagine what that did to use to hear that. We would have treated her with it as a puppy when she would have been able to sustain a surgery. Now it's too late. So it healed wrong, and she over compensated with her right leg but we were always told the legs were due to Cushings. Thankfully we are in good hands now since last fall with our new vet. The only thing we've been doing is treating her pain but the vet would like us to try a round of Adequan injections and feels this is something Athena will greatly benefit from and is able to do. We are going to do it.
The crisis she had with her eyes, her head tilts, etc. was a vestibular crisis but not due to her ears or anything like that. More than likely from the Cushings and the neurological decompensation and calcification on the nerves but the good thing in this is she bounded back remarkably fast which most take a few days and some take weeks. For Athena it was hours...and she's been okay ever since.

We thought we had lost her..or were going to have to let her go but the vet said she's got plenty of life left and we saw it the other day when she found her stuffed animals and was playing again. Even though she can't see...she's back to playing and being her strong silly self. What a relief. Our vet said she understands how we felt that way because it's very scary to see a dog go through that but we did the right things by giving her some food, pain med and her Cerenia for possible nausea..and that may have just saved her and let her bounce back so fast. Whew.....

Reality that the Cushings is advanced in her young body and she can't seem to get as stable as she should be with the diabetes. She could have another attack like this again and it could be worse and would render her in worse shape...at that point decisions would be made. We will NEVER allow her to suffer or live a diminished quality of life and we can't do any surgery, nor would we for any reason at her age and health status.

The one thing right now that is really overwhelming is her insulin which I plan to call the vet back on Monday to ask about. Athena is on Humlin NPH by Eli Lilley and it's nearly $200 a vile now and she needs two a month on top of her pain meds, RC food, and now the Adequan which we want her to have to help those back legs be stronger to deal with her blindness...it's just overwhelming. We would go into hawk for our dogs but we want to know if there is another insulin that wouldn't drain the piggy bank as bad. The pharmacist even asked up ( because we get it at the pharmacy) why she isn't on several others available that are 1/3 of the cost and just as effective.

Does anyone here have a dual diagnosis dog with Cush/Diabetes? What type of insulin are they on? Anyone on this type? At the time she was placed on it we went along with it thinking it was the best and because she had unstable Cushings due to not tolerating Veteryol that almost killed her ( she's on a compound version now)

We want to ask the vet would it be a huge ordeal to change her from this one to another insulin because this one hasn't really stabilized her as best as can be in the last 6 mos since her diagnosis.

Our vet is one that would never make us do something to just do it. This vet hospital is unlike our previous one that guilted you into everything, made you do stuff that was not needed, and had a 300 percent markup on everything. This vet now is awesome, and there is a military discount and they really go above and beyond but right now everything is adding up so much due to the insulin....

Does anyone have any thoughts on that?

Thanks so much

Moderators: Prefer to stay on the Cushings side of the house. We were on the diabetes end for a bit but there were a few folks there that were not easy to deal with and it totally different than the Cushings crew.. THANKS :-)


Athena's current meds: Humlin NPH 30 units Q12 hours with food
Gabapenten, Carprofen for pain with intermittent Tramadol PRN
Trilostane q12 hours 1/3 flex tab Compund Version ( cannot tolerate Veteroyl
Name brand). Cerenia PRN. RC Glycobalance food
July 8th will start loading dose of Adequan for rear legs

[Squirt's Mom]

I have once again merged your latest thread into Athena's original thread. We like to keep all posts about each dog in one thread. That way it is easier to keep up with the history for that dog. Thank you for your cooperation in the future.

You are more than welcome to talk about her diabetes here in the Cushing's site however we are not the experts on that disease and you will not get many replies on Diabetes...we simply don't know. Our forte' is Cushing's, theirs is Diabetes. You will be shorting yourself by leaving the diabetes forum for us. ;) If you just don't like that forum you can try some of the Facebook groups if you are on Facebook. BUT again you will be shorting yourself because FB groups are filled with misinformation, opinion presented as fact, and pure nonsense. So the best bet, even tho you may not like everyone there, is to stick with K9Diabetes. If you are having particular problems with certain individuals who are being rude, dismissive, etc. then contact one of the Admins there and let them know.

I have had several dogs with Vestibular and if you search that condition here you will find that several others have as well. What I have seen in mine was that it came on very quickly with circling to one side or the other for weeks and when that got better they still didn't move forward in a straight line - they moved, or actually staggered, sideways, circling from time to time. Nausea was a big part of it for all of them which resulted in a loss of appetite. In the dogs who had eyeballs the eyes move side to side very rapidly - this is the hallmark of Vestibular according to our vets. It took months before any of them were right again. Athena's case is very different from any I remember reading about or seen in my own. She is lucky it left as quickly as it did!

As for switching insulin - I won't even attempt to discuss that or anything about diabetes treatment. I was just diagnosed as Type II and it is a very difficult disease to get a handle on and control. In humans there is no one path, no one diet, no one treatment that works for all - it is widely varied. And from the little I know about canine diabetes the same is true for them. I have no first hand knowledge or experience so I can't in good conscience offer guidance on that disease. Again, I strongly recommend sticking with the diabetes forum.

But I CAN change her thread title and will be glad to do so! :)
Hugs,
Leslie

[WeLoveAthena]

I have once again merged your latest thread into Athena's original thread. We like to keep all posts about each dog in one thread. That way it is easier to keep up with the history for that dog. Thank you for your cooperation in the future.

You are more than welcome to talk about her diabetes here in the Cushing's site however we are not the experts on that disease and you will not get many replies on Diabetes...we simply don't know. Our forte' is Cushing's, theirs is Diabetes. You will be shorting yourself by leaving the diabetes forum for us. ;) If you just don't like that forum you can try some of the Facebook groups if you are on Facebook. BUT again you will be shorting yourself because FB groups are filled with misinformation, opinion presented as fact, and pure nonsense. So the best bet, even tho you may not like everyone there, is to stick with K9Diabetes. If you are having particular problems with certain individuals who are being rude, dismissive, etc. then contact one of the Admins there and let them know.

I have had several dogs with Vestibular and if you search that condition here you will find that several others have as well. What I have seen in mine was that it came on very quickly with circling to one side or the other for weeks and when that got better they still didn't move forward in a straight line - they moved, or actually staggered, sideways, circling from time to time. Nausea was a big part of it for all of them which resulted in a loss of appetite. In the dogs who had eyeballs the eyes move side to side very rapidly - this is the hallmark of Vestibular according to our vets. It took months before any of them were right again. Athena's case is very different from any I remember reading about or seen in my own. She is lucky it left as quickly as it did!

As for switching insulin - I won't even attempt to discuss that or anything about diabetes treatment. I was just diagnosed as Type II and it is a very difficult disease to get a handle on and control. In humans there is no one path, no one diet, no one treatment that works for all - it is widely varied. And from the little I know about canine diabetes the same is true for them. I have no first hand knowledge or experience so I can't in good conscience offer guidance on that disease. Again, I strongly recommend sticking with the diabetes forum.

But I CAN change her thread title and will be glad to do so! :)
Hugs,
Leslie

Hi Leslie
Thank you for merging everything yes if you could just change the subject line for us to update just that word would be great instead of with the original title was on the original post

Unfortunately there was a particular individual that kept showing up in my posts on the diabetes site that was just downright annoying no matter what we said they just came back with such annoying irritating and aggravating posts

In the middle of dealing with all this effort last thing you want to hear while I don’t mind constructive criticism or opinions I believe that there’s a way to be kind and tactful about it and not downright annoying

This person just thought they knew everything and while they may have known a lot they were very obnoxious to the point that I asked for a thread to be removed from the diabetes site

Other than this forum we don’t do any social media we’ve never had a Facebook Twitter or any of those things and never will

we just feel like those places are a three ring circus :-)

Yes I Thena recovering very quickly from her crisis which we are so thankful for and the vet was amazed but we are always amazed at how strong this sweet lab is. She’s a strong soul that overcomes so many things today it’s just wonderful to watch her play and be happy considering how bad she was the other day where we thought we were actually going to lose her

I’m going to call the vet tomorrow about her insulin. I spoke with two pharmacists that are very much dog advocates and felt that Athena would be fine on a different insulin that wasn’t so outrageously overpriced and believe me they were kind enough to give us discounts and still it’s over the top $$$&& but they didn’t see why she had to be on the specific name brand insulin. So we will be checking on that tomorrow but on top of that Athena hasn’t really been stabilized with her numbers even though they say not to worry too much about that and more how she feels

Right now getting the Cushing’s regulated is what we’re working on. It was going well now it’s not she’s on a compound version of her Cushing’s medicine that may need it dose increase the vet believes that’s what needs to be under control for her to respond better to her diabetes treatment

[Katy1]

Hi,

I also have a dual diagnosis pup. Annie is a 10 year old miniature schnauzer who has been diabetic for over a year and was diagnosed with cushings in February of this year.

I share your frustration with the k9 diabetes forum and I’ll leave it at that. As far as insulin goes, Annie has always been on Novolin N—that’s what it says on the box and we buy it at Walmart for 26.00 a bottle—-no kidding. We started off buying it at CVS but were paying 120.00 for it there. We found out about the Walmart price by accident.

Uncontrolled cushings has a direct effect on how insulin works or doesn’t in dogs but you should probably talk to your vet about that. I hope this has helped a little. Blessings to you and Athena. Karen

[WeLoveAthena]

Hi,

I also have a dual diagnosis pup. Annie is a 10 year old miniature schnauzer who has been diabetic for over a year and was diagnosed with cushings in February of this year.

I share your frustration with the k9 diabetes forum and I’ll leave it at that. As far as insulin goes, Annie has always been on Novolin N—that’s what it says on the box and we buy it at Walmart for 26.00 a bottle—-no kidding. We started off buying it at CVS but were paying 120.00 for it there. We found out about the Walmart price by accident.

Uncontrolled cushings has a direct effect on how insulin works or doesn’t in dogs but you should probably talk to your vet about that. I hope this has helped a little. Blessings to you and Athena. Karen

That’s strange I just posted a response but it disappeared anyway I wanted to thank you because your post helped us tremendously that’s the exact insulin that both are pharmacists told us about. Calling the vet tomorrow on that

I feel the same way about the diabetes site and I’m trying not to say a lot but I too will leave it at that I probably already said too much but I definitely will not be returning there

We are just trying to do the best we can for our girl to give her the best days that she can have it for as long as she can have without letting her suffer

Again thank you so much for your post it really did help us a lot :-) we will keep you posted

I forgot to say that yes were working on controlling her Cushing’s it may just require an increase in her compound medicine which we may be doing this week. She’s on the flex tabs but the pharmacy is out of state and has notified our vet that the flex tabs are no longer available and it’s going to be an elixir form that we will have to give her

[Katy1]

Hi back, I’m glad I could give you some hopeful-helpful information. I spent time this afternoon reading through your prior posts. My goodness you guys have been through hell and back with your pups over the years and now your baby Athena.

We have traveled similar paths but I don’t know your first name. I totally understand if you want to remain anonymous. However, because we both have dual diagnosis pups and neither of us really connect with the diabetes site would it be ok if I send you a personal message through this site? I’m not trying to invade your privacy, it’s just that I think we could be sounding boards for each other off the public forum.

First of all, my husband and I thank your husband for his service. And we thank you too for your service. My husband is a Vietnam vet but was not in direct combat. We also have health challenges. Like I said, we have more in common than you know. Blessings to your family, Karen

[WeLoveAthena]

Hi back, I’m glad I could give you some hopeful-helpful information. I spent time this afternoon reading through your prior posts. My goodness you guys have been through hell and back with your pups over the years and now your baby Athena.

We have traveled similar paths but I don’t know your first name. I totally understand if you want to remain anonymous. However, because we both have dual diagnosis pups and neither of us really connect with the diabetes site would it be ok if I send you a personal message through this site? I’m not trying to invade your privacy, it’s just that I think we could be sounding boards for each other off the public forum.

First of all, my husband and I thank your husband for his service. And we thank you too for your service. My husband is a Vietnam vet but was not in direct combat. We also have health challenges. Like I said, we have more in common than you know. Blessings to your family, Karen


Yes :-). Please send me a PM. Thanks

[Katy1]

I will send you a message tomorrow. Today was a long day so please forgive the brief delay. Blessings, Karen

[WeLoveAthena]

I will send you a message tomorrow. Today was a long day so please forgive the brief delay. Blessings, Karen

Absolutely :-). We understand it’s been a very long week for us
Chat soon Thanks so much

[Katy1]

Did you receive my message? Karen

I hope all is well.

[WeLoveAthena]

****UPDATE****
Athena recovered very quickly within hours of what they determined was a vestibular crisis
She had a very detailed exam by our actual vet and found out that one of her eyes is completely blind and the other one is partial but she is losing that sight rather quickly in that eye but with her cataracts they think she can still see around them a little bit she does amazingly well going where she needs to go but one of us is always with her if not both of us when she goes outside. She does really good in the house and we are hoping when we move she adjusts quickly. At her house we will have ramps everywhere and not stairs so it’ll be great for her

She still on the same pain medication and we just received her new Cushing’s medication which is a compound form of Veteroyl because she cannot handle the name-brand stuff but this time it’s an elixir form because the Pharmacy that we were getting it from in Arizona can no longer ship to our state so we had to go through another compound pharmacy which only makes an elixir form praying that it’s basically the same thing and there’s no side effects from it

She was placed on Adequan and we agreed and then we kind of went back-and-forth because we just didn’t want to have to let her have another injection of something given she gets to insulin shots twice a day but we decided to go for it and today she had her first injection. I gave it to her the first five shots are given IM. Being a nurse I’ve given thousands of those kinds of shots to humans and I’ve been through so much as a nurse and combat sounds that I cannot believe how edgy I was about giving Athena this shot but I guess it’s because she’s our dog and our girl. But I just got past that by knowing that we are trying to help her and not hurt her but for all that built-up stress of giving her an injection IM she did great she didn’t even act like it phased her it was a highly successful first injection. WOOOO HOOOO!!

She got a very special treat for that :-)

I forgot to mention the only other changes we switched from the $225 + Humlin N to the Novolin N for $25. Thankfully so far she’s doing well on the note from when and this has allowed us to free up funds for her other needs we would never have switched her without talking to the vet or doing our homework which we did extensively speaking with several pharmacists and a pet pharmacist And input from some awesome people on this site are wet was a little unsure about it but she said to watch her closely and maybe Athena is just one of those dogs that will do well since she’s pretty unique in so many ways. Athena always falls into that small percentage category. We had to adjust her Cushing’s medicine because if we can’t get that under control her diabetes will never be all the way under control either and that’s what we are battling but at least she’s holding out good on this insulin because she needs 2 vials a month it was getting outrageous just for her insulin and we want to make sure she has everything she needs

We've said it once and will say it again she’s quite an amazing lab!

Hope everyone here is doing well just thought I would give everybody the update after that scare we had with her last week

[WeLoveAthena]

Our Beautiful Silver Labrador Athena crossed the Rainbow Bridge @0842 on Saturday 7/27/19
Will explain more later. Unable too at this time. Our hearts are completely broken but she’s free now. she flying by the light of the silvery moon. Our beautiful Silver Belle Athena was everything to us....everything
Thank you to all that helped us since the day we arrived here :-(

[labblab]

I am so, so sorry to read this news. I know how precious Athena has been — and will always be — to your family. In the midst of your own sorrow, thank you so much for letting us know what has happened. Athena now joins our other angels on our special memorial thread:

https://www.k9cushings.com/forum/showthread.php?9161-Remembering-All-Who-Have-Left-Us-(2019)

She’ll always be honored by her family here, and we’ll always remain here for you, as well, at any time that you may wish to return and tell us more.

My heart goes out to you from across the miles,
Marianne

[Joan2517]

What sad news...I am so sorry for the loss of your beautiful girl.

[Squirt's Mom]

I was so saddened to read your post telling us that Athena had left this life. :( Having been in your shoes more times than I care to count I know too well how you are feeling today and in the weeks to come. It was 5 years this May that my beloved Squirt had to leave and I still cry for her. The void she left behind will never be filled...and I don't really want it to be. All those tears I have shed and will shed are simply an expression of the love we shared. I believe she remains with me - I see signs from her all the time, and I know I will see her again one day when my job here is done but there are times I want so badly to just touch her again right then and knowing I can't breaks my heart all over again.

There is no doubt Athena was deeply loved and I know she carried that love with her across that Bridge. She will hold that love in her heart until the day you cross that Bridge and are reunited with her once again. Until then, she will watch over you just as you watched over her all those years.

My deepest sympathies,
Leslie




Rainbow Bridge
Author unknown

There is a bridge connecting Heaven and Earth.
It is called the Rainbow Bridge because of its many colors.
Just this side of the Rainbow there is a land of meadows,
hills and valleys with lush green grass.

When a beloved pet dies, the pet goes to this place.
There is always food and water and warm spring weather.
The old and frail animals are young again. Those who are maimed
are made whole again. They play all day with each other.

There is only one thing missing. They are not with their special
person who loved them on Earth. So, each day they run and play
until the day comes when one suddenly stops playing and looks up!
The nose twitches! The ears are up!
The eyes are staring! And this one suddenly runs from the group!

You have been seen, and when you and your special friend meet,
you take him or her in your arms and embrace.
Your face is kissed again and again and again, and you look
once more into the eyes of your trusting pet.

Then you cross the Bridge together
never again to be separated.