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Thread: My big boy Gable

  1. #151
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    Default Re: My big boy Gable

    For a blood draw, I can just walk in. They already know i'm coming in sometime. This is just to test the cortisol level, right? My vet won't be in and i just want to make sure they know what they are testing for.
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  2. #152
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    Default Re: My big boy Gable

    Yep, that’s my understanding, just a pre-pill resting cortisol. I can’t remember whether he had his electrolytes checked with his ACTH? If so, I wouldn’t see any need to repeat them so soon. If not and if it’s been a while, they could always run a basic blood chemistry panel, too, just to make sure everything’s OK in that department. That way, you’d have added reassurance that he’s not being oversuppressed.

  3. #153
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    Default Re: My big boy Gable

    If he had it with the ACTH test, they didn't tell me, so i'll assume not. I'll tell them to include it tomorrow. Thanks, Marianne.
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  4. #154
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    Default Re: My big boy Gable

    My vet called this morning with Gable's results:

    His resting cortisol is 4.1 (ref range from 1.0 - 5.0)
    Alk Phosphatase is 403 High (ref range 5 - 131)
    Testosterone is less than 20.0

    The vet was so excited about the pre-pill testing. He checked with a Dr. Nichols, who seems to be the "it" endocrinologist around these parts, who was also very excited about the pre-pill testing and said that they have found that bigger dogs sometimes do better on lower doses....gee, where have I heard that before?? LOL!

    So, I don't know what that high Alk means...
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  5. #155
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    Default Re: My big boy Gable

    The elevated Alk Phos is a typical finding of Cushpups, and reflects steroidal effects on the liver. Gable’s elevation is actually fairly mild compared to many dogs, and really nothing to worry about. It may or may not ever return to being within the normal range. But again, that’s no big deal.

    The really interesting thing is Gable’s cortisol level! Thank you guys so much for being our guinea pigs with this new testing protocol. From these results, there are no worries that he’s being oversuppressed, and that’s something that we were fretting about after his ACTH. In fact, based on the new monitoring chart, theoretically you could actually increase his dose since he’s still exhibiting symptoms! Given where his result fits into the chart below, you’ll see that they talk about increasing the overall dose and/or dosing frequency. If you don’t feel comfortable raising his dose just yet, one thing you might consider is to divide his current dose into morning and evening administrations, unless feeding him and dosing him twice daily is a pain for you. For instance, given the capsules you already have, you could give him the 30 mg. in the morning and the 10 mg. at dinner. Dechra says that if twice daily doses are not equal, give the bigger dose in the morning.

    It might be worth a try, just to see if that improves his symptoms any. If not, you might go ahead with an overall dosage increase. Just some thoughts to consider. And yes, Dr. Rhett Nichols is a huge name among American endocrinologists and Cushing’s researchers. If your vet can actually consult with him, you are in super good hands! I’d be curious to know what he’d recommend doing, given Gable’s results.

    Oh, and I guess we can rule out testosterone as the cause of Gable’s erections. Really dunno what else to think about that...

    Anyway, good job, Joan! This new testing is exciting, for sure! Oh, and here’s that monitoring flowchart:

    http://www.k9cushings.com/forum/atta...5&d=1521562345

    Marianne

  6. #156
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    Default Re: My big boy Gable

    Great job, Joan!!! And yes, thank you so much for trying this new protocol out!!!

    I agree with Marianne on splitting his dose if he is still showing signs; 30 mg in the morning and 10 mg in the evening.

    And again....GREAT JOB!!!

  7. #157
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    Default Re: My big boy Gable

    Thanks, Lori! Really, the only thing I've done is listen to you all and put my foot down with the vets about how I want the treatment to go this time.
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  8. #158
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    Default Re: My big boy Gable

    Came home to vomit today in the kitchen, two spots. Not sure if it was Gable or not, didn't seem big enough to be his, so I didn't give him the 10mg tonight with dinner. He seems fine, not lethargic, was playing with Cooper this morning, and he ate dinner.

    Could have been one of the others...Doree has wax buildup in her ears and is acting a little funny, sleeping so soundly that sometimes I think she might be going deaf. This morning my husband thought she was dead. She's eating though, but drinking more than usual.

    If Gable still seems okay, I'll give him his 30 mg in the morning with breakfast.
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  9. #159
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    Default Re: My big boy Gable

    Good call, Joan. How are Gabe's symptoms? Sorry to hear about Doree and hope she is back to normal soon.

  10. #160
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    Default Re: My big boy Gable

    He's still good, Lori. It probably wasn't him. He seems fine. We can't believe how much he's been playing...with Cooper, with toys again.

    Doree is acting strange...she seems confused. I will probably take her back to the vet tomorrow. I forgot to show them something else that's on her face besides the lump on her lip. And I think the cream is too much for her ears. They are getting gooky with it and it seems to be building up. Of course my husband could be putting too much in, but I made him stop last night. The worry now is her heart murmur went from a 3 to a 4, but she's not symptomatic, no coughing, just sleeping more soundly than she ever did. She became the matriarch after Lee died, and she's more attached to my husband. He will be devastated if anything happens to her...our little Doree Darling.
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

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