Newly diagnosed and scared

[Pbalca426]

Hi everyone. My eight year old boston terrier Rambo was diagnosed with cushings last week. Vet said he seemes to be in the pretty early stages. He wants me to start giving a half of a lysodren pill twice a day starting tomorrow. He also gave me prednisone and told me to give a half tablet once a day. Has anyone had any experience with this? From what I have read the prednisone is used as an emergency pill. Any advice and experience would be greatly appreciated as I am scared to death to do the wrong thing!! Thank you all in advance!

[DoxieMama]

Hello and welcome to you and Rambo. I have no experience with lysodren but others do; with the holiday weekend in the US it may be a bit before someone else sees your post. But I'm sure when they do, the experts will be able to chime in with suggestions.

In the meantime, can you provide us any more information about Rambo's diagnosis? What symptoms does he have that led to the testing, and what were the results of those tests? Actual numbers for bloodwork that is out of range, as well as those from an ACTH or LDDS test if they were performed, would be helpful.

[labblab]

Welcome from me, too! Shana has already asked many of the questions that will help guide our thoughts and suggestions. But since you are starting the Lysodren today, I’ll cut to the chase re: the typical loading protocol with which we are familiar. Here’s a link to a post that provides a lot of helpful information:

http://www.k9cushings.com/forum/show...d-related-tips

First, in order to judge the appropriateness of the dose, we’ll need to know Rambo’s weight and also the size of the Lysodren tablet. Secondly, has your vet instructed you re: the signs to watch for that will indicate that Rambo has had enough loading doses of the Lysodren and the daily treatment should end?

I am concerned that you’ve been told to give daily prednisone in addition to the Lysodren. A few vets feel that this eases the loading process for the dog. But our experience here over the years is that the daily prednisone can make it easier for a Lysodren overdose to occur. Since the prednisone acts as a substitute for cortisol in the body, the prednisone can mask the observable effects of the Lysodren that signal that the loading phase should end (e.g., decrease in thirst, even subtle changes in appetite). As a result, you may continue giving the Lysodren for too long a time with a resultant overdose.

We are not vets, so I don’t feel comfortable with telling you to change the treatment plan without first discussing it with your own vet. But if it were me, I’d want to talk further about the pros and cons of the daily supplemental prednisone. As you’ve already discovered from your own research, it is far more common to reserve the prednisone solely for rescue use should natural cortisol drop too low.

Once again, welcome to both you and Rambo, and we’ll look forward to learning more about your boy!
Marianne

[Pbalca426]

Thank you so much for your quick responses! Incresed thirst and urination are what lead me to the vet. I noticed the symptoms beginning around 3 months ago. He also began to develop a potbelly and seemed hungrier then usual. He had both the ATCH and LDDS tests run but I don't not have a copy the full results but I will get them on Monday when my vet reopens! Rambo weighs 27 pounds and I was instructed to give him 1/2 of a 500 mg tablet twice a day. And the prednisone prescribed was 5mg and 1/2 a tablet a day. I was told decrease in appetite would be my first sign to stop dosing which is scary to me because Rambo has always loved to eat! The link you provided had great information!! Thank you both so much again!

[Squirt's Mom]

Hi and welcome to you and Rambo!

We are a Lyso house, or were when treating my cush baby. The loading dose is 50mg/kg/day divided into 2 even doses. At 27lbs, Rambo weighs 12.2727...kg. So the loading dose would be 12.27x50mg = 613.6363...mg a day/2 for a dose of 306.1818...mg twice a day. Since Lysodren only comes in 500mg tablets that would be rounded to around 275mg 2x a day. Half a tablet would also be acceptable (250mg 2x/day). Lysodren can be compounded to the any dose not available by using the 500mg tablet if needed. But I think this dose will be ok tho it may take a bit longer to load. The med MUST be given with a meal so the drug can be properly absorbed. Using pred along with the Lyso is a bit like trying to put out a fire with gasoline however. AND the use of the pred WILL ensure it takes much longer to load than needed. Pred should be used ONLY as a rescue measure if the cortisol should drop too low.

Read the link Marianne posted on the tips for using Lyso and that should help a great deal. Don't be afraid - this drug is life-saving and used correctly will help Rambo regain much of his old self. Ask any questions you may have and NEVER hesitate to express any concerns you may have. If you see ANY of the signs listed such as a decrease in appetite (which may be very subtle such as looking up from his feed bowl if called when before he would not have done so) or a decrease in water intake (we have a spreadsheet to help track water intake here - http://www.k9cushings.com/forum/show...s-Water-Intake) stop the Lyso immediately and call the vet for an ACTH in the following 2 days. This is where the use of pred can really be an issue as Marianne explained.

I'm glad you found us and look forward to hearing more soon!
Hugs,
Leslie

[Pbalca426]

Thank you so much! I have already placed a call in with my vet and will definitely be discussing the prednisone! I was extremely nervous about starting the lysodren but am now feeling much better and more confident as you have all given great information!! I appreciate it tremendously! It's great to know I'm not alone

[Pbalca426]

I just wanted to update, I talked to my vet and he confirmed all you had said. Apparently he was dealing with an emergency at the time I came in to pick up the medication and the girl at the front desk had given the wrong instructions. Just wanted to say thanks again!

[Squirt's Mom]

Oh wonderful! I am so glad you talked to the vet and got that straightened out. Too often we have seen where techs get things confused so it is always good when the vet will talk with us. Way to go, Mom....that's the way to be proactive and speak up for Rambo! Good for you!

Hugs,
Leslie

[molly muffin]

Hello I just wanted to check in and see how the loading went with Rambo. Everything going alright?

[Pbalca426]

Hello, sorry I haven't posted! I've been so preoccupied with Rambo and the holidays my mind was on overload! Thank you so much for checking in!! I am beyond happy to report that Rambo has been doing great! After starting his Lysodren a little over a month ago he has had 2 ACTH tests. The first was 5 days after staring the loading phase and the results came back good so we went on to half a tablet once every 3 days. We retested a month later and got the results back today that everything is where it should be and to continue on and to retest in 3 months! He seems to be doing great and is gaining many of his "quirks" back which I had previously thought prior to diagnosis were lost due to age. His appetite and water consumptiion are back in check, but he still seems to be asking to go out a little more then before. Anyone have any input on if this is normal? It also could be due to the fact that when it is cold he likes to pee very quickly and come back in (can't blame him! We are in Ohio and in negative temperatures now!) Also prior to diagnosis I noticed his back legs would slid out a little on kitchen floor and he wasn't jumping as much. He doesn't really have any trouble with his legs sliding anymore but still hesitates to jump on couch and bed sometimes. I have tried buying steps which he wanted no part of. It's hard to know what is age related and cushings related. Does back leg strength contunue to get stronger? More exercise? Any suggestions on vitamins or natural supplements? Thank you so much, I am so happy to have found a wonderful support group! I hope you all had a great holiday!