Newly diagnosed and scared

[molly muffin]

Well glad there is a diagnosis and a plan to treat it. Hopefully you'll see an improvement soon, although I understand it can take awhile to clear up

[Pbalca426]

Hi just heard from vet and wanted to share a quick update. Rambo went in for bloodwork and an ACTH test yesterday. Vet said his blood work came back good, ALP (I think is what he said) was still elevated some, which isn't uncommon with cushings, but that it was down some from last time. His post ACTH was 3.6. Yay! He said after his induction (which was probably 5 or 6 weeks ago) he was at 3.9 , so just to watch him for vomiting, diarrhea, or loss of appetite to make sure it's not going down anymore. Going to recheck in 6 weeks. His skin definitely isn't getting any worse, which is good. I actually think some new hair might be starting to grow! Thankful for some good news today! Hope everyone is doing well!

[Squirt's Mom]

WOOHOO!! Great news at last! And talk about perfect post #s!! I know you were thrilled to see those numbers! YAY!! Hopefully it will be smooth sailing from now on.

Hugs,
Leslie

[molly muffin]

Awesome news and a very good post result. Congratulations.

[Pbalca426]

Hi all, hope everyone is doing well! Just wanted to check in and get some advice. Since getting over the demodex, Rambo's hair has grown back fully and is now extremely thick and wavy we just had a blood and stim re-test yesterday and heard back from vet today. His previous post from June was a 3.9 I believe. Yesterdays post was a 5.2 or 5.4 with his phosphorous levels slightly elevated from last time. Rambo is still doing great, maybe noticing a slight increase in appetite and water intake but nothing crazy. Vet gave two options.. option 1 is to increase weekly dose from 1/2 lyso tablet 4 days a week to 5 days a week and rechecking in 6 weeks. Option 2 is to keep doing what we are doing since it's only slightly over the 5 post and no significant changes in Rambo and to recheck in 2 months. He said hes not sure there is a right or wrong option at this point but that he would be slightly concerned that the post could continue to rise and we would need to go through another induction phase. Any opinions and thoughts would be greatly appreciated!!

[Harley PoMMom]

I'd go with the increase in the Lysodren dosage, but I'm not sure by how much. To clarify the dosage for me, he is getting 1000mg total being split into 250mg 4 times a week? And the vet wants to increase by adding in another 250mg, right?

[Pbalca426]

Yes, that's correct.

[Squirt's Mom]

Do we know if Rambo has the pituitary or adrenal form of Cushing's? I looked back thru his thread and didn't see where he's had an abdominal ultrasound. So my concern is 1) he has the adrenal form and if so we would expect his cortisol to be more difficult to control or 2) there is something else going on, like a tumor on one of his organs causing a stress response of elevated cortisol in spite of the Lysodren. 1250mg/week is a massive dose for a dog Rambo's size - about 3x what we would expect him to need. Personally, if I could afford it, I would want the ultrasound done asap then decide whether to go with a dose increase or a re-load.

Let us know what you decide and how this sweet boy is doing!
Hugs,
Leslie

[Harley PoMMom]

1/2 tablet twice a day

I am happy to say I can finally update with some good news! After almost a couple weeks and 3 very expensive ACTH tests, Rambo's post is finally below 5 and we are ready to start maintenance!! We will be doing 1/2 lysodren tablet on Monday's, Tuesday's, Thursday's, and Friday's. Rambo's drinking and urinating have almost returned to normal, it's so nice not to have to take him out several times in the middle of the night! Lol! Will do another ACTH rest in 3 weeks. Thank you for everyone's help and support so far it feels great to finally be able to share some good news!! Hope everyone has a great weekend!

I'm including these posts so I can get a handle on Rambo's loading dose, so please bear with me If I have this right, Rambo loaded on 500mg daily (250 mg given twice a day) and this was given for a couple weeks? Now, can you tell me exactly how long he was on this loading dose?

Generally with Lysodren the loading dose is 50mg/kg so for Rambo's weight, at that time, of 27 lbs his loading dose should have been 633 mg being split and given twice a day. However since Lysodren comes in 500mg tablets it was easier just to divide those pills in half and give that, right? Which would explain why it took longer for him to load.

Lysodren does involve tweaking to maintain the load and sometimes the dog may even need to be reloaded.

[Pbalca426]

Rambo has not been diagnosed with the adrenal or pituitary. At the time of his first appointment with the IMS which was back in January I believe we had talked about doing an ultrasound. The vet said for several reasons (which I cant remember off the top of my head right now) that he was fairly certain we could rule out adrenal so we didnt proceed with the ultrasound. As you said though, I'm thinking it may be wise to see about getting one now. What would the different treatment for adrenal vs pituitary be? I am also concerned about the high maintenance dose causing more damage to Rambo.

Rambo's last load was in March and it lasted very close to 2 weeks, I cant remember the exact number of days. He had several ACTH retest since then and was always in the 3. range and has been doing great, and still is, so it's a huge bummer to get this latest news! His most recent test which was done on Monday 9/10 at 3:00, his last pill before the test was on Friday at around 2:00. Could this have been too long of a time to make his post number rise?