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Thread: Recently diagnosed, looking for any insight from the community.

  1. #41
    Join Date
    Mar 2009
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    rural central ARK
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    Default Re: Recently diagnosed, looking for any insight from the community.

    I am glad to hear she is doing better and that her vet was able to help calm you by explaining things in a clear manner. I hope she continues in this trend and that before long you are seeing more and more of your old girl.

    Hugs,
    Leslie
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  2. #42
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    Mar 2018
    Location
    Houston, TX
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    Default Re: Recently diagnosed, looking for any insight from the community.

    We're still kind of in a holding pattern but I have a quick question.. Has anyone noticed an issue with poop urgency? There have been a few times where Phoebe is pacing and panting and then has to poop suddenly. This is after being outside a lot just moments before. Urgent to where she poops inside if she doesn't go out immediately. It's very unlike her to poop indoors. Her poop is solid.

    I think I'm going to take her off the milk thistle and see if that helps..

  3. #43
    Join Date
    Jun 2012
    Location
    Canada
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    16,150

    Default Re: Recently diagnosed, looking for any insight from the community.

    Oh Phoebe is a beauty! You can just right ACTH, we know what you are talking about.

    We just had a member, whose dog was having soft stools who found that the food was contributing to the issue. So that is a thought too, perhaps in conjunction with medication it isn't working for her now? Just a thought.
    Are you going to get an ACTH done?

    Poor girl, I'm sure she feels horrible to lose bowel control. Removing milk thistle, might help, and you'd at least see if that is what caused the loose bowels.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  4. #44
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    Mar 2018
    Location
    Houston, TX
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    Default Re: Recently diagnosed, looking for any insight from the community.

    I have her next ACTH stim test scheduled for next week. Her vet wanted to wait a full two weeks after changing her dosing to twice a day to see what her levels were at. The stool isn't loose (otherwise I'd be worried about her cortisol levels being too low), it's just that it's inside. It's been less frequent over the last couple of days so I'm keeping her off the milk thistle for now. I just didn't know if it was a known thing.

    Thanks for the feedback

  5. #45
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    Jun 2012
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    Canada
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    Default Re: Recently diagnosed, looking for any insight from the community.

    Has removing the milk thistle made a difference in her having accidents inside the house (stool)?
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  6. #46
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    Mar 2018
    Location
    Houston, TX
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    Default Re: Recently diagnosed, looking for any insight from the community.

    It has not. Although her thirst has subsided, she still frequently has accidents inside of both types. I'm bringing her in tomorrow for her next round of ACTH stim test and a blood panel to see where she's at. It's been two weeks since she started on the split dose and I'm not thrilled with the results. When she's not shaking, she's panting. She has been getting up on the couch by herself with some frequency so that's promising. But I can see the CC continuing to spread down her back. We'll see where we are this week when the test results come back.

  7. #47
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    Mar 2018
    Location
    Houston, TX
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    Default Re: Recently diagnosed, looking for any insight from the community.

    So Phoebe went to the vet this morning to do her latest ACTH stim test and my husband picked her. He spoke with the doctor so this is all second hand info from what he can remember. He prescribed her an antibiotic for 10 days because he found bacteria in her urine. This one is supposed to be good for bladder and hair so it'll help combat any kind of infection her skin may be fighting while it treats what he found in her urine. It may help with the frequent urination she's been experiencing. He said that the skin that is bare is looking better, but the skin that has hair where the hair is coming out still looks bad. It appears that the skin where the calcinosis first appeared seems to be healing so the reset of the skin should follow suit. He spoke with two internal medicine specialists and will be sending her results to one of them for treatment recommendations. He said the internist sees stubborn cases like this all the time and has treatment options. The internist had mentioned that splitting the dose gives the best results this treatment path (trilostane) can give, and did not recommend going higher... My husband said that the doctor mentioned some other drug treatment that's more about the suppression of the actual pituitary gland but he's not sure.. I think he may have been talking about lysodren but he doesn't think so. And she doesn't have abnormal Cushing's so I don't think it was the herbal treatment.

    We should get the results in a few days and he'll confer with the internist to see what our next steps are. The CC is continuing down her back along her sides so clearly her cortisol levels are still too high, but if she doesn't want to increase the dosage then I don't know what else we would do. She may want to try lysodren to see if she gets a better reaction. I wouldn't be thrilled since it's a more dangerous drug, but this isn't working. She is still constantly either panting or shaking and miserable until she's fast asleep, and even then her shoulders twitch usually.

    Hanging in there..

  8. #48
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    Apr 2009
    Location
    York, PA.
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    Default Re: Recently diagnosed, looking for any insight from the community.

    One thing to remember is that CC takes a long time to improve so patience is a must (I know how hard that can be as I am not a patient person). An UTI will make a dog drink/urinate more and may even cause some panting so hopefully those antibiotics will help soon, if not, I would ask to have the urine cultured so that the exact bacteria can be known and than the correct antibiotic will be prescribed.

    You're doing a wonderful job and thanks so much for the pictures!

    Lori

  9. #49
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    Mar 2018
    Location
    Houston, TX
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    Default Re: Recently diagnosed, looking for any insight from the community.

    Thanks for the comments, Harley

    I just spoke with her vet and the results of her last ACTH stim test are:

    Pre: 2.1 (Range 2-6)
    Post: 5.3 (Range 6-18)

    He is going to run these numbers by the internal medicine specialist who has been working on her case with him, but he's pleased with the numbers at this time. He says that the CC that I see getting worse may be due to the lag between controlling her cortisol numbers and how long CC takes to rupture and begin to heal, which makes sense. He said that there is for sure new hair growth in the oldest patches that have healed, and that her skin looks good so far, so we're going to stay the course with this treatment. I speculated that the shaking could be from the UTI, which he agreed may be the case. He said that because these are the best her numbers have looked so far, he would like to just slow down and let the antibiotics handle the UTI and see how she does over the next month. He doesn't want to throw a bunch of stuff at her and try to treat different things all at once because it's too difficult to determine what is helping and what is not.

    I think we're in a good place with her numbers, and I'm hoping that healing the UTI will improve her overall disposition. She is routinely getting on and off the couch, so that's good. We put our bed on the floor so that she could access it again, and it turns out she's a big fan of bed on the floor... Who knew?? (We knew)

  10. #50
    Join Date
    Jun 2012
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    Canada
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    Default Re: Recently diagnosed, looking for any insight from the community.

    CC is calcium deposits under the skin that have to push up and out. That is what causes the sores. As long as cortisol is too high, calcium deposits can form, once there they have to push up and out, so the ones that are healing now, are ones that already have pushed out, the newer areas is where the calicium was formed already. What you want is no new calicum deposits to form that have to come out. Often you for cc to not form any new deposits you want the post number under 5.0, so you are close. That is just what we see on here and every dog is different of course.

    It is not unusual for cc treatment to take 6 months or so for skin to clear and that is with no new deposits forming. This due to how long it takes to go through hair and skin cycles.

    The UTI could definitely be a factor in the urination frequency, so that should clear up with the antibiotics. (cross fingers0
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

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