Emma - New Member Post

[emmagirl]

Hello. I feel like I’ve been away from the forum forever. Each time i start to post, something pops up that needs my immediate attention; most of the time it’s Emma!

When I summarized the dates of her tests and the results, I realized she has had two kinds of testing: ACTH Stim and SNAP Cortisol. I am interested in knowing the difference between the two. Emma’s Testing Timeline:

12/27/17 ACTH stim/IDEXX 2.3 27.6 starts on Trilostane compound - 0.1 of 50mg solution (I might not be stating the the number on the first line on the syringe correctly)

1/29/18 SNAP/in-house? 7.5 (no pre given)
3/29/18 SNAP/in-house? >10 (no pre given) neither of these showed her pre cortisol level, and >10 sounds like an estimate.
All 3 tests done by a vet whose service I left. Not knowing about Cushings yet, I had followed her lead, & None of the tests had specific timing; food, no food was never mentioned. The new vet started from the beginning again. (Poor Emma)

4/17/18 New vet. She put Emma on 10mg Vetoryl once a day.
5/4/18 ACTH Stim/IDEXX 4.6 7.5 / 14 day retest rule was followed. Vet wanted fasting then 8am dose. I told vet I would rather she eat, but did dose her at 8am, so she could be tested 4 hours later. Emma stayed on 10mg Vetoryl/day.

5/31/18 ACTH Stim/IDEXX 1.3 3.2 / 30 day retest rule was followed. Dosed at 8am with food, test 4 hrs later. Her next test will be 3 months from this date. I’m concerned they are low, but except for an isolated day here and there, I’m very thankful she is not showing symptoms.

[labblab]

Hey, it’s good to see you girls back again! The difference between the SNAP test and the “plain” ACTH is that the SNAP test was performed on equipment in the vet’s office, while the plain ACTH was sent out to a lab to be analyzed. IDEXX is the outside lab that your vet is using now, and they are also the people that make the SNAP testing equipment. So I’d expect that the results on both types of tests would be similar, but to be totally directly comparable, it’s probably helpful to stick with one or the other for the majority of subsequent tests. It sounds as though your current vet prefers sending the blood to IDEXX for the testing, and that will be just fine to continue that way.

Emma’s May result of 1.3 and 3.2 is really very good — that post level of 3.2 is right in the middle of the ideal therapeutic range. So as long as Emma is outwardly doing well, I think you’re on the right track now :-))). My only cautionary thought is that since her cortisol did continue to drop further during those last two weeks of May while still taking the same dose, there’s always the chance they could still drift further down in the future. But in reality, that chance always exists for any dog — cortisol levels may change and doses may need to be tweaked. So that’s good that you’ll have her rechecked again in August. And as carefully as you watch her, of course you’ll know to take her in sooner if she seems to be unwell.

I know it’s been a long haul, but you’ve done a great job of taking care of Emma and I hope it’ll be smooth sailing now for you throughout the rest of the summer! Thanks so much for checking back with us.

Marianne

[emmagirl]

Thank you, Marianne. It's so good to hear from you again! Thanks for the distinction between ACTH and SNAP tests. And I feel better about her results knowing the post result is midway between low and high.

I would like to ask the community about the food they are feeding their Cush dogs....and other misc. health questions....where would i post those questions?

Enjoy the rest of your summer.....

Sharon and Emma too!

[labblab]

Sharon, you can go ahead and ask your food and other questions right here on your original thread. That way, people will be able to review Emma’s health history in the event it will affect any of their recommendations to you.

I just have to add how much I love your avatar photo of Emma — she just looks like such a sweetie!

Marianne

[emmagirl]

I don’t know how I did it but I just lost my reply :~( when I finished I clicked on Post Quick Reply and it sent me back to a login page. So I will write again tomorrow- too tired too write again tonight! (Today) Anyway, thanks Marianne for the nice compliment about Emma. She IS a real sweetie and very gentle. She has my heart. ❤️

[labblab]

I’m so sorry you got logged out prematurely! Another member has complained about that recently, so I’m really not sure what’s going on there. If you’re not already doing so, I just want to remind you to make sure to check the “Remember Me” box when you first log in. But if even that’s not helping, two other suggestions: compose your reply elsewhere like in a word processing document and then copy/paste it in here, or else just copy the reply you’ve composed here prior to clicking the “post” button. That way, you’ll still have it saved yourself in case something goes haywire and you’re logged out. We’ll be watching for your new reply later today!

Marianne

[emmagirl]

Hi Marianne, you’re exactly right. I should be composing in Note or any app that saves your work as you write! I know this, but I will get in a time crunch and skip that step and then something happens and wham! I'm spending even more time trying to recover! Lol

Anyway, I’m very excited about the site I just stumbled upon.
http://vetnutrition.tufts.edu

http://vetnutrition.tufts.edu/2018/0...c-ingredients/

The site at vetnutrition.tufts.edu is a clinical nutrition service presented by Cummings Veterinary Medical Center at Tufts University, and provides extensive information on pet nutrition by board certified pet nutritionists at Cummings Veterinary Medical Center. Their blog is Petfoodology, and I have only gotten into one or two articles but realize the importance of a site like this for all pet owners.

One of the articles I read (the second URL above) is by Lisa Freeman, a 20 year nutritionist with a PhD who discusses heart disease in dogs that might be attributable to grain-free diets and other trends in pet food caused dog food makers claims that have no scientific proof behind them. The article explains how " Most nutritional recommendations focus on treating pets that already have heart disease but there is much less information on the role of diet in causing heart disease." The article goes on to say a recent increase in heart disease in dogs eating certain types of diets may shed light on the role of diet in causing heart disease. Ms. Freeman says "it appears that diet may be increasing dogs’ risk for heart disease because owners have fallen victim to the many myths and misperceptions about pet food. If diet proves to be the cause, this truly is heart-breaking to me.

She mentions the trend in new “exotic” ingredients like kangaroo, lentils,duck,pea,Buffalo,tapioca,salmon,lamb,barle y .....can actually be hurting dogs & cats.

Then she states "in the last few years I’ve seen more cases of nutritional deficiencies due to people feeding unconventional diets, such as unbalanced home-prepared diets, raw diets, vegetarian diets, and boutique commercial pet foods." That article really got me thinking!

I know there can be other causes, but wouldn't it be miraculous if we can answer the question "why is there a sudden rise in thyroid disease in cats, and cushings disease in dogs", or any of the diseases that seem to be on the rise and plaguing our fur babies , with the answer of diet? Maybe we have been foolish to rush out and spend extraordinary money for grain-free and exotic animal pet food just because dog food marketing has led us to believe we would be bad pet parents if we didn't.

Well, I'll get off my soap box now. I'm going to read more on the other articles devoted to diet and heart disease, and search for any on cushings. Emma has heart disease as well as cushings, and anything proven to help her is a blessing. I feel certain about one thing, though, we are going back to a kibble that is not grain free!
I will be back later to ask some questions of the community.
Sharon

'Unconditional love has fur, four paws and a grateful heart'
​

[Joan2517]

This is very interesting, Sharon. I had been feeding my dogs Wellness Original, grain free for years and only just switched to Science Diet W/D in the past few months.
Lena had Cushings and Gabe does along with Thyroid problems.

[Harley PoMMom]

I just wonder if she may be a bit bias since she is in the veterinarian field. Those overly priced dog foods sold at the vet's offices such as Royal Canine, Hills, most contain ground corn as their first ingredient so I imagine that they have been getting some flack about that...just a thought.

[labblab]

Unfortunately for me, since I’ve been feeding Luna a pea and lentil-based grainfree food for quite a while, the worries about the link with this particular heart problem seem to be legit :-((((. I just now Googled it, and apparently there were numerous articles released nationally last week that discussed the FDA study this vet is citing. Here’s a link to the FDA’s report itself:

https://www.fda.gov/NewsEvents/Newsr.../ucm613355.htm

In opposition to claims, I’ve never felt that a grainfree food was any more “natural” or inherently healthier for most dogs. Heck, who has seen a dog scavaging potatoes or lentils any more frequently than oats or barley. But I’ve been picking grainfree foods just because, based on reviews, I thought the manufacturer’s quality was better than average. But I believe many of these manufacturers also have lines of food that contain more traditional ingredients, and I now plan to start transitioning Luna over to something different.

At this point, it looks as though the concern is limited to this one specific type of heart disease. So we shouldn’t rush to conclude that the risk is heightened for a whole range of health problems. Plus, I’m always cautious about correlational observations — they don’t always prove that one thing actually causes another thing. For instance, pet owners who feed their dogs high-end “boutique” foods may also be more likely to be able to afford more regular vet visits, thus increasing the likelihood that an illness will be diagnosed in the first place. But obviously there’s enough concern here among vets to catch the FDA’s attention, and they do say some dogs improve once they are shifted off the grainfree food. Since I have no good reason to feed Luna a bunch of peas and lentils, I’m gonna switch to a more traditional formula, myself.

Sharon, I just wanted to add that this info underscores my personal reluctance to generally recommend any specific kind of food here on the forum. Every dog comes to us with its own specific health history and issues that may need to be addressed. And to date, I’ve not seen credible research that establishes that any one type of diet is specifically better for treatment of Cushing’s. So I think it’s especially great when folks can identify professional nutritionists who can help them design diets that are optimal for their dog’s specific needs. And you certainly can feel free to ask additional questions about nutrition here — I’m just afraid that, a lot of times, my own answer may be, “it all depends...”

Marianne