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Thread: Duke-5 1/2 year old male Vizsla newly diagnosed

  1. #41
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    Glad to hear that the GI issues have resolved and that the CC has improved!! Hopefully his maintenance dosing regimen will keep the cortisol under control. You are doing such a wonderful job! Keep us updated, please.

    Lori

  2. #42
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    It really sounds like things are going very well, other than the insominia. Hopefully you'll find something that works for that too.

    Crossing fingers
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  3. #43
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    May 2017
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    Exclamation Re: Duke-Insomnia Help Please

    Insomnia Help Please!!!!

    I'm desperate, it has been over 6 months since Duke and I have slept for more than 3-4 hours max and the last 2-3 weeks we are back down to less than 3 hours. Dukes restlessness and insomnia are getting worse although other symptoms seem to be improving. We have tried melatonin, Trazodone, Prozac and last night Xanax. Duke seems to be agitated and anxious and just can not settle down, the Prozac caused more agitation and anxious behavior with the dog panting, pacing, barking, pawing at me and crying. Last night was the first try with Xanax and while not as bad with the Prozac he slept less than 2 hours and was unbelievably agitated and anxious all night and morning, pacing, crying, pawing at me. I tried feeding him extra food around 12:30 AM when he would not settle down to go to sleep (full belly) and again fed him at 3:30 AM (cooked sweet potato and some canned food) hoping that the carbs and food would help him settle down-- no luck. I've tried the extra food before and even feeding dinner later or splitting his dinner into 2 meals hoping that a full belly would help with sleep but is has not. So far the only thing that has helped a bit has been the Trazadone at 300 mg and that has only allowed us to get 3-4 hours sleep AND does not seem to cause agitation. When he did his induction treatment with Lysodren we had a 2 week improvement in the insomnia (he was also started on Trazadone) with him sleeping 6 hours which felt like a miracle! The IMS seems stumped and I'm not sure knows what to do. It does seem like his days and nights are flipped since he is sleepy during the day and it is hard to keep him awake as he takes frequent naps. His worse hours regarding anxiety and agitation seem to be between 3 AM and 6 AM-- none of this makes any sense. I'm reaching the end of being able to continue much longer and can not function with no sleep as this problem is getting worse each night and we are getting less sleep each night .
    Last edited by Duke's Mom; 08-20-2017 at 08:54 AM.

  4. #44
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    Just a thought - there are humans who react the exact opposite to some medications, like sedatives or narcotics. Instead of having a sedative or soporific effect they have the reverse effect and cause hyperactivity. A friend of mine and my daughter were that way. A pain pill would have them up chatting like magpies for hours and hours! Talk to the IMS about trying a mild stimulant and see what effect that has...but I would do that during the daylight.
    "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.

  5. #45
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    I wonder if Benadryl may help? Every now and than my boy, Marvin, gets these itchy spells which I give him Benadryl for and it makes him sleepy.

  6. #46
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    Actually what Leslie said is quite possible. We've seen dogs react to medications with hyper activity and anxiety.

    Lori, has a good suggestion with the benadryl too, but I wouldn't do any of this together.
    First I'd try taking him off of all the medication for prozac, xanax, etc. And have him off for a few days so you know it is all out of his system, then try the benadryl.
    I know that this may mean less sleep during these couple days but the object is to make sure he is clear and see if the meds are having an adverse affect on him, then to try the benadryl.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  7. #47
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    Thank you so much for the suggestions and ideas. It is very clear to me that Duke reacts in a paradoxical way to may things including medication to help his insomnia. Luckily he only had 2 doses of Prozac and one dose of Xanax , when it was clear that this caused increased agitation he did not get them again. I also stopped the amino acid L-theanine and this seems to have helped too regarding less agitation so everything has an opposite effect. This too is the dog that get GI issues to the point of IBS when his cortisol is high and when it is normal his stool and GI status are fine.

    I like the idea of stopping everything for the insomnia which right now is Melatonin and Trazadone and seeing what happens. I'm concerned that trying benadryl will also result in stimulation and agitation. Since removing the AM dose of Melatonin Duke seems even sleepier during the days. I'll have to talk with the IMS regarding trying a mild stimulant no idea if these are ever used on dogs. He loves coffee but I don't think it is safe beyond the taste he gets in the AM with us.

    In humans there is a rare type of cushings called "cyclical cushings", bad insomnia is one of the clinical symptoms along with a pattern of regularly changing or cycling cortisol levels in a variety of patterns. It is usually caused by a pituitary tumor. There is no literature regarding this disease in dogs but that may be because the dogs can not describe their symptoms nor would anyone do the extensive hours of testing needed to document the cyclic pattern. That said Dukes symptoms and clinical presentation is so similar to that of people with this type of cushings, not that it would change anything regarding treatment. It would explain the insomnia however

  8. #48
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    That is interesting. I've never heard of cyclical cushings in dogs, but anything is possible.

    Dr.Bruyette s the only one I see that even mentions cyclcal cushings in dogs as a possibility and he doesn't go into what it would mean.

    he remaining nonclassic, less well-understood categories of Cushing’s syndrome etiologies include ectopic ACTH production by a tumor, meal- or food-induced Cushing’s disease, cyclical hyperadrenocorticism, occult hyperadrenocorticism and atypical hyperadrenocorticism, says Bruyette.
    http://veterinarymedicine.dvm360.com...-be-overlooked
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  9. #49
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    May 2017
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    Default Re: Duke-5 1/2 year old male Vizsla - update

    Duke Update
    After 3 weeks on maintenance Lysodren at 50% dosing (250 mg M-W-F), Duke started to show signs of Cushings again- poly x3 and hair (that was just starting to grown back) coming out in handfuls anytime we pet him, along with increasing insomnia and agitation ! I quickly scheduled an ACTH recheck (test #6 since 6.30.17) one week ahead of the planned time. No surprise it came back a bit high...
    Pre 2.8
    Post 6.7

    So the IMS feels the 50% maintenance dose is not holding things in check and he has moved back into cushings with his adrenals regrowing too fast now. She is hesitant to move to 500 mg M-W-F (what his maintenance dose should be) and feels instead he needs the medication every other day. The current plan is to dose every other day alternating 250 mg and 500 mg as the dose given on the alternate days he gets the medications (dose equivalency of 375 mg QOD ~ 1312.5 mg/week). She hopes that more rapid dosing may slow the regrowth of the adrenals. Her concern is how fast he was induced and went too far and that he is just very sensitive. Recheck with Test #7 (slowly going broke) in 2 weeks.

    Based on everything we both strongly suspect that Duke has a macroadenoma and possibly an ACTH secreting tumor- likely secreting in a cyclical nature. Brain imaging would only tell regarding tumor size but not if it is ACTH secreting; further neurological s/s that may emerge over time would also be strongly diagnostic. Knowing this would not change the plan of treatment and just add several additional thousand of $$ to the costs. We are over $6000 into this poor dogs care since starting this journey in late May 2017 with no end in sight to the continued testing as he is so difficult to stabilize .

    The positives are his CC are 90% resolved, he has hair again- even if it is falling out, his GI issues are 99% resolved, he is happy and playful again.
    Last edited by Duke's Mom; 08-31-2017 at 09:06 PM.

  10. #50
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    Default Re: Duke-5 1/2 year old male Vizsla newly diagnosed

    I have followed your saga and efforts to treat Duke since May. I empathize with your struggle and know that this latest probable diagnosis must be incredibly frustrating and heartbreaking. You are an amazing mom to Duke and his inability to sleep at night, and thus your's, must feel like the proverbial bridge too far. I hope you can hold on to the good things and find hope and peace going forward.
    Carole
    Skippy's Mom

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