Franklin, 4½ yo maltese, trilostane (updates)

[lulusmom]

Hi Jane,

Positive thoughts and good vibes being sent your way from me and mine.

Glynda

[frijole]

Mountains of good wishes and hugs!!!! Kim and clan

[MiniSchnauzerMom]

Jane,

Sending my positive thoughts and good wishes for Franklin also!

Louise

[Franklin'sMum]

Hi Everyone,
:D:D:D:D:D We have great news to report....... The CT showed nothing :D:D:D Yep, nothing out of the ordinary, no macrotumor, nothing!!! :D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D it was perfectly ordinary :):) Dr K is currently out of the country (back to the US for a couple of weeks, so our appt was with the chief resident, a very nice fellow, very friendly and sat on the floor to listen to Franklin's heart, and poke at his ears and such.
The only thing is that he wrote down Franklin had an irregular femoral artery pulse :confused:.
He said that if the seizure things get worse, they may consider the need to do an MRI to check for intracranial lesions, or the possibility of something like meningitis (I didn't know pups could get that?) and to do that, they would need to perform a CSF (cerebral spinal fluid), at that point, my hearing/comprehension was off, and I took it to mean like a spinal tap (like on E.R), and he had to tell me again, cerebral. That they somehow take the fluid sample from the brain, I said ooh I don't like the sound of that. He said that he doesn't think its necessary at this point, we'd need to weigh the possible risks against the benefits, and he told me the mortality rate (1 in 100) and I said NO that won't be happening, don't do that. He also said they have an IMS, and would I like to speak with her? He'd try and arrange something.

He called me, and said that she'd re-arranged her day, and if I could be there at 3pm, and didn't mind waiting for a while, she could fit me in. She was concerned about the fat in his diet (omega 6/9, ground sunflower seed), and said that lipidemia can trigger neuro symptoms.
And no more raw food. Or calcium supps. So we'll do that for a month (also no trilo for that month) and go back for a full blood work-up, probable adrenal panel (from utk), and urine/protein ratio.

She is worried about the protein loss in his urine, and the leucocytes, and today did a cyntocyntesis (sp?) to do a culture, since the previous sample in February was free catch.

So all in all, life is wonderful :), the boy is still something of a mystery, but John looks like he may have been right, saying that sometimes the simplest things can have scary symptoms.

Big shout out to Marianne, Lori, Jenny, Leslie, Glynda, Kim and Louise for sending good luck wishes, positive thoughts and vibes, they really helped!!! :D:D:D

Lots of love, HUGE (((hugs))) and a sigh of relief,
Jane and Franklin xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
________
Ship sale (http://ship-sale.com/)

[littleone1]

Hi Jane,

I'm so glad that the CT didn't show anything.:)

I understand your not wanting to have the draw done. Hopefully a change in Franklin's diet will help, and that the seizures will go away on their own.

Take care. I'll be keeping both of you in my thoughts and prayers.

[labblab]

WHEW!!!!!!!!!!!!!! What a huge sigh of relief from all of us, too!!!!!!

:D :p :) :D :p :) :D :p :) :D :p :) :D :p :)

Marianne

[Casey's Mom]

Great news Jane!!:D:D:D:D:D

Love and hugs,

[Roxee's Dad]

Hi Jane and Franklin,
Great news...I think it's cause for a little celebration :D:D:D:D:D

I sure do like good news! Makes my day so much better!:):D:):D

[lulusmom]

Yippee!!!! I am sure you are flying high right now and feel a huge sense of relief....kinda like getting rid of a 50 ton boulder that's been sitting on your shoulders. I know the feeling. I'm so happy for both of you and hopefully you can just enjoy each other to the max without anything gnawing at you.

[Harley PoMMom]

Hi Everyone,
:D:D:D:D:D We have great news to report....... The CT showed nothing :D:D:D Yep, nothing out of the ordinary, no macrotumor, nothing!!! :D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D it was perfectly ordinary :):)

This is such GREAT news!!!! I am sooo happy to read this and so relieved too, but no more than you, I know! ;):D

Love and big hugs,
Lori

[MiniSchnauzerMom]

Alrrrrrrright Franklin. Nothing out of the ordinary....love hearing those words!!!

Louise

[Franklin'sMum]

Hi lovely, sweet friends, including but not limited to :p,
Terri, Marianne, Ellen, John, Glynda, Lori, and Louise :) Thank you for all of your woo hoos, yee hahs, yippees and other carousing... oh hang on, some of those are still me :p.

I will smother him with kisses and hugs and tell him (when he wakes up) that his aunties and uncles are so very happy and relieved about his good news. We've only just made it home about 30 mins ago- enough time for fresh water in the bowls, the A/C on and throwing in a load of washing. Poor little fella has diarrhea :(, maybe from the change of water that he's used to, to a day and a half of different filtration/ purification or something?

The sweet child is sooo tired. When Franklin decided it was bed-time last night, he didn't get up at all through the night. So he had about 9 and a bit hours sleep. Made a heck of a change from the night before, when it was 1.30 before he settled down for the night :eek:

Just a change of subject here,- if any body ever needs to go to"southpaws", I'm very sorry for the circumstances, but the pup or kitty will be in great hands. Amazingly friendly staff, they obviously love pups, and they couldn't do enough. I asked if they could put the CT on CD, and they asked if I had 20minutes to spare while they did.
They gave after-care instructions for Franklin (feed 1/2 his regular size meal, keep him warm when he's asleep, not allowed to play with the pup in the next cabin yesterday, and to expect some coughing- from having the tube down his throat.)
The docs also checked Franklin's blood pressure yesterday 109/87 with a mean of 73 (anybody know what that means, please?) and 109/56 with a mean of 86, so I'm guessing it may have been a little low due to the anasthetic (the first # should be 110-160, and the second should be 60-90)

Thank you all for your thoughts and prayers, and for holding my cyber hand through this :),
With much love to you and your sweet babies,
Jane and Franklin xx
________
GLASS BOWLS (http://glassgallery.tumblr.com/glass-bowls)

[John II]

:D:D:D Great News Jane!!! :D:D:D

[Franklin'sMum]

Thanks John! Woo Hoo!
Love and cuddles to you and Angelina,
Jane, Franklin and Bailey xxx
________
BMW WELT (http://www.bmw-tech.org/wiki/BMW_Welt)

[Harley PoMMom]

Poor little fella has diarrhea :(, maybe from the change of water that he's used to, to a day and a half of different filtration/ purification or something?

Hope our Franklin is over his poops and is feeling more like himself now!

The docs also checked Franklin's blood pressure yesterday 109/87 with a mean of 73 (anybody know what that means, please?) and 109/56 with a mean of 86, so I'm guessing it may have been a little low due to the anasthetic (the first # should be 110-160, and the second should be 60-90)

What I am thinking here Jane: Mean also represents in mathematics, a value that is intermediate between other values, e.g. an average or expected value. So Franklins diastolic pressure (bottom number) might have fluctuated somewhat and they also gave you an average.

Thank you all for your thoughts and prayers, and for holding my cyber hand through this :),
With much love to you and your sweet babies,
Jane and Franklin xx

Love and big hugs,
Lori

[Franklin'sMum]

Hi Lori,

Thank you for the explanation for the blood pressure mean/averages :). Our boy is feeling better today, still soft poop but at least it was poop shaped :o. He has had way more energy this evening, although didn't argue mith me about only having a short walk.

Thanks to everyone for all of your support and kind words, especially over the last few days, and I'll keep you updated as we get more information,
Love
Jane, Franklin and Bailey xxx
________
Mexico City Hotels (http://mexicocityhotel.info)

[mypuppy]

Hi Jane,
Woohooooooooo from me and Princess as well. Thinking of you both and healthy thoughts are being sent to my sweet little face. xo, Luv. Jeanette

[Harley PoMMom]

Hi Jane,

Your posts can make me laugh even when I don't feel like it! :D

Hi Terri,
I've read that doggie cataracts don't cause blindness like they do in people, and Bailey has had cataracts for a few years now, and he can still see people and pups on the other side of the street when he's inside on the couch. He kindly lets Mum and Dad know, by scaring the snot out of them :D:p:D

Love from
Jane, Franklin and Bailey xxx

I've been wondering how you and Franklin are doing, we haven't had an update for a while...:(

Love and hugs,
Lori

[Franklin'sMum]

Hey Lori and everyone,

Glad you liked the comment! :D I can be on the phone to them, and then hear sudden woofering, followed by "OW!!! Hold on. Let me take my hearing aids out! Where did that come from? He was asleep 2 seconds ago... Oh, sheesh, my ears are still ringing!"
It's really quite funny :p
I hope this post finds you and yours well. We've been well, thank you for asking. Franklin is still off the trilo, and seeking cool surfaces to lay on during the day and evening. He's eating well, drinking 350-400ml per day, not dripping urine anymore, and enjoying life. He is panting a bit when just laying around, though.

We have an appointment at Southpaws on the 4 May, for a stim, UTK panel, chemistry profile, blood count, and possible UPC (I'll take in a sample, just in case), and maybe an abdominal ultrasound as well. The credit card will take another pounding :rolleyes:.We want to see if his lipids have come down (since hyperlipidemia can cause neuro symptoms) and he hasn't been allowed to have certain treats. If the lipids are still high, they said last time that Franklin may need to eat a dedicated low fat diet. So I bought Optimum Healthy Weight Management dry food. He's been having some of that along with his regular wet food. Woo hoo! He likes it!! Half the battle right there :)

I've been thinking about changing his diet to Evo/Innova. I got 2 little cans of the wet food from the petgoods store, and he LOVED it.
Anybody have any thoughts?

Franklin hasn't had another "episode", but he did a weird thing... He ran back and forth through the house, rubbing his head on the furniture for 5mins. I could get his attention and distract him, then he'd start running and rubbing again. The only thing different that day was he had a half a haircut (by me). He didn't want his arms and legs done, maybe thinking shaved arms/legs mean blood pressure check or I.V? So he had short hair on the body, and hairy arms and legs :o
I'm sure John (Roxee'sDad) would be horrified by my handiwork :o:p, but rest assured, I will not give up my day/night job... Unless I win lotto! :D

Thank you for checking in on us, Lori, and love and hugs to you all,
Jane, Franklin and Bailey xxx
________
WENDIE 99 (http://www.lovelywendie99.com/)

[Harley PoMMom]

I've been thinking about changing his diet to Evo/Innova. I got 2 little cans of the wet food from the petgoods store, and he LOVED it.
Anybody have any thoughts?

I think Innova is a really good food, it does, however have Vit. C added so if ones pup does have tendency to form kidney/bladder stones, like my Bear, this isn't a good idea.



Hey Lori and everyone,

Franklin hasn't had another "episode", but he did a weird thing... He ran back and forth through the house, rubbing his head on the furniture for 5mins. I could get his attention and distract him, then he'd start running and rubbing again. The only thing different that day was he had a half a haircut (by me). He didn't want his arms and legs done, maybe thinking shaved arms/legs mean blood pressure check or I.V? So he had short hair on the body, and hairy arms and legs :o
I'm sure John (Roxee'sDad) would be horrified by my handiwork :o:p, but rest assured, I will not give up my day/night job... Unless I win lotto! :D

My pom. Bear when he gets back from the groomer is so very happy that he runs all around the house and rubs himself! Or maybe he is marking his territory all over again! :confused::eek: I don't know, but he does do this every time I bring him back from the groomer.

Thank you for checking in on us, Lori, and love and hugs to you all,
Jane, Franklin and Bailey xxx

I will be watching for your update from Southpaws! And I am so very, very happy that Franklin has had no more episodes! YAAA!!!

Love and hugs,
Lori

[littleone1]

Hi Jane,

I'm so glad that Franklin hasn't had any more episodes. That's really great.:)

Take care. Give Franklin a hug from me.

[mypuppy]

Hi there Jane,
So glad to get a great update on our "little booger"...haaaaaaaaaaaaaaaaaaaaaaaaaaaa....I am just so very happy for both of you. Keep up the great work and give yourselves some tight hugs from me and my "big booger" Princess. LOL.
Luv ya bunches, Jeanette
ps: BTW, I rub myself on the couch at time to scratch that itch when my hubby's not around...haaaaaaaaaaaaaaaaaaaaaaaaa.....

[Roxee's Dad]

Hi Jane,


I'm sure John (Roxee'sDad) would be horrified by my handiwork , but rest assured, I will not give up my day/night job... Unless I win lotto!

Too funny, believe me when I do my own pups, they don't turn out so well. I think it's because they are older and I don't want to put them through any more than I have too. AND since I'm not getting paid, I don't need to impress anyone but my pups, well, and wifey too!

Glad Franklin is feeling good.

[Franklin'sMum]

Hi All,

Things are going reasonably well for Franklin. Some of his results are in, so here's the latest...
These are the results from Franklin's March cysto.
Casts/crystals-nil
sp grav->1.060
ph- 8.5
Protein- ++
Glucose/ketones/bili/Bacteria- Neg
Culture- No growth seen after 24 hours

Haematology- May 4 (Fasted)
MCV fl 58.4 (60-77)
MCHC g/L 362 (300-360)
smear ex- Red cells and leucocytes normal in morphology. Platelets appear adequate in number.
Biochem.
Alb g/L 40.7 (24-38)
NA mmol 148 (138-156) K mmol 4.6 (3.8-5.8) CI mmol 106 (100-115) Na:K 32 (25)
Trigly mmol 1.69 (0.1-2.7) Woo Hoo! Within range!
ALP IU/L 979 (10-120)
Chol mmol 11.60 (3.9-7.8)
Ca mmol 2.70 (2.1-2.8) Yay! within range!!

cPLI snap - abnormal (they didn't print the actual number)

Free catch urine sample still showed protein, so another cysto was performed-
Leuc- ve
Nitrite- ve
ph- 9
Protein - 3+++
glucose/ urobilinogen- normal
ketones/ bilirubin- ve
blood- 4+
USG - 1.025

This next bit is from my notes, because I haven't received the report, yet.
U/S- results- liver enlarged, heard the word echogenicity mentioned.
Spleen- clear, no lumps, bumps or nodules
Gallbladder- some sludge. Not enough to warrant meds right away, IMS wants to try a super low fat diet first to see if that clears up the sludge.
Adrenals- L .63, R .58, but both within the normal range
Bladder- small
Heart- no problems

I mentioned to her that Franklin has been panting when he's just laying around, so 3 chest x-rays were done. The only thing that was out of the ordinary (from a regular pup) is his liver.

In March, Dr B said that if his lipids and triglycerides didn't come down, we should try a low fat diet. Kind of thought we'd have to go that route, so for the past 3 weeks, Franklin's dry food has been low fat (Optimum Healthy weight management), along with regular wet food.
At the beginning of the appointment, I asked about changing his diet to Evo/Innova, and asked if the vitamin c in it might be an issue for Franklin (thanks Lori). She said that it should be fine. After the u/s and gallbladder sludge was found she then said she wanted to try him on a low fat diet. And to cut down on his treats. :eek: I told her that if it wasn't for schmackos, I wouldn't be allowed to leave the house. She's got the same idea that a few folks here have done, slice up and bake the low fat food, and serve that as treats. So we were given a can of Science diet and also Royal Canin. He'll get to try those in the next few days. Franklin's weight was also down, this time he weighed in at 7.2kg, and Dr B said she wouldn't be concerned if he got down to 6.5kg, maybe even 6.2kg. The boy has been hovering around 7.6/7.7 for easily 3.5 years now. Maybe its just me, but I'm thinking thats his ideal weight. 6.2?:eek:
Blood pressure was 135.
Stim test for adrenal panel were done. Due to go to UTK, but the person from the lab (a dermatologist/pathologist) said that with dermatology, they quite often do adrenal hormones. They had the following day to check around and see if they could do it, otherwise it would be going to UTK. I haven't heard back yet, and I also haven't phoned them (I was sleeping yesterday).
Dr B explained the high alk phos could be caused by gallbladder issues, and isn't convinced that Franklin has cushings (since the ACTH assay was done while on trilo), so Franklin remains off treatment until further direction.

Hope this finds you and your babies well,
with love, Jane, Franklin and Bailey xxx
________
Vaporizer volcano (http://volcanovaporizer.net/)

[Harley PoMMom]

Hi Jane,

So happy to read that things with Franklin are going well.

With the cPLI snap test, I believe, you usually only get an abnormal or normal response, not a specific number. Although the article that I am quoting below is about the cPL snap test, I would think the cPLI snap test would work the same way.


A negative SNAP test virtually rules out pancreatitis. A positive test result needs to be followed up by measurement of a Spec cPL in the laboratory.
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2008&PID=23843&O=Generic

As far as Franklin's urinalysis results the one thing that is worrying me just a little bit is the blood in his urine. Did his IMS mention anything about this? He was tested for a UTI, right?

Here's a pretty good informative article about urinalysis testing.
http://www.peteducation.com/article.cfm?c=0+1302+1473&aid=3136

Blood pressure of 135!!! :D I'd be so happy if Harley could get his there...we are trying! Great job Jane!!!

Everything else looks great, he is concentrating his urine, his Na:K ratio is excellent, triglycerides and calcium are within normal ranges...Oh Jane, you are doing such a wonderful, wonderful job!

Love and hugs,
Lori

[Franklin'sMum]

Hi Lori,

Oops, it was a cPL (canine Pancreatic Lipase SNA, to be exact) that he had. Nice catch, thank you.


As far as Franklin's urinalysis results the one thing that is worrying me just a little bit is the blood in his urine. Did his IMS mention anything about this? He was tested for a UTI, right? In March, the cysto sample was tested for bacteria and crystals, both were negative. The May sample came back with a "fat drop" in his urine, I asked her how does fat happen in his bladder? and she said that sometimes the needle picks up some fat from the abdominal wall as it passes into the bladder, so I'm imagining that it kind of works the same way with the needle piercing skin and some blood getting into the needle. I'll phone her tomorrow and double check though.

Thanks for those links. It's now midnight, so I'll read them tomorrow.



A question please, Lori. You said his Na:K ratio is excellent, now the Na, K and CI are all within normal ranges, but they have the ratio as 32* with a normal range of 25- . So is that something to worry about? I'm so happy that Franklin's triglycerides and calcium levels have come down :D

Big hugs to you, and gentle hugs to the boys,
Jane, Franklin and Bailey xxx
________
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[Harley PoMMom]

Hi Jane,

I do believe that it may be true with the needle piercing the skin, but I would think the blood seen would be just ++, not 4+...this is what has me just a bit concerned...but I am always such a worry wart when it comes to pee...my little Bear has me on my toes due to his bladder issues!

Franklin's Na/K ratio is perfect. Here's a quote from an article titled: "Low Sodium: Potassium Ratios in Dogs and Cats" by J.A. Charles, BVSc, MVS, DACVP
Department of Veterinary Science, University of Melbourne
Werribee, Victoria, Australia



The normal serum sodium:potassium (Na+:K+) ratio in dogs and cats lies between 27:1 and 40:1

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6584&O=Generic

So, what I did was take the mean average of those numbers (27 & 40) and I got 33.5...Franklin's Na/K is 32...perfect! IMO!!

Give cutie-pie Franklin some extra hugs and kisses from Harley and me, and like I said...sometimes I just overly worry about things.

Love and hugs,
Lori

[Franklin'sMum]

Hi again Lori

Ah, thank you for the info on electrolyte ratios :) It seems that my brain just can't keep things straight :o. As Dr B was passing over his results, she didn't specifically mention the blood 4+, so I will definitely phone her tomorrow and ask for further info and clarification.
Will post what I find out.
Thank you so much for your kind words and extra hugs and kisses from you and Harley.

Lotsa love from us,
Jane, Franklin and Bailey xxx
________
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[AlisonandMia]

I'm thinking the blood may be from the cysto - the needle passing through the adnominal/bladder wall rather than rather than it actually being in the urine as such. That is probably why the Dr. didn't comment on it.

Alison

[littleone1]

Hi Jane,

I'm glad to hear that Franklin is doing better. I hope that everything clears up and that everything will be good.

Take care.

[Franklin'sMum]

Hi everyone,

Alison, I just got off the phone with the specialist, and meanwhile a 4+ isnt that common in a cysto, it's not unheard of. UPC result is in-UPC 2.5, normal <.5. She said the blood in the sample could be why the protein level is so high.
Franklin will be getting another cysto and a dipstick from his regular vet in about 2 weeks, to see if this result is an isolated incident. Will also be having another UPC done at the time.

A couple more questions needed to be asked... In my notes there was no mention of his pancreas, and the IMS said today that it didn't look too bad, but showed increased echogenicity.

His adrenal panel couldn't be done in Australia, so has been sent to UTK (YAY!!!:D) Should have the results in 2-3 weeks.

Alison, you mentioned in a reply to someone (I'm sorry, can't think who) that chewstix (greenies and veggie things) had been causing Fanconi syndrome in dogs. Do you happen to know if Dentastix by Pedigree has been an issue? The bag in the cupboard says its made in EU, so whether that's Europe or European Union, I'm unsure.

Hi Terri,
Thanks for checking in, and also for your good hopes for Franklin. At the moment, his issues seem to be proteinurea, and gallbladder sludge. The doc isn't rushing to treat the proteinurea at present, until we find out if it's "real" protein loss or caused by something else.
Hi Ho, Hi Ho, it's off to google I go :rolleyes:.
Hoping you and Corky are doing well.

Love, Jane, Franklin and Bailey xxx
________
Lovely Wendie (http://www.lovelywendie99.com/)

[AlisonandMia]

Fingers crossed that the protein is because of the blood - and that he blood was a fluky thing with the cysto. I remember my GP saying how they add a little bit of blood (not enough to be visible) to a urine sample to get it to read positive on protein testing when training medical students to do urinalysis.

Alison

[Franklin'sMum]

Hello to my wonderful k9c friends :D,

First of all, a HUGE thank you to you all for guiding me on this journey, holding my hand during assorted panic attacks and melt-downs, educating me, and not least, caring. We couldn't have made it without you. And if we had stayed with the cat woman "guru", we wouldn't have :(.

Franklin's UTK results came in..... :D:D:D:D:D:D:D:D:D:D, here they are

test: result(baseline) normal range post result normal range
cortisol ng/ml 46.5 2.0-56.5 151.2 70.6-151.2
androstenedione ng 2.41* 0.05-0.36 9.83* 0.24-2.90
estradiol pg/ml 100.6* 23.1-65.1 95.4* 23.3-69.4
progesterone ng 0.27* 0.03-0.17 2.32* 0.22-1.45
17OH progesterone ng 0.44* 0.08-0.22 5.30* 0.25-2.63
aldosterone pg *** 30.1 11-139.9 187.1 72.9-398.5

*outside the reference range
**normal range values for neutered male dogs (N-37)
***normal range values for male and female dogs (N72, baseline, N23 post ACTH)
These results indicate the presence of increased adrenal activity.
Comments received from the Uni of Tennessee: Values are increased as indicated. Consider items 1 through 5, or item 8 on the treatment option sheet, which can be viewed at the following web address

So Franklin has Atypical cushings. Part of the mystery is solved, now for those darn kidney symptoms. He is still losing protein in urine.

His IMS rang me earlier, and said that she is going to Anaheim in the next few days/week, for a convention of IMS's/endocrinologists. If anyone has any questions they would like answered, just let me know and I'll email them to her.

On a different note, has anybody heard of something called "the maltese conundrum"? I came across the phrase last week on a website (don't remember where), and apparently maltese can have elevated liver enzymes, but not liver disease. Also the bile acid test (to check for liver shunt) is sometimes not reliable in maltese, as they have something in their blood which interferes with something else, sometimes leading to a high bile acid result in some individuals, while they don't have liver shunt.
Work has gotten in the way of googling this week :rolleyes:, so I haven't been able to check the validity of that.

From the bottom of my heart, thank you, thank you, thank you, thank you, thank you for helping me to help my son.
I would be lost without him, and lost without you all,

Huge happy hugs and slobbery kisses to you and yours,
Jane, Franklin and Bailey xxx
________
BRUNETTE BLONDE (http://www.fucktube.com/categories/413/blonde/videos/1)

[mypuppy]

Hi there Jane,
It's been a while. So glad you were able to determine one aspect of Little Franklins problem - atypical. GO figure! Nevertheless so sorry you still have that other issue pending. I will most definitely be praying that your IMS comes back with some very valuable info at her convention and look forward to you sharing it with us. I do so hope it is positive to help Franklin and perhaps even so e of our other pups. That is the best we can hope for right. please keep us posted and hope everything else is good with both of you. Thinking of you always. Luv you both bunches. XO Jeanette and lots of gentle belly rubs for Franklin.

[Harley PoMMom]

Hi Jane!

That is truly the beauty of this forum; we all learn from each other, we are here for each other, and know that we can come here to rant, rave, laugh or cry with each other...one is never alone on this journey.

I have a question :eek:

cortisol ng/ml 46.5 2.0-56.5 151.2 70.6-151.2
Is Franklin's post cortisol number exactly the same as the high normal reference range?

I see that Franklin's estradiol is elevated :mad: dang it! That's a bugger hormone to get down but not impossible...so have you and his IMS discussed a treatment plan?

I have not heard of "the maltese conundrum," when you find out more could you let me know as this sounds very interesting.

As far as the protein-loss the one med. they use in pups is enalapril but with Franklin not having elevated blood pressure I'm not so sure if I would...ask your IMS about this and if you do let me know the answer, please.

Sending big hugs to you and Franklin from Harley and me.

Love and more hugs,
Lori

[labblab]

Hi Jane,

Can you remind us where things stand with Franklin's trilostane dosing? Is he "on" or "off," and if "off" -- for how long a time? Also, what was his most recent dosing protocol?

Thanks for this additional info. :)

Marianne

[BestBuddy]

I read it as

cortisol ng/ml 46.5 (2.0-56.5) 151.2 (70.6-151.2)

Jenny

[John II]

Hi Jane,

Congratulations on getting some definitive answers! :D

Although, you've now got me worrying about "the maltese conundrum" and "Fanconi syndrome" as Angelina gets Dentastix by Pedigree as well. Ah there's always something! ;)

So how will you proceed with atypical Franklin? No more Trilostane, the more natural options?

[AlisonandMia]

Sorry - I missed the fanconi question. Here's a link to some info: http://www.k9cushings.com/forum/showthread.php?t=599

I think the Dentastix should be ok and I don't think they've been linked to the fanconi-like syndrome. The problem seems to be related to irradiation of imported foods and most of the irradiated stuff has come from China or somewhere else in Asia.

Alison

[Franklin'sMum]

Hi Everybody and big happy (((hugs))) to you all, :)

Hi Jeanette
Thank you for keeping the boy child in your prayers :) much appreciated. Absolutely I'll keep you informed of what Dr B passes on from her convention.
Hugs and ear scritchies for you and Princess. Have you noticed a resolution in symptoms, yet?

Hi Lori,
Yep, you read that right, 151.2 for the post cortisol result. So it's very close to true cushings with elevated hormones. I'm thinking his first ACTH stim test (345/1031nmol/l AU, 12.50/37.36 ug/dl US) may have been the stress of it (he'd never had a blood test before), and maybe he was under the weather (aside from his "episode" that day.)

I think his IMS, Bronwyn would prefer to try to lower the protein in his urine by diet changes first, and see if that helps. That's also the idea about his gallbladder sludge, he's currently eating Royal Canin digestive low fat to try and clear that before using medication. (I think she said ursidol?) When he gets sick of the royal canin, I give him a couple of meals of My Dog, then he goes back to RC.

I'm currently trying to formulate a diet for him (head exploding icon) to address his needs- liver, kidney and pancreas. I know that there are actual nutritionists who do that, but my thinking is if I can learn how to do that, I can come up with a few different recipes for him. And also learn how to alter recipes to address medical needs that might pop up in future. Or recipe changes if he turns up his nose at a particular ingredient. Without paying for each alteration :o.

The 'maltese conundrum' does sound intriguing, doesn't it? I'm pretty sure there's a scrap of paper laying around the lounge room that has more detail than my feeble mind remembered :rolleyes:, but at the moment, it's lost in the build up of clutter.

HI Marianne,
Franklin has been off trilo since March 12 2010. From earlier on in the year, he went off of it in January, when he was laying in the heat (35C). Stayed off for a month and a half, to do the faulty adrenal panel in Australia. I was okayed to change his dose to 15/15 when we started back up, which was March 1. He was on 15/15mg on and off until March 11, but missed some doses due to Franklin not wanting food, or a soft poop, and another episode of inco-ordination. But a long answer short, completely off trilo since the 12 March :)

Hey Jenny,
You read it right, 151.2 post cortisol. At least we know that trilo isn't the drug for him if his cortisol does rise further. And a never-ending sigh of relief that we dumped the cat woman whose experience of cushings was reading a 2003 article, and passing herself off as someone knowledgable on the subject :eek::mad::mad: I got my hands on that article, and it must have been so long since she read it, she disregarded key points of treatment :mad:

Hi John,
I haven't discussed treatment options with the IMS as yet, but the treatment sheet from UTK recommends melatonin and lignans still. It will be interesting to see what Bronwyn learns at her convention. Personally I would prefer to try the mel. and lignans for a few months first, assuming that there is even another way to treat naturally. Thanks to all the folks here, the thought of Lysodren doesn't terrify me (anymore :):o), so if it becomes a neccessity, we'll deal with it.

I will try and find that aforementioned scrap of paper with some detail of the conundrum of maltese (not including our own conundrums :p) and post that.
A friend who races greyhounds said that greyhounds have their own lab values particular to the breed, and suggested it might be the case with maltese too. Would certainly go a ways to explain Franklin's liver enzymes. So the google continues...:rolleyes:

Hi Alison,
Thanks for easing my mind about the dentastix. He loves them. I buy the big dog pack, and break them in half. It gives double the amount, for an extra 40 cents ;)

Thank you all for checking in on us, we love you all and send good thoughts and wishes to each and every one of you :)

Jane, Franklin and Bailey xxx
________
NOVA (http://www.chevy-wiki.com/wiki/Chevrolet_Nova)

[lulusmom]

Hi Jane,

Having two Maltese boys, I am familiar with the Maltese Conundrum. First think about the definition of conundrum...it means a difficult question or riddle. Maltese is a breed that can have elevated bile acids yet they are perfectly normal. They are also a breed that is genetically predisposed to portosystemic shunts. The conundrum for a vet that is doing a bile acid test on a Maltese is that if the results are high, they can't automatically assume that there's anything going on with the liver. The conundrum or quandry is, "do I ignore the finding because this is a Maltese knowing that they can be perfectly normal with elevated bile acids or do I do further testing to determine if perhaps we're dealing with a shunt or other issues."

Most portosystemic shunts in Maltese are congenital and are diagnosed at a very early age. A dog can develop an acquired shunt later in life as a result of liver disease but I don't believe Maltese are more predisposed to this as any other breed. You also have to remember that when looking at bile acids for a dog with cushing's, particularly those that are not yet stabilized with treatment, a good majority will have elevated bile acids due to the disease's secondary effect on the liver. This usually normalizes once the disease is adequately controlled. I hope this helps.

Glynda

[Franklin'sMum]

The conundrum or quandry is, "do I ignore the finding because this is a Maltese knowing that they can be perfectly normal with elevated bile acids or do I do further testing to determine if perhaps we're dealing with a shunt or other issues."

You also have to remember that when looking at bile acids for a dog with cushing's, particularly those that are not yet stabilized with treatment, a good majority will have elevated bile acids due to the disease's secondary effect on the liver. This usually normalizes once the disease is adequately controlled. I hope this helps.

Glynda

Hi Glynda and thanks!

I did have to read it 5 times, though :o but yes, that does help, and explains it much better than I could've.

So, another question, if you don't mind, I was reading on spoiledmaltese.com that up to 80% of Maltese have MVD (microvascular dysplasia) and quite a few of that 80% remain asymptomatic. Does that also mean that Maltese can have "normal" (for them) liver enzymes, while being classified as elevated by the labs that run chem panels and profiles, considering that the labs use the averages of all kinds of pups to arrive at their reference range?
Or am I reading too much into this?

Thanks in advance for any thoughts you or others might have,

Lots of love and slurpy kisses,

Jane, Franklin and Bailey xxx
________
Homemade Heat Gun (http://www.vaporshop.com)

[mypuppy]

Jane,
Don't be silly. It is my total pleasure to keep the little precious face and all the others here at the top of my prayers. It's the least one can do with all this. As for Princess still no complete resolution of symptoms just a little less water consumption. Waiting to hear back from my lovely IMS to discuss twice day dosing. Truth be told Im ready to take on Glynda asmy IMS since she seems to be on the ball with all this, hey Glynda, what do you say? LOL . Jane, hope you get some answers yourself soon. Takce care and luv ya both bunches. Warms and tight hugs to you and Franklin . Jeanette

[lulusmom]

Hi Jane,

MVD takes you back to the Maltese conundrum because MVD causes the increase in serum bile acids. I'm not sure that 80% of all Maltese walking the face of the earth has MVD but I believe that 80% could be the right number for dogs that are genetically related. Then again they've been so over and badly bred, maybe they are all related now. :D I'm of the opinion that overbreeding has caused a lot of the Maltese's health issues but they aren't alone. Yorkies, Bichons and Shih Tzus are also breed over represented when it comes to MVD. Think about it.....these are all wildly popular designer breeds that have been in huge demand for years. Nevertheless, I'd be very interested to know where the poster on Spoiled Maltese got his/her information. Can you ask the poster to give you a copy of link to his/her references? Not that I'm concerned about my two boys but I would really like to know more.

With respect to the liver enzymes, I would suspect that if a Maltese had a mild increase in bile acids caused by MVD, he/she could also have mild elevations in liver enzymes, particularly the Alt but sometimes they can be normal. Franklin's Alt is normal and his alk phos looks just like what we see so often with cushdogs. Are you concerned that Franklin may have MVD which is contributing to his elevated liver enzymes?


Truth be told Im ready to take on Glynda as my IMS since she seems to be on the ball with all this, hey Glynda, what do you say? LOL

Now that's funny!!!!

[mypuppy]

Glynda, aint nothing funny about that. I was serious. haaaaaaaaaa....I'd take you in a heartbeat. Man, you really are a geek. haaaaaaaaaaa....who luvs ya, J.

[Franklin'sMum]

Hi Glynda,

D'oh! My head is about to explode! :o I'm trying to figure out the possible reasons for his alk phos levels (if not PDH cushings, at present, anyway), and kidney stuff due to the gallbladder sludge, protein and blood in urine, and how this interacts with that, and so on, so I apologize for my denseness :D


Nevertheless, I'd be very interested to know where the poster on Spoiled Maltese got his/her information. Can you ask the poster to give you a copy of link to his/her references? Not that I'm concerned about my two boys but I would really like to know more.
Ok, nothing definite on that. I have scoured SM, and read (from posters) estimates ranging from 50% to 80%, but have not found any science to back that up. A google search wasn't any better, either.
Something I did read there, though, a lot of breeders don't even run bile acid tests on their dams and sires, but claim that "they've never had a dog with liver shunt", which basically translates as 'if it's not diagnosed, it doesn't exist in our lines'. So I wonder how many MVD pups there really are.

With respect to the liver enzymes, I would suspect that if a Maltese had a mild increase in bile acids caused by MVD, he/she could also have mild elevations in liver enzymes, particularly the Alt but sometimes they can be normal. Franklin's Alt is normal and his alk phos looks just like what we see so often with cushdogs. Are you concerned that Franklin may have MVD which is contributing to his elevated liver enzymes?

It's crossed my mind that Franklin might have MVD, or an aquired shunt due to liver issues. A liver health /MVD info place said it could be a shunt, and I replied that he doesn't fit the symptom profile (just for a change :rolleyes:). Franklin wasn't the runt of his litter, but one of the 2 biggest pups, he doesn't rub his head after every meal, or every meal with red meat, but he does occasionally vomit after eating (just the last mouthful, probably caused by him eating it too quickly), didn't fail to thrive or anything else that is usual for a shunt pup. His U/S in May showed little black blobby things on his liver, and when I asked what they were, the IMS said blood vessels.

His circling episodes that his IMS thinks could be caused by hyperlipidemia, the liver MVD people said hepatic encephalopathy :eek:, and IMO he doesn't fit that either. To start him on 'lactulose' to get/keep his poop soft, and something else so ammonia gets excreted quickly, and other things I can't remember right now, but pretty extreme for a pup that doesn't seem to have the condition. And quite possibly cause problems with his existing issues.

But at the moment, he's sleeping happily on the couch beside me, has been eating well, drinking normally, and still loves his strolls, so we wait patiently for news from the IMS, direct from the US :)

Love to all,
Jane, Franklin and Bailey (who's still kicking on strongly :D) xxx
________
DIFFERENCE BETWEEN STEROL AND STEROID (http://www.rehab-forum.com/steroid-rehab/4009-whats-difference-between-sterol-steroid.html)

[Franklin'sMum]

Hi friends,

I haven't been on much lately, I've been learning about nutrition (it's been a hard slog. I'm one of the many people who consider chocolate a food group :o:p) and kidney function.
On the other hand, his IMS came back with a treatment plan- it includes a fine needle aspirate of his kidney/s and liver :eek:, lysodren and enalapril. She feels that the protein loss in Franklin's urine is what needs to be addressed immediately, and she thinks the cause is glomerular disease.

She is fine with me coming up with a recipe/s for him, and even recommended reading materials (to add to the other reading materials already recommended and bought ;)). You've all still been in my thoughts and prayers each day.

I have said no to the biopsies at the present time, and am waiting on flaxhulls to begin treatment with melatonin and lignans. I picked up the analfor (enalapril maleate 5mg) last week, and was not going to start them till we had done a cbc and profile, blood pressure check and UP:C. The last test result came back in today. It was a 12 hour fast.
Here are the out of ranges:
* Bicarbonate 26 mmol/L (16-24)
* Alkaline Phosphatase 995 U/L (< 120)
* Albumin 45 g/L (22-36)
* Lipase 755 U/L (1-70)
* Cholesterol 9.7 mmol/L (3.6-8.8)
(lab note)- Note moderately to markedly elevated lipase alongside cholestasis; any signs of pancreatitis?
and the UP:C-
Creatinine: 4.2 mmol/L
Protein: 1.71 g/L
Protein/Creat Ratio: 3.6 (<1.1)

Debbie, if you're not too busy, would you mind translating this into english for me, please? *RBC Morphology A few nucleated red cells, rouleaux+,
Due to clumping, they didn't do a platelet count, but wrote that "platelet numbers appeared normal in the film".

Franklin's amylase remains at less than half the ref. range, and the trigs have come down to within range again :). His last test (in May) also had alk phos in the 900's, but he was sedated that day for the May up:c and ultrasound, and his IMS thinks that would explain the alk phos level. I would have thought it would come down a little over the next month, though :(.

We started the enalfor today. The dosage on the enalapril website says .5mg per kg, and Franklin is down to 7.4kg, and the blood pressure average was 100/80, (a little low) so we're doing 3/4 of a tablet, with gp vet's blessing ;).

Franklin remains a happy, healthy (seeming), little boy, who is enjoying snuggling up to me on the couch under the blanket (it's our winter, and great weather for hibernating), is eating well, still the Royal Canin food, and will hopefully continue eating that until we get a recipe or two assessed to begin homecooking.

Any thoughts, ideas or experiences on any of the above is as always gratefully received, and wishing you and your babies health and happiness,
Jane, Franklin and Bailey xxx

[Squirt's Mom]

Hi Jane,

Good to hear from you and Franklin again!

Nutrition is so much fun and it opens a whole new world, huh? I hope that soon I can get back in the groove and take more courses! :)

I am rather handicapped at the moment since I don't have access to my computer and files saved there but I did a bit of looking for you this morning. Here are a couple of links that may offer you some assistance in coming up with a diet for your sweet boy.

From my point of view, diets that contain calcium tables, human vitamins, and organ meat need to be avoided. Calcium can be easily made and more accurately measured by making it at home from egg shells. If you want the directions, I will be glad to provide. Protein is not the enemy, phosphorus and the imbalance that occurs between it and calcium when the kidneys are not functioning properly are the issue...as I'm sure you have learned by now! ;)

If you have it available there, Dr. Shawn Messonnier's book, Natural Health Bible for Dogs and Cats is a great tool to have in your library. You can get it from Amazon.com, I know...I did. :p

This link is from Dr. Lew Olsen, LMSW-ACP PhD:
http://www.b-naturals.com/newsletter/kidney-diet/

Dr. Olsen also has a Yahoo! group devoted to canine nutrition that can be found here:

http://pets.groups.yahoo.com/group/K9Nutrition/

Some good links and info:
http://www.dogaware.com/health/kidney.html

Hugs,
Leslie and the girls - always

[StarDeb55]

*RBC Morphology A few nucleated red cells, rouleaux+,
Due to clumping, they didn't do a platelet count, but wrote that "platelet numbers appeared normal in the film".

Red blood cells, when in circulation, normally do not contain a nucleus like all other cells in the body. The RBC nucleus is pushed out of the cell while the cell is still within the bone marrow. Mature, normal RBCs are not nucleated. Frequently, the presence of nucleated RBCs in the circulation may indicate that the body is under stress of some type such as bleeding, anemia, etc. If there was nothing abnormal on the CBC, then it's really hard to say what is going on. Platelet clumping is an artifact, usually due to a traumatic, bad blood draw. With platelet clumping, the analyzer can't do an accurate platelet count as the clumps are usually counted as white blood cells. When this happens, the WBC count may be falsely elevated, plt. count falsely decreased, but this is going to be dependent on how bad the clumping is. It's very difficult to say if the rouleaux is an artifact or something to worry about. What rouleaux means is when you look at a blood smear under a microscope, the RBCs should be laying in a single monolayer, not overlapping. The presence of rouleaux means that the RBCs look like stacks of coins. In a human patient, rouleaux may mean the presence of some type of abnormal serum protein or even a specific type of blood cell malignancy called myeloma.

Debbie

[Harley PoMMom]

Hi Jane,

Estradiol can make the ALP values elevated, which I know you knew! But I am just wondering if an elevated estradiol level could make ones pup start loosing protein in their urine too. Yunhee, Harry's Mom, also has proteinuria and elevated estradiol with a normal BP. I realize all dogs are different but...Maybe, Dr. Oliver could answer that question since one of his specialty areas is Endocrinology....hmmm.


(lab note)- Note moderately to markedly elevated lipase alongside cholestasis; any signs of pancreatitis?Forgive me Jane, but pancreatitis was ruled out with a snap PLI test, right?

Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

[mypuppy]

Hi Jane,
Yes it has been a while for you, but we are always so happy when you come back to report. Wow, I did read your post and wish I can possibly help in any small way, but I basically got lost. I saw Debbie's post and that was as foreign to me as it gets. Debbie huh? Jane was not kidding when she said in English. Lol. Jane I am so glad your precious little sweet face is happy and snuggling regardless of what is going on with him. I do so hope you find the source of his problem. Luv ya bunches and keep in touch. kisses to the little one. Xo Jeanette

[mypuppy]

Ps: chocolate is not a basic food group? Chucks. Lol

[littleone1]

Hi Jane,

I don't have anything to offer, as alot of this is foreign to me. I'm glad that Franklin is happy and is doing well.

[Franklin'sMum]

Hi All,

Hi Leslie,
Thank you so much for your looking, I really do appreciate it :) you said calcium tables, did you mean calcium tablets? I'm thrilled to avoid organ meats :D, however I do usually get the human supplements for him - they go through stringent quality testing, and are more likely to contain exactly what is stated on the label. I will be avoiding multi vitamins though. Kidney pups (if that's what Franklin is) shouldn't get added vit A or D.

I've come across these directions for eggshells- rinse and let dry o/night, then put in a coffee grinder. The odd thing is, the protein loss and occasional blood in urine are his only symptoms of kidney problems. Phos is normal, so we don't neeed a phos binder at present, BUN and creatinine are perfect.
Don't get me wrong, I've read repeatedly that by the time lab values show kidney disease, up to 70% of kidney function is lost, but I've also read that hyperlipidemia and cholesterol and untreated cushings can cause protein loss in urine, so the question remains- does he have the beginning of kidney dis, or is it a result of everything else? I have no intention of having a biopsy done. If it is kid/dis, why remove a piece of kid, the risks involved, plus there is always the chance of the result being inconclusive.

I don't have Dr Messonnier's book yet, but I plan on adding that to the library of Franklin :p Thank you very much for the link to Dr Olsen's group, just joined, and in the process of going through their links and archives. I love the dogaware site, it's been one of my faves for quite some time.

Hugs to you my dear friend, and take care.

Hi Debbie,
Thank you so much for your time and explanation :)
The presence of rouleaux means that the RBCs look like stacks of coins. In a human patient, rouleaux may mean the presence of some type of abnormal serum protein or even a specific type of blood cell malignancy called myeloma. So, according to a previous blood test (May, I think), he had elevated MCV and low MCHV (or vice versa)- both related to iron, and a site somewhere mentioned a "protein metabolic" disorder as a possible cause. Franklin is due to have another round of tests in a week or so, and it will be interesting to see those results compared to these.
I don't understand how it could have been a traumatic draw. He doesn't squirm, and handles it really well. They only had him out back for a few minutes, and no squeak, yelp or other sound was heard. If the clumping happens again, I'll get cheeky and ask for someone else to do the draw :o.
Thank you again, and belly rubs to the kids :)

Hi Lori,
Interesting- the possible connection between estradiol and proteinuria. Hmm, indeed. Yep, I think Dr O would be the one to ask. I'll get back to you on that. I have read that untreated cushings in general can cause prot. loss, as can elevated lipids and cholesterol. So the boy seems to have hit the jackpot :(. I've also read a number of studies that state supp'ing with omega 3 is kidney protective, and can lower lipids and cholesterol, and blood pressure. He's now getting omega 3 at each meal.
Meanwhile flaxhulls.com is looking into shipping to Australia (I thought it would be a given), and I'm unsure if melatonin on it's own would do anything for him.

The snap cPL actually had an abnormal result. :eek: I did email the IMS about my plan for a diet (low fat, high boi-available protein, low sodium) and she wrote back *The proteinuria needs to be addressed NOW, not the pancreas or liver issues!!!*
So I think I've had a stroke. When did something that can be fatal in a few days become something that can be put on the backburner? Especially considering that the lipids and chol. could be the cause of the protein loss??? :(:mad::confused::eek::confused:

We haven't had a spec cPL yet. I'll try to get that organised so he can have that done on his next visit.

Hugs to you and yours,

Hi Jeanette and Terri,
It is a lot to take in, huh? I get lost so often, need to leave a trail of breadcrumbs to find my way. Too bad I'm using M & M's instead, and eating them as I go! LOL! :p It goes like this- where did that article go? Is it in the folder marked kidneys? kidney function? kidney nutrition? foods to avoid? Ah, there it is. (read half way through) no, that's not what I was looking for. Close. click. open. click. back. click. read. read again. read again. hmm. And then yelling AAAARRRRRRRRRRRRGGGGGGGGGGGGHHHHHHHHHHH, disturbing Franklin's sleep, scooping him up for a cuddle and smothering him in kisses :)
Thank you both for your kind words, and Franklin thanks you for his kisses,

With love and best wishes to you all,

Jane, Franklin and Bailey xxx

[Squirt's Mom]

Hi Jane,

:o uhhh....yeah...tabLETS....:p Brain faster than the fingers at times!...or is that vicy-versy? :rolleyes::)

The eggshells need to be baked at 350 degrees for about 5-10 minutes before grinding...otherwise you got it going on!

Using the multi-vitamins is what I was trying to refer to...you are on the mark with using individual human vitamins...didn't come across very clear there, huh?

I don't blame you at all for not wanting to put Franklin through the biopsy process. Your TLC will go very, very far in helping him IF this is a kidney dysfunction and not a manifestation of some other problem.

Hang in there and keep in touch!
Hugs,
Leslie and the girls - always

PS...How is Bailey doing these days?

[Franklin'sMum]

Brain faster than the fingers at times!

The eggshells need to be baked at 350 degrees for about 5-10 minutes before grinding...otherwise you got it going on!

Using the multi-vitamins is what I was trying to refer to...you are on the mark with using individual human vitamins...didn't come across very clear there, huh?

I don't blame you at all for not wanting to put Franklin through the biopsy process. Your TLC will go very, very far in helping him IF this is a kidney dysfunction and not a manifestation of some other problem.

PS...How is Bailey doing these days?

Hi Leslie,
I have the same problem, and sometimes I seem to mash the keys as well, then reading through, I'm like, English, Jane, come on- get with the program!
Baking the eggshells? I hadn't read that anywhere, so thank you very much for that handy hint. I'll start saving eggshells in preparation.

With the human vitamins- these days its just automatic. Especially with the lastest recall. Why do some of these companies think they can just put anything in a container, slap a sticker on it saying dog/cat vitamins, regardless of what's in it, or even the safety of it? It blows my mind :mad:

Thank you for your very kind words- I try to be a good slave :p:rolleyes: This morning, Franklin took me for a jog. So after a little while (after my knee twinged for the second time, and I'd already coughed up a lung) I managed to gasp Honey look, *cough splutter*, a tree. Don't you wanna *cough* pee? 5 degrees C and really foggy may not be the ideal setting for jogging (the un-fit human says) ;).

Bailey is doing great, thank you so much for asking :). He's no longer vomiting bile :D. I came across something that said to give a little food or a snack before bedtime, so there's something in the pup's tummy overnight, and Mum has been doing that. It would probably be 6-7 weeks since the bile situation was happening. He's perky and trots around quite happily, tail wagging. The vetmedin and flusapex have really been miracle drugs for him. He sleeps alot, snuggles up on the couch to Mum, has bursts of energy and makes some demands now and then :). Thank you again, Leslie, and big ((hugs))

With love,
Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi all,

Just a quick update on the little guy- we started the enalapril a week and half ago, and yesterday was his bp follow up. They used the machine they have used on Franklin prior, and kept getting readings of 60/30 :eek::eek: with a heart rate of 130. So they sent someone across to the other clinic to get the doppler machine, and it wasn't working right either. (He's also been slow to eat, and not finishing his food for the last 2-3days)
The docs tested other dogs there with both machines, and still couldn't get a consistant result, but they did Franklin 15 or so times, still averaging 60/30. While Franklin was in the cage, he apparently had a case of explosive diarrhea, and his soft puppy toy was injured in the fall-out :( Still soggy from the washing machine.

It was the same doc, and same nurse that usually does his blood pressure as well. The doc said that it couldn't possibly be accurate, or Franklin wouldn't have been as strong and energetic as he was. I rang the gp vet to ask if it's ok to stop the enalapril till we get another bp check, and he said 'no, should be fine to keep going, but call the IMS', and she said "no, stop dosing, and get it checked again tomorrow'. Yep, we go to the only place that has a bp monitor within an hour and a half drive, we can get it checked tomorrow. ???. No problems, don't need to wait till it's been calibrated/serviced or anything. Needless to say, we didn't get it checked today.
Just found out that there's a new vet university about 2 hours away, so I'll call them and see if they have a bp monitor. Due to work, we wouldn't be able to get there till Friday at the earliest, though.

Here's something interesting that the IMS said- if you can feel the pulse at the leg/groin junction, it usually means that the blood pressure is over 100. Thought I'd pass that along.
We're back to gp vet in the morning for cbc, profile, spec cPL, and urine check (just for UP:C), so will post results when I get them.

Oh, Debbie, I read your response to Kim about the traumatic blood draw, and it not being traumatic for the pup, just the way the blood is handled after the draw. Thanks for that.

That's all for now, hope you and your babies are doing really well,
Love and big cuddles and belly rubs,
Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi dear friends,

Franklin's results are in, and the out of range stuff is:
* Anion Gap 27 mmol/L (15-25)
* Creatinine 37 umol/L (40-140)
* Alkaline Phosphatase 974 U/L (< 120)
* Albumin 40 g/L (22-36)
* Lipase 80 U/L (1-70)

Woo hoo!! :) His lipase is almost normal, and cholesterol and trigs are within range-->
Cholesterol 8.6 mmol/L (3.6-8.8)
Triglyceride 1.1 mmol/L (0.2-1.7)
So that does make a change. The spec cPL was great : 59ug/l Normal range is <200
We eventually went to the University hospital (I say eventually because I had a case of 'can't follow the directions' crossed with 'it's my first time behind the wheel of a car') as I drove like Magoo, squinting for street signs, and like Miss Daisy was in the back :o.
The blood pressure from the hospital read oscillometric average 141/78- mean 99. Doppler average 141/66, so enalapril will begin again. I'm thinking 1/2 tablet (tab is 5mg) per day.
Franklin has begun on the melatonin and lignans, and his appetite is extremely healthy. It's winter here, so he's not drinking so much, but they also say water consumption goes down with home cooking, as home cooked is something like 70% water. Haven't changed over completely to home cooking, but it's being mixed in with his Royal Canin.
He loves the "crispies" (diced lamb or beef, boiled to remove most of the fat, then popped into the oven to remove the moisture and make them crispy.) Sort of my take on homemade schmackos (like a jerkey), while trying to keep them healthier for him. Guessing I don't have to be quite so anal about the fat, now though. They are quite yummy, and I think he gets a kick out of seeing his mum eat his food :p, or is thinking he gets to eat more people food.

Hugs and belly rubs from us to all of you,
Jane, Franklin and Bailey xxx

[mypuppy]

Oh Jane,
You really crack me up with your posts, so keep them coming cause we could all sure use a lot of that humor in life--lol. First I'd like to say that I am extremely happy for both of you in that some of his tests came back within range. yehhhhhh! That is always a big load off. As for the other results I do so wish I can comment but I will leave that for the experts whom Im sure will soon. Lastly, thanks for teaching me something new today. I never knew home cooked meals provide as much as 70perc. Water. I knew some but not that much. Wow! I have been cooking chicken breasts and venison for my Princess in the croc pot because she has been getting a bit finicky with her doggie food, so I incorporate the extra food into her dry kibble and no problem. Spoiled Princess that she is. Jane great to hear from you as always. Hope you get some comments soon on Franklin and let us know what next with the little precious face. Warmest regards and much love to the both of you. Winter! Ugh, I don't want to even hear that word after our last brutal winter. Stay warm. Xo Jeanette and Princess

[littleone1]

Hi again Jane,

I'm glad to hear that some of Franklin's test results are now in the normal range, and that he's doing well. Hopefully, the next time he has blood tests, everything will be in the normal range.

Big hugs for you and Franklin.

Take care my friend.

[Casey's Mom]

Great results Jane!! Give Franklin a belly rub from me,

[Franklin'sMum]

Hi Jeanette, Terri and Ellen,

Thank you all so much for your warm wishes and thoughts, much appreciated :).
Big hugs to you and yours, and belly rubs too
With love,
Jane, Franklin and Bailey xxx

[marie adams]

Hi Jane,

I am glad to hear Franklin is doing well and the test are within normal range---YEAH!!!:D:D

Your posts are great to read with the humor going on--I so feel like that most of the time--what I have a problem with is I know the word, but something similar comes out of my mouth--my husband goes nuts trying to figure out what I am saying, but my daughter says it is scary she understands me.:o

Thank you for the info:

Marie- this is from Monica Segal's book, K9 Kitchen, pg 80,
Quote:
Tyrosine is an amino acid. It's available in good supply in meats. skipping a little- Without enough tyrosine, a black coat can start to fade or take on a red/orange cast

I give Maddie a raw chicken diet along with a dry venison with no grains at all. I will check the label on the dry to see if it has tyrosine in it. The small amount of new fur looks blacker so we will see. I have noticed even before the cushings symptoms started she has had the red cast so maybe her previous food didn't have enough in it.

It is amazing how this disease makes you so much more aware of their diet and just well being.

Thanks!! And big hugs to you all!!!:):)

[Franklin'sMum]

Hi everyone :)

Franklin has been on melatonin and lignans for 6 weeks now, and I think they're working :). We haven't had a UTK panel re-done as yet, planning on doing that in 3 months, but I think his "girly" hormones are close to under control- Bailey and Franklin got together for a play date 2 weeks ago, and they played!! Bailey wasn't trying to hump Franklin (too much :rolleyes:) Makes a huge change :D

Franklin had an ACTH, profile, cbc and UP:C done on Monday, and I'd like your combined take on things before my head goes *pop* :eek::o
We don't have the result of the UP:C yet. Here's the thing- Franklin stopped eating the royal canin, even with parmesan cheese on top, or rice or ground beef mixed in, so we went back to regular commercial food (the same foodies he was on before RC), so I was expecting the trigs, lipids and cholesterol to be up. I'm going to include his entire panel, as some things are just on the ref range.
BTW, this was a 10 hour fast.
% x109/L
Hb 161 g/L (115-180) WBC 9.8 (6.0-14.0)
RCC 6.85 x1012/L (5.00-8.00) Neut 74 7.3 (4.1-9.4)
HCT 0.47 (0.37-0.55) Lymp 17 1.7 (0.9-3.6)
MCV 68 fL (63-74) Mono 4 0.4 (0.2-1.0)
MCH 24 pg (20-25) Eos 5 0.5 (0.1-1.2)
MCHC 344 g/L (310-360) Baso 0 0.0 (< 0.2)
Band 0 0.0 (< 0.3)
Plat 546 x109/L (200-900)
RBC Morphology- Polychromasia+,
WBC Morphology-Show normal morphology
Platelet- Show normal morphology
Sodium 147 mmol/L (140-155)
Potassium 4.7 mmol/L (3.8-5.8)
Chloride 103 mmol/L (100-120)
Bicarbonate 24 mmol/L (16-24)
Anion Gap 25 mmol/L (15-25)
Urea 5.3 mmol/L (2.5-9.0)
* Creatinine 37 umol/L (40-140)
* Glucose 7.2 mmol/L (3.5-6.7)
Bilirubin < 2 umol/L (< 11)
ALT 76 U/L (< 80)
* Alkaline Phosphatase 1040 U/L (< 120)
Protein 70 g/L (55-78)
* Albumin 45 g/L (22-36)
Globulin 25 g/L (22-42)
Albumin/Globulin Ratio 1.8 (0.5-1.8)
Calcium 2.75 mmol/L (2.00-2.80)
Phosphate 1.2 mmol/L (0.8-2.0)
Creatine Kinase 104 U/L (< 401)
Amylase 755 U/L (< 2400)
* Lipase 160 U/L (1-70)
* Cholesterol 10.7 mmol/L (3.6-8.8)
* Triglyceride 4.0 mmol/L (0.2-1.7)
TIME Serum CORTISOL (nmol/L)
OHR 163
1HR 281
The ACTH stimulation pattern is not consistent with hyperadrenocorticism. ?History - diagnostic or therapeutic monitoring?

The creatinine *might* be explained by this- the kidney site says coq10 is better absorbed with omega 3 fish oil, so when I've been giving coq10, it's been with the fish oil. They say that coq10 can lower creatinine (which was never elevated). On the other hand, the low creatinine results have only been since Franklin started the enalapril for protein loss. After the freaky bp episode, I'm only giving him half the dose (which is 2.5mg)
AlkPhos just keeps going up :( and I had doubled his Milk thistle on some days :(. You might remember that the last couple of urine tests showed glucose. GP said that for diagnostics / monitoring, they go by blood glucose. Now that's slightly elevated, too :confused:. Vet did say that if an undx'd diabetic pup came in, they would expect 15+.
I gave up homecooking a few weeks ago, and am getting a diet formulated by someone who knows what they're doing- I didn't want to create further issues, now these results on commercial food. :confused:
To my knowledge, albumin can be elevated by dehydration. Dehydration can cause protein loss. Every test Franklin has had, has shown high albumin. Since Franklin's tests are most of the time happening in the morning, do you think it's possible that he just hasn't been up long enough to have enough fluid?
Here's another thought... I'm planning on asking our vet if maybe we can try subq fluids for a week or so, and then run another panel to see if that makes any difference in his numbers. Does that sound like an ok plan? Any thoughts or ideas? I'm stumped :(. My little man laughs in the face of conventional veterinary science, doesn't read the books, and doesn't really fit any mold for diagnostics.
I said to myself a couple of months back that if we still don't have a clue (don't remember the time frame), we're done. No more poking or prodding. Just the occasional blood test to see how things are. But I'm not willing to maybe let this proteinuria get worse, and maybe cause renal disease (if that's not what it is currently). The thing that is really confusing to me is that this doc says this, and that doc says that, which boils down to "it's a very serious condition." (That they can't name, haven't dx'd, and seems they're only guessing at.) Don't get me wrong, I realise they have the education yada yada, and that me refusing biopsies might hobble them a bit, but he's not a guinea pig :mad:. Thankfully they haven't told Franklin that he *might* have such a serious condition, because he remains as happy as a piggy in the proverbial. Laughing, running around, playing with his toys, loving his walkies and snuggling. He's eating well and not drinking huge amounts. Growling for me to come get his toys when he flings them off of the bed :rolleyes:.
Anyways, I'll stop rambling. Any thoughts are as always HUGELY appreciated. Sending you all love and hugs and best wishes,
Jane, Franklin and Bailey xxx

[littleone1]

Hi Jane,

I'm glad to hear that Franklin is doing better.

I wish I could offer you some advice, but I know that the results of their blood work can be very confusing at times. Hopefully there is nothing serious to worry about.

The Corkster and me are keeping everything crossed that it is only something minor.

Give Franklin and Bailey hugs and belly rubs from me.

[Franklin'sMum]

Hi Terri,

Extremely confusing :confused:. Thank you for you and Corky keeping everything crossed. Franklin thanks you for his hugs and belly rubs, and I will pass them along to Bailey next time I see him :)
Hugs to you both my dear friend, and some ear scritchies for Corkster :)

Jane, Franklin and Bailey xxx

[Harley PoMMom]

Hi Jane,

So happy to hear Franklin's been feeling so well and frisky!! It does do our hearts good when they want to play and snuggle with us!

The only comment I have is about his lipase, as I remember his snap PLI came back abnormal. If it were me I would have this confirmed with a spec PL.

As you probably already know the pancreas has two functions: 1) exocrine - to produce the enzymes needed to digest food, and 2) endocrine - to produce hormones, including the hormone insulin, which facilitates the uptake and storage of glucose (sugar) and amino acids (proteins).

If the endocrine function of the pancreas does not work properly, a condition called diabetes may result.

The quote below is about digestive enzymes and is taken from an article by Jörg M. Steiner, Associate Professor and Director Gastrointestinal Laboratory at Texas A&M University, and he is also one of the men who developed the spec PL test.



According to a generally accepted pathogenic model, pancreatic acinar cells ultimately respond in a common fashion to a variety of harmful stimuli, leading to inappropriate intracellular activation of trypsin and subsequently activation of other digestive zymogens. The activated digestive enzymes cause local changes, such as inflammation, hemorrhage, acinar cell necrosis, and peripancreatic fat necrosis. Digestive enzymes released into the blood stream may cause systemic changes, including systemic inflammatory changes, systemic vasodilatation leading to hypotension, pulmonary edema, disseminated intravascular coagulation, central neurologic deficits, respiratory failure, renal failure, and multiorgan failure. http://www.hcvma.org/notes/SpeakerNotesJorgSteiner.pdf

Although in this article, I believe, Dr Steiner is talking about the long term effects of pancreatitis, I don't think one can deny that pancreatitis, whether it is acute or chronic or in its mildest form, is a disease that veterinarians need to address promptly.

Keep up the great work Jane, you are such a wonderful mom to Franklin! Big hugs to both Franklin and Bailey from Harley and me and hugs to you too!

Love and hugs,
Lori

PS I did ask Debbie to look at your lab results.

[labblab]

Hi Jane! It is always so good to hear from you, and just like Lori says -- it is wonderful that Franklin is acting so perky!!! I'll also be anxious to hear what Debbie has to say about all the test results. But in the meantime, one quick question (and I apologize for not already remembering the answer :o)...but is Franklin currently taking trilostane or is he on a break?

Marianne

[Franklin'sMum]

The only comment I have is about his lipase, as I remember his snap PLI came back abnormal. If it were me I would have this confirmed with a spec PL.
Hi Lori,
On the 28 June, Franklin's lipase was 755 U/L (1-70) :eek: so we got the spec cPL and more bloods done on 15 July, results were lipase 80 U/L, and spec cPL 59ug/l (<201) :) GP vet has said on a few occasions that the lab seems to have high lipase readings.
I don't know if it makes a difference, but before the 28 June testing, he had comm food with lots of fish in it (rich in omega 3) and before15 July was... my home cooking ;) ta daa!
Here's a question for you, Lori- if bloodwork is only a snapshot in time, is it possible Franklin has had pancreatitis in the past but is over it, or would a previous bout of pancreatitis show up on a spec cpl and be over 201?


As you probably already know the pancreas has two functions: 1) exocrine - to produce the enzymes needed to digest food, and 2) endocrine - to produce hormones, including the hormone insulin, which facilitates the uptake and storage of glucose (sugar) and amino acids (proteins).
A week ago, I noticed some undigested food in his poop. Upon closer inspection :o it turned out to be rice and carrot (from comm. food the day before). I haven't noticed undigested food since, but gave him the same flavour tonight for his tea, so tomorrow will be telling.


If the endocrine function of the pancreas does not work properly, a condition called diabetes may result.
Although in this article, I believe, Dr Steiner is talking about the long term effects of pancreatitis, I don't think one can deny that pancreatitis, whether it is acute or chronic or in its mildest form, is a disease that veterinarians need to address promptly.
I've just been reading that a number of diabetic dogs can develop pancreatitis and /or persistant hypertriglyceridemia. So, if one function of the pancreas (exocrine- undigested food) isn't working optimally, would that mean that by default the endocrine functions would also have trouble doing their job?


Keep up the great work Jane, you are such a wonderful mom to Franklin! Big hugs to both Franklin and Bailey from Harley and me and hugs to you too!
Thank you so much for your kind words Lori :). I owe you and the rest of my family here so much. Thank you to you and Harley for all of our hugs :D


PS I did ask Debbie to look at your lab results.
Thank you Lori, I know Debbie's very busy with her own pack at the moment, and always being here for us, too.

Huge (((HUGS))) to you my precious friend, and huggles to Harley and Bear. Maybe Alex if he's not picking on Bear :p
Love,
Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi Marianne,

No problems about not remembering stuff, and no need to apologise, I have the same mental blank sometimes. Franklin has been off trilo since mid March, and is only taking lignans (1/8 tsp) once per day, and melatonin 3mg twice per day (since mid July). Early August we began 2.5mg enalapril for the protein loss.
Other things he's on are - omega 3, taurine, carnitine, glutamine, milk thistle, vitamin b, vitamin e and co enzyme q10. Not all of those are given each day, the poor little guy would rattle when he walks!
The above ACTH result is (in my mind) pretty freakin' good! :) all things considered,
love,
Jane, Franklin and Bailey xxx

[labblab]

That's what I was thinking -- that he hadn't been taking the trilostane for a while. Does this ACTH result represent a big jump from his numbers last spring? (For those of us in the U.S., here's the "converted" results...Pre: 5.9 ug/dl; Post: 10.2 ug/dl). What with all your struggles trying to get him stabilized and feeling well, I'm also thinking that his behavior is your most important guide right now. And as long as he's not exhibiting strong Cushing's symptoms, then I surely understand why you're not launching back into the trilo. But with a "post" result of 10.2 ug/dl, I'm wondering if you may be nearing a cusp when the cortisol may start kicking back in again...

But then again -- maybe not, and I've got my fingers crossed that you will be able to continue with an extended trilo vacation!! ;)

Marianne

[Harley PoMMom]

Hi Lori,
On the 28 June, Franklin's lipase was 755 U/L (1-70) :eek: so we got the spec cPL and more bloods done on 15 July, results were lipase 80 U/L, and spec cPL 59ug/l (<201) :) GP vet has said on a few occasions that the lab seems to have high lipase readings.
I don't know if it makes a difference, but before the 28 June testing, he had comm food with lots of fish in it (rich in omega 3) and before15 July was... my home cooking ;) ta daa!
Here's a question for you, Lori- if bloodwork is only a snapshot in time, is it possible Franklin has had pancreatitis in the past but is over it, or would a previous bout of pancreatitis show up on a spec cpl and be over 201?

OMGoodness, Jane, How did I miss Franklin's spec PL results done in July!! So sorry about that...my mind <sigh>

To answer your question, I believe that since the spec PL test has a specificity and sensitivity of >95% for diagnosing pancreatitis in dogs that the likelihood of Franklin having pancreatitis is almost nil. I also believe once a dog has a pancreatitis flare-up that this dog will forever have pancreatitis, it may be in it mildest form but it is something that has to be monitered closely. I think this is where Harley falls in, he has pancreatitis and shows no symptoms but his spec PL tests are high.



A week ago, I noticed some undigested food in his poop. Upon closer inspection :o it turned out to be rice and carrot (from comm. food the day before). I haven't noticed undigested food since, but gave him the same flavour tonight for his tea, so tomorrow will be telling.


I've just been reading that a number of diabetic dogs can develop pancreatitis and /or persistant hypertriglyceridemia. So, if one function of the pancreas (exocrine- undigested food) isn't working optimally, would that mean that by default the endocrine functions would also have trouble doing their job?



Are Franklin's carrots raw? The difference between raw and blanched or slightly cooked is the poop! Raw veggies can be seen in the poop, undigested. That's why it's best to cook them a little so that they can digest them and get the nutrients. Same goes for the rice, when I cook Harley's rice I cook it until it is a mush mixture...I think Leslie compared this to wall-paper paste?? It when all the rice seeds have cooked open, I add 3-4 cups of water (or more) to 1 cup of rice when I am making rice.

But to answer your question;
In pancreatitis, inflammation disrupts the normal integrity of the pancreas. Digestive enzymes which are normally safely stored in granules are released prematurely where they digest the body itself. The result can be a metabolic catastrophe.

If the pancreas is affected so as to disrupt its ability to produce insulin, diabetes mellitus can result; this can be either temporary or permanent.
http://www.marvistavet.com/html/body_canine_pancreatitis.html

Sometimes pancreatitis can lead to Exocrine pancreatic insufficiency. EPI is a syndrome caused by insufficient synthesis and secretion of digestive enzymes by the exocrine portion of the pancreas. In dogs with EPI caused by chronic pancreatitis, destruction of pancreatic tissue may not be limited to the acinar cells, and concurrent diabetes mellitus may develop.

Hope this helps.

Love and hugs,
Lori

[Franklin'sMum]

Hi Marianne,

No, actually it's a fair drop from when he was on trilo :confused::rolleyes:
18 Jan pre 263nmol (9.5ug/dl) post 562 (20.3)
22 Feb pre 249nmol (9.0ug/dl) post 529 (19.1)
4 May pre 46.5ng/ml (2.0-56.5ng/dl) post 151.2ng/dl (70.6-151.2ng/dl) -UTK panel.

THe only reason I got him stimmed on Monday was his appetite is sometimes crazy, barking at me for more food, sooky growling and tapping me. Not all the time, but thought hmm, wonder what's happening here? He usually eats 300-350grams of food per day (10-12.5oz) (not including snacks) and there were a few days in the past month where he ate 500grams (17.8oz), and still was a couple of times asking for more. He did that ages ago, and the next day wouldn't eat until lunch or tea time, but this past month when he's wanted/had a lot of food, the next day he had breakfast at around the usual time.
Granted, we're coming out of winter, and it has been cold, but that's pretty out of character for him. The mind boggles, and so does the boy child :rolleyes::)

Jane, Franklin and Bailey xxx

[Franklin'sMum]

Are Franklin's carrots raw? The difference between raw and blanched or slightly cooked is the poop! Raw veggies can be seen in the poop, undigested. That's why it's best to cook them a little so that they can digest them and get the nutrients. Same goes for the rice, when I cook Harley's rice I cook it until it is a mush mixture

Sometimes pancreatitis can lead to Exocrine pancreatic insufficiency. EPI is a syndrome caused by insufficient synthesis and secretion of digestive enzymes by the exocrine portion of the pancreas. In dogs with EPI caused by chronic pancreatitis, destruction of pancreatic tissue may not be limited to the acinar cells, and concurrent diabetes mellitus may develop.

Lori

Hi again Lori,

Sweetie, don't worry about missing or forgetting results, I know you're always helping people here, and there's lots of info whizzing around. You do great Lori :)
The rice and carrots were from commercial food, so I imagine they're cooked. Franklin does like the wall paper glue rice, and I always cook the veggies. I stopped home cooking a few weeks after glucose showed up in his urine, but before it showed in his bloods.
I don't want to create false problems that Monica will be addressing, especially if the problem only exists due to my ignorance of nutrition :o. You know, fixing this and causing that when the this only occurred after I caused it :o. So we've been back on commercial food for a few weeks now.

Thank you for the link and your info, I'll read it tomorrow when I get up,
Much love and many hugs,
Jane, Franklin and Bailey xxx

[labblab]

Hi Marianne,

No, actually it's a fair drop from when he was on trilo :confused::rolleyes:
18 Jan pre 263nmol (9.5ug/dl) post 562 (20.3)
22 Feb pre 249nmol (9.0ug/dl) post 529 (19.1)
4 May pre 46.5ng/ml (2.0-56.5ng/dl) post 151.2ng/dl (70.6-151.2ng/dl) -UTK panel.

...The mind boggles, and so does the boy child :rolleyes::)

Jane, Franklin and Bailey xxx
Ye Gads!!!! I had totally forgotten or altogether missed Franklin's cortisol drop after discontinuing the trilostane...:eek: :eek: :eek: :confused:

I am totally flummoxed, and my sentiments are now just the same as yours... :o ;)


The above ACTH result is (in my mind) pretty freakin' good! all things considered

[lulusmom]

Hi Jane,

It is a really weird that Franklin's stimulated cortisol level has consistently gone down since you stopped dosing with Trilostane. :confused: While not that common, there are documented cases of dogs that have gone into spontaneous remission of cushing's. It is believed that in these cases, the dog embolizes the pituitary microadenoma, meaning the tumor breaks up and is absorbed, as in disappears. I am really hoping that perhaps this may be what is happening with Franklin. I'll be staying tuned for updates.

Hugs to you and Franklin.
Glynda

[StarDeb55]

Jane, I'm back from a holiday weekend & trying to look at Franklin's latest bloodwork. I'm sorry to have to ask you this, but trying to sort out the whole panel is kind of mind blowing for me at the moment. Could you please repost only the abnormal results, even if they're only slightly abnormal? It will take me some time to go through them as the reporting units are not what I'm use to seeing.

Debbie

[Franklin'sMum]

there are documented cases of dogs that have gone into spontaneous remission of cushing's. It is believed that in these cases, the dog embolizes the pituitary microadenoma, meaning the tumor breaks up and is absorbed, as in disappears. I'll be staying tuned for updates.

Hi Glynda,

WOO HOO!!! :D:D:D:D:D Spontaneous remission? I can handle that :). I'll keep you all updated, (even though I don't quite know what I'm updating about these days) :o
Thank you so much Glynda, and for our hugs
Love
Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi Debbie,

Did you enjoy your weekend? I hope it was great :) Sorry to blow your mind with these results :o, I really do appreciate you taking a look. My apologies about including the whole report previously.

RBC Morphology- Polychromasia+,
Bicarbonate 24 mmol/L (16-24)=24mEq/l (16-24)?
Anion Gap 25 mmol/L (15-25) =25mEq/l (15-25)?
* Creatinine 37 umol/L (40-140)=.41mg/dl (.45-1.5)?
* Glucose 7.2 mmol/L (3.5-6.7)129mg/dl (63-120)
* Alkaline Phosphatase 1040 U/L (< 120)
* Albumin 45 g/L (22-36)= 4.5g/dl (2.2-3.6)
Albumin/Globulin Ratio 1.8 (0.5-1.8)
* Lipase 160 U/L (1-70)
* Cholesterol 10.7 mmol/L (3.6-8.8) 413mg/dl (138-339)
* Triglyceride 4.0 mmol/L (0.2-1.7) 353mg/dl (17-150)
Serum CORTISOL
OHR 163nmol/L (5.90ug/dl) 1HR 281 (10.1ug/dl)
Aside from cortisol, I got some of these from
http://http://www.soc-bdr.org/rds/authors/unit_tables_conversions_and_genetic_dictionaries/e5196/index_en.html
and the ones with=? are from
http://http://www.unc.edu/~rowlett/units/scales/clinical_data.html

I'm really hoping that at least some of those reporting units are what you use, rather than only applicable to the east coast of Siberia :o. Once again, Debbie, thank you so much.
PS- please don't be sorry for asking me to do something that will make things easier on you :)
Big hugs and lots of gratitude,
Jane, Franklin and Bailey xxx

[StarDeb55]

Jane, other than the typical liver function elevations, there is nothing here that is worrisome, IMO. Polychromasia is a term used to describe a specific type of red blood cell. A polychrom RBC is a "young" RBC recently released from the bone marrow into circulation. If increased polychromasia is noted on a blood smear, it usually means that the bone marrow is under some type of stress due to a lot of different things. Some of these things may include anemia which can be due to a number of different things including blood loss or poor nutrition. With just a 1+, I really don't think this is anything to worry about, especially with a normal hemoglobin. Hemoglobin was normal, if memory serves?

Debbie

[Franklin'sMum]

Hi Debbie,

Thank you very much, and yes hemoglobin was normal. Thank you so much Debbie, I really do value your opinion :). Whew! Ok, I'll relax a little now. Not too much, just a little ;)

Big hugs to you and the boys,
Jane, Franklin and Bailey xxx

[mypuppy]

Hi Jane,
I haven't been on much (hectic summer with the kiddies), but wanted to post briefly and say a quick hello and I am glad you can relax about the little precious face. Hope all else is going well. We are doing ok and Princess is still going strong, aside from some eye issues. Due for stim on 9/16. thinking of you and Franklin often with much love. Tight hugs to both of you. Xo Jeanette and Princess

[Franklin'sMum]

Hi Jeanette,
Long time no see! :) Glad to hear everything is going well with you guys :) Yes, Debbie's great for reassurance when the labwork confuses the poop out of me :o. I'll be looking for Princess's results, ok. Don't be a stranger Jeanette.
Love you big bits,
Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi everyone,

Franklin has been really well and cruising along :), so imagine my surprise when he had staggering episode tonight :(. It only lasted 2-3mins, not much circling but a lot of sitting and still had the backwards walk thing going on and he is fine now, but... :confused: Appetite -good, energy -good, toys- chewed :p. He was very still for about a half hour after the ep, but is back to being Franklin.

We have an appt on Monday with a different vet. (Story of why follows). I met her many years ago- she used to work at the farm vet's practice. We used to have a beautiful muppet (toy poodle) named Pokie - well, Ralph actually, and he was allergic to bee stings. This was all before Franklin's current vet came to town.
So, quickie update for those keeping up, Franklin has been spilling glucose in his urine for a few months, but it only just appeared in a blood test a couple of weeks ago. So I'm now having the "is he diabetic? Is it from the food he eats?" kind of thoughts. Bought a glucometer, and have been getting him used to having his lips folded back, and ears also. Letting him hear the 'click' sound of the device, and today I pricked him :eek:. He handled it very well, but I think that the device setting depth wasn't right for him, so I upped it to the next level. So that may have got a blood drop, but I couldn't open his lips for the next minute to check, or finish the test. So that will be going to the other vet, and she can show me what I'm doing wrong, and we'll get a read (hopefully). A semi- multistix test the other day showed no glucose or ketones, but as said, it was only a semi test- I kinda goofed.
Warning- need to vent
Our regular vet /vet nurse is a husband and wife team, and are giving conflicting info- oh crap, our dog isn't vaccinated/ we over vaccinate our dog, and there's no problem or danger :eek:
Not helped by nurse putting the hard sell on me- you MUST do something about heartworm, Jane. His vacc is 3 months overdue. Mozzies will be hatching in the next few days, are you willing to take the chance of Franklin getting heartworm? I said, It's not the season yet and it's not a vacc, it's an insecticide. She said so's the worming tablets. I say- yes but they don't last 15 months is his system. Blah, blah. Then she says her dog is on heartguard, and revolution, and gets the Proheart. No parasites there. Then she adds that their dog has had heartworms since it was 12 months old :eek::confused: What???
But they got the dog when it was a puppy, so here's my question (that I won't ask them :p) How does a vet's dog get heartworm, if they are following their own advice of yearly vaccs for everything under the sun? One month they worm her every 3 months, then she says they worm monthly.
Doesn't help the cause that according to nurse, (I spoke to her this week, not the vet) that vet won't write a prescription for me to take elsewhere, as dispensing is part of his business. Great. Yeah. But when I'm being charged $50 extra for something, or in one case $110 extra on top of what it actually costs :mad::mad::mad:
Told if I want a script written to get it from IMS. I was told by vet last week that they would order his bp meds monthly for us (we're the only ones who use it), I said to nurse not to do that just yet, as if there is no great reduction in the protein loss we may need to change meds. She said "vet won't do anything without IMS's authority". (That would probably explain his reaction in July when I requested the spec cPL- he asked "Did Dr X authorise that test?" I tell you it was all I could do not to say 'no, and dr x isn't the one who'll be paying for it, either!')
Don't get me wrong, I consider these folks extended family, and love them dearly. They're just giving me the poops at the moment. AAAAAAAAARRRRRRRRRRRRGGGGGGGGGGGGGHHHHHHHHHH!!!!! So, that's why we're checking out this other vet to maybe add to Franklin's team. Interview next week ;)

If you've made it this far down the page, thanks for listening. Will try to be in a better mood about this situation.
Big hugs and lots of love to you all,
Jane, Franklin and Bailey xxx

[littleone1]

Hi Jane,

I'm sorry to hear that Franklin is having more issues. I hope that these are minor issues that can be taken care of very easily.

Don't worry about venting, as we all need to do it and have done it. I understand why you're going to see another vet. I hope everything goes well.

Give Franklin a big hug from me.

[Franklin'sMum]

Thank you Terri,

That's so thoughtful of you. GP vet said IMS recommends a tick borne disease panel to try and rule out other causes of proteinuria, so at least there's a next step.
Are you noticing improvement with Corky's infection?
Love,
Jane, Franklin and Bailey xxx

[Squirt's Mom]

Hi Jane,

How is Franklin today? Any more episodes? I hope not! That had to be scary for you!

Let us know how he, and you, are doing!
Hugs,
Leslie and the girls :D - always

[apollo6]

Dear Jane
You have all the right in the world to sound off. I am going through similar stuff with the vet. Charged $63.00 for Apollo's compounded Trilostane.:mad::eek:
Hope you are all doing well. We keep on fighting for our cushing pups.

[Casey's Mom]

Hello Jane, sorry about your vet frustration - its okay to vent.

Hugs to that little cutie Franklin,

[BestBuddy]

Hi Jane,

I get the frustration!

I would think that if Franklin was diabetic then you would be getting glucose in the urine all the time. The fact you are getting some glucose is a bit of a confusion but a diabetic dog not on insulin would be getting worse by the minute.

I do hope you can get some answers soon.

Jenny

[gpgscott]

Hi Jane,

Don't feel bad about the vet rant, in reading the story I feel frustration myself.

My take on this is that vet's are like any other business and need to charge appropriate value for goods and services to stay in business. I really do not like it though when someone is held hostage so to speak for a script to submit to a low cost provider because the vet in question does not purchase in quantity to secure low market rates.

Hang in there, I also try very hard to examine every puchase I make both for my pup's wellbeing as well as my families. I outsource a number of meds for myself but I do make sure they come from a reputable pharm.

Good luck, you seem to like these people, I hope you can find a way to stay under their care without paying needless $.

Scott

[Franklin'sMum]

Hi my wonderful friends,

Hi Leslie,
Franklin is well, thank you for asking. No more episodes since. I'm just so grateful that if he's pottering around, he does come over to me before it starts, which gives me the chance to try and comfort him. Sure, sometimes he has squirmed, and I've put him on the floor/ground, but for the most part I like to think that talking to him and trying to hold him or keep him steadywhile it's happening makes him feel better. It does me :o. This one wasn't as scary as the first couple or the one I videoed in March, it seemed more mild, and didn't really seem to last as long. Franklin did one circle, and the rest was either sitting or staggering a few backward steps. The only other thing that makes this time different from the others is he was trying to eat grass throughout the episode. He'd had a couple of treats, but hadn't eaten his tea at the time, so doubt it was an upset tummy.

Hi Sonja,
$63 for compounded trilo sounds like it could be a bargain on this side of the pond. Of course that depends on how many doses it is for. We are doing well, sweetie, and thank you for checking in on us :) Hoping you get some joy with your vet, and hugs to you and Apollo.

Hi Ellen,
Franklin thanks you for his hugs, and blushed when I told him you said he's a cutie :D. It seems quite normal for one of us here to vent about what we think should be being done, as opposed to what is being done. I know that the vets have the schooling and (sometimes) the experience that we need, and I really appreciate that they do. And I love that some of them go out of their way to learn new things or read articles to keep up in a conversation with us :p.
Hugs to you, and belly rubs to the gorgeous girls Casey and Desi :)

Hi Jenny,
"but a diabetic dog not on insulin would be getting worse by the minute." Sigh of relief. He's back to being his regular self :).
I'll just update here on my latest thoughts about the glucose :o, I came across a file that lists drugs that can elevate blood glucose, and enalapril is on the list. Well, more to the point enalapril ??????zide (or something) is on the list, and has a different brand name than Franklin's. But still contains enalapril as the main ingredient. So now I wonder if all of this is because of the enalapril? I hope we can get some answers soon, too, Jenny. Maybe Monday's vet will have some experience with mystery patients ;)

Hi Scott,

My take on this is that vet's are like any other business and need to charge appropriate value for goods and services to stay in business. I really do not like it though when someone is held hostage so to speak for a script to submit to a low cost provider because the vet in question does not purchase in quantity to secure low market rates I understand what you're saying completely, Scott, but here's my confusion (well, some of it). The drug he is on for the protein loss in his urine (enalapril) is metabolized by the kidneys, and usually is not the first choice due to that a protein losing neuropathy /enteropathy is sometimes a pre-cursor to chronic renal failure. So in theory the kidneys are being worked harder, when the end result may be the kidneys become faulty, and can't keep up with the body's basic needs.
I also would have no problem being charged an appropriate value for goods, but that's not happening. Now, if Franklin had an ifection, I wouldn't be comparison shopping the price of a/biotics. It wouldn't matter to me if they added a nice profit for themselves (no doubt they do :rolleyes:), but if it's something that Franklin will need to take for months or years, then don't rip me off is all I'm saying. Enalfor-Enalapril maleate (Merial) from vet $63, same dose/ingredients/amount, (Alphapharm) from local chemist $10.50
Trilostane from vet $220 100 tabs (and he was buying that in bulk at the time). One time they accidently left the compounding sticker on, and on the label it had $110. In my mind, that's more than "an appropriate value". If they do this with everyone, that's their holidays, kids college funds, new car, holiday house, yacht... Ok, probably not quite yacht, but.
Before that trilo sticker, I didn't even know where my trilo was coming from, and they don't have a brand new state of the art whizz bang facility with all new stuff that needs paying for. Thank you for your good luck wishes, Scott- I'm hoping I don't have to sell my organs :eek::)

Anyways, I'm in a much better mood :), and will keep you all in my thoughts and prayers as always. Thank you all so much for being here and all of your support. I would truly be lost without you.
Lots of love,
Jane, Franklin and Bailey xxx

[BestBuddy]

I feel the same about the cost of vet drugs. I also got really mad when I felt I had been overcharged for medication that was listed for humans at the chemist for $15 and the vet charged me $75.

I did ask why and was told that there were lots more hands they were being passed through and each one took their cut. The drugs were purchased from the pharmaceutical company then sold onto a Vet supplier and then onto a distributor and finally to the vet. I also don't mind paying a few dollars for the purchase but I will not be paying everyone who has managed to touch the pill bottle.

Luke needed to take pred for a foot problem and they wanted to charge $10 for 10 tablets....I said no as I take them myself and can get 100 tablets for $7 and they are the same strength.:D I know how to share.:D

Jenny

[Franklin'sMum]

Hi Jenny,

I had no idea the amount of hands things go through to finally get to us, the parents. But I imagine the trilo went straight from the compounding chemist to a delivery company or aussie post to get to our vet.
Thanks for the details.
I know how to share. ha ha :). I bet that goes with food, too- "Ma, Joey ate that bit", "Na-ah Luke just wants more" mmm, yummy people food :D

Jane, Franklin and Bailey xxx

[BestBuddy]

Just had a very complex dinner, 3 dim sims, steamed of course and a glass of Sav Blanc. I now have a packet of cheese twisties under my arm and a block of dark mint chocolate to watch the footy, and I'm not going to share any of it.

Go Maggies....or the Cats....who cares I have junk food and I am happy.:D

Jenny

[Franklin'sMum]

3 dim sims, steamed of course and a glass of Sav Blanc. I now have a packet of cheese twisties under my arm and a block of dark mint chocolate
mmm, yummy people food! :)

Go Maggies....or the Cats....who cares I have junk food and I am happy.:D

Jenny

Enjoy the footy (and your junk food). Go 'all in brawl' !!:D My team didn't make it :(

[gpgscott]

My take on this is that vet's are like any other business and need to charge appropriate value for goods and services to stay in business. I really do not like it though when someone is held hostage so to speak for a script to submit to a low cost provider because the vet in question does not purchase in quantity to secure low market rates.
Scott

Hi Jane,

Sorry I just had to restate this as it is clear the way I have put it makes you think I am suggesting it is appropriate for a vet to withhold a script.

Let me try to be plainer. I think we all have the right to question the costs of goods and services and in the case of a medical professional in a non emergency situation have every right to expect to be given a prescription with which we can shop for the lowest price on the prescribed med.

You did also bring up in your response to me that you have concerns that the most appropriate med is being prescribed and to me that is an issue unrelated to where the med is purchased.

I was agreeing with you on the cost issue, I hope this note helps clear that up.

Scott

[addy]

On the prescription note, I would have to get metronidazole from my vet and Zoe's dose always was 1/2 of the pill and my dang pill cutter NEVER cut the darn pills right. Imagine my surprise when I asked the IMS could she call in a metronidazole prescription for Zoe to my human pharmacy. She said "no problem give me the phone number". When I went to pick the pills up, not only were the pills cheaper than from my other vets, the human pharmacy had cut the pills in half for me PERFECTLY. Sometimes we get a break:)

Hope Franklin is okay and you have a really good weekend!!!

Addy

[Franklin'sMum]

Hi Scott,

Thank you for re-quoting your quote. Even when I quoted your quote I missed the sentence about being held hostage for a script :o. My blind spot is getting bigger :o I didn't take it that you thought it's ok to not write out a script (blind spot, didn't see it), I thought you were saying the prices/profit for those two things are appropriate because vets are running a business. Or that they pay high prices if they don't buy in bulk and therefore pass the expense on to us. Sorry for any confusion I caused.

I think my yammering about the choice of med was carried over from an earlier post about changing meds if it didn't start working more effectively soon, and trying to get an option for where to purchase, and the bit about not knowing where the trilo came from (also earlier post related) was about having no way to contact the chemist if questions arose between one order and the next, if Franklin's behaviour or something changed.

Scott honey, you didn't cause any confusion, you responded to mine. :D I really should finish my thoughts/sentence sometimes :o and re-read before hitting 'send'. Now to just hide in the background for a while (slinking away icon) ;)

Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hey Addy,

Imagine my surprise when I asked the IMS could she call in a metronidazole prescription for Zoe to my human pharmacy. She said "no problem give me the phone number". Imagine me falling on the floor with shock! :D Wow, easy and painless for you :D

When I went to pick the pills up, not only were the pills cheaper than from my other vets, the human pharmacy had cut the pills in half for me PERFECTLY. Sometimes we get a break:)

Hope Franklin is okay and you have a really good weekend!!!

Addy
Oh, excellent! I always wondered if there is a dosing/testing problem when the tablets don't cut properly. That really did work out well for you both :). Franklin is great, thank you :D I've just been watching him dream (twitch, wriggle, kick) :p Thanks Addy, you and Zoe have a great weekend too!:D

Jane, Franklin and Bailey xxx

[mypuppy]

Hi Jane,
So sad to hear the little precious face is dealing with some stuff, and you too...UGHHHHHHHHHHH. I wish there was more I can say to help honestly. I will just pray he is just fine in no time. BTW, some vets stink sometimes so do not worry. In fact, Princess had her stim yest. with her IMS, never has been warm and fuzzy with Princess nor I, barely examines Princess when we've been there, and yesterday she was working with a student intern by her side, and all of a sudden Miss Congeniality with her fake hugging, kissing and sweet talking to my baby. Ugh...amazing how some people can turn it on and off, just like that. So do not fret and do what you must for your baby's sake. And we would be lost without you too, so keep ranting and venting if you must, don't we all? Luv you bunches and the little boy...xo Jeanette

[Franklin'sMum]

Hi wonderful people!! :)

We met the vet this morning :). SQUEAL!! Wow. Franklin has some dry, thickened pink skin in his ears, been like that for months. Been scratching for months, too :(. I had asked reg. vet to have a look months ago, and he said, "no mites. Lots of hair and some wax". Today vet said it's an allergy, and gave us cortavance spray. She said with using it for a few days it doesn't get into the bloodstream. The allergy/scratching isn't anywhere else on his body- she took off his jammies to have a look ;).
We're both impressed with her attention to detail. She admitted that her experience with cushings is limited, only had 2 patients, the last was 5 years ago. They both treated and did well with Lyso. She's not familiar with atypical cushings, or melatonin and lignans as a treatment option, but is willing to learn :D

She does accupuncture without needles. It's a thing with a red light, told me the name phyto something? Does that sound familiar to anyone? We had a lovely chat while she examined Franklin, then read an abbreviated history I had prepared earlier :p. And she's willing to work as part of a team :D, writes scripts, and if they have a patient needing an o/night stay, she takes the patient home. She did say that if it's not a pain issue, she'll sleep through the night, but if patient needs monitoring/pain meds that she will get up every 4 hours to check and administer the pain killers.

In this time, we were very happy with her answers, and belly rubs (and keep in mind she has only had a glimpse of what I'm like :rolleyes::eek:), and then I asked her if she would be willing to fill out a questionaire I had written up, complete with yes/no tick boxes.
(Anyone say anal?)

She was talking out loud as she did it, and at the end of it, I asked her if she was willing to have us as clients, and she said yes. :D She doesn't offer after hours weekend emergency service, but did give me her mobile phone number so that I can at least speak to her :D. We will still be using previous gp vet for certain things (and that's also where his synacthen is), but all in all, WOO HOO!

Love, hugs and belly rubs to all
Jane, Franklin and Bailey xxx

[Harley PoMMom]

She does accupuncture without needles. It's a thing with a red light, told me the name phyto something? Does that sound familiar to anyone?


Never heard of it but when I googled it I found this: Applied Photonic Therapy in Veterinary Medicine http://www.wozenphotonictherapy.com/subpage1.html

Give sweet Franklin some hugs and kisses from Harley and me.

With love and big hugs,
Lori

[gpgscott]

Sounds like a very promising beginning Jane.

Hoping it all tranlates into the best treatment for Franklin.

Scott

[Roxee's Dad]

Hi Jane,

Sorry I haven't posted to you in a while but I have been following along. Just wanted to let you know I am so happy for you and Franklin that you found a nice vet and one that is willing to take the time to talk with you. Wishing you and Franklin continued success.

Belly rubs to Franklin from me and mine. :)

[lulusmom]

Hi Jane,

It sounds like you found a great vet. Any vet that takes their patients home after hours, if necessary, is more than okay by me. You two will make a great team for Franklin. I think it's totally awesome that you actually asked the vet to fill out a questionnaire. :D:D:D I'm sure you had to fill out a questionnaire before the vet saw Franklin and turn about is fair play in my book. Why didn't I think of that? :D

[Harley PoMMom]

Hi Jane,

It sounds like you found a great vet. Any vet that takes their patients home after hours, if necessary, is more than okay by me. You two will make a great team for Franklin. I think it's totally awesome that you actually asked the vet to fill out a questionnaire. :D:D:D I'm sure you had to fill out a questionnaire before the vet saw Franklin and turn about is fair play in my book. Why didn't I think of that? :D

I totally agree with what Glynda said, and the questionnaire, was indeed, ingenious!

Love and hugs,
Lori

[littleone1]

Hi Jane,

I'm glad you found a good vet. It means so much when they are willing to listen and go the extra mile.

[Franklin'sMum]

Hey Lori,

That's it! Thanks for that link, that's excellent! :D Franklin thanks you both for his hugs and kisses, and sends some fresh slobbery ones your way :) and please update us about Harley. Inquiring and caring minds want to know. Big hugs to you my friend,

Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi Scott,


Hoping it all tranlates into the best treatment for Franklin you and me both, brother :)

[Franklin'sMum]

Hi John,

Thanks for your wish for our continued success. Previous main gp vet did take the time to talk with me, but I feel that over the last few months he's been a backseat passenger on our journey and not stepping upto the level that he should :(. If it's broke, fix it ;). Just need to find a way to tell him that we've "added" a member to the team.
How are you and Rozee doing? Have you blinged up Rozee's cart yet? :p More swimming lessons? The boy child loved his belly rubs, love, hugs and ear scritchies to you and yours respectively :p

Hi Glynda and Lori,

Hoping that Franklin will never need to be hospitalised, but had to make sure that he wouldn't be alone. I actually didn't need to fill a questionnaire, I wrote out a quick (2 page) Franklin summary of the main points and issues (didn't want to lose any appt time with filling out new patient stuff, thought bringing it would save time :p) The questionnaire (I can't take the credit) came about due to Leslie doing the same thing some time ago, a pre interview before learning the hard way if the nearby vets had any cushings experience, or short-comings. I just expanded the scope a little. Big thanks Leslie :D, it truly was a great idea :D and I hope you don't mind that I pinched it :o:p.

Hi Terri,

Sigh of relief. Phew! :D And she hit the special spot under his chest that make his arm twitch and scratch the floor :p. Usually takes a few minutes to find the exact spot, but he turns to goo :).

Hi Jenny,

She's never done (had never done ;)) a lip prick glucose test before yesterday. I wasn't quite successful with the strip :o, so she took a teensy bit of blood from his arm vein and it was 4.1mmol on the freestyle lite, multiplying by 18 makes it 73.8mg dl, and adding 60 points to the meter reading (to make it more animal-ish) makes it 133.8mg dl or 7.4mmol. If my math is correct. That's a big IF. Does that sound about right to you?
I asked her to compare it against her glucometer- by this point the blood in the needle was at least 5 mins old, and hers said 7.something. She explained that the blood needs to be checked straight away otherwise it changes the gluc. reading, is that true?

Huge (((hugs))) to all, and much love,
Jane, Franklin and Bailey xxx

[mypuppy]

Jane,
I had to laugh with this one comment, That's a happy visual of little Franklin twitching and scratching on the floor. Thanks for sharing. Luv ya bunches. Xo Jeanette


And she hit the special spot under his chest that make his arm twitch and scratch the floor :p. Usually takes a few minutes to find the exact spot, but he turns to goo....

[BestBuddy]

Hi Jane,

At around 10 (180) there will be glucose spilling into the urine. Your numbers look too good for diabetes.

I found with my meter (compared to vet and lab) was only 1-2 (10-20) different when Buddy's BG was between 2-10 (20-180) , then I had to add about 2-3 (20-40) if he was in the higher numbers. Your meter may not have been far off either.

Blood degrades pretty quickly once the air hits it, not sure of how long it takes but I always tested withing a minute of getting my blood drop.

Jenny

[Franklin'sMum]

Hi Jenny,

Woo Hoo! :D I can handle numbers looking too good to be diabetes :) Thank you for easing my mind on this. (Phew). So I'll just put the glucometer away, and now wait (im)patiently for the results of the Idexx lepto and tick panel to come back. Heartworm test was negative :D yay!

Big Hugs,
Jane, Franklin and Bailey xxx

[addy]

Wait a minute, did I see a birthday for Franklin?

Happy Birthday To You:D
Happy Birthday To You:D

Happy Birthday Dear Franklin

Happy Birthday to You:D

Hugs and warm wished for a wonderful day,

Addy, Zoe and Koko

[apollo6]

Always good to here good news.:)Glad to here Franklin is doing better.
Hugs Sonja and Apollo.

[mypuppy]

Happiest Bday wishes to the precious faced Franklin.

We love you and sending you the best wishes and hope all your doggie wishes come true.

Lots of bday belly rubs. xo Jeanette and the Princess

[Squirt's Mom]

Noooo, it's not Franklin's BD...it's Jane's birthday! As she said, I had a blond moment! :p One of many in my long life! LOL

Hugs,
Leslie

[mypuppy]

Oh noooooooooooooo! guess Jane's not the only one who had a blonde moment--lol. Let's try this again. Happy birthday to you Jane and I hope your wishes come true also. Enjoy your day to the fullest and I know your day is complete with your precious face by your side. Enjoy each other today. love you dearly and lots of bday hugs. Xo Jeanette and Princess

[addy]

oh, I started it, daaaa okay well,

Happy Unbirthday dear Franklin!!!!

And Happy Birthday Dear Jane


lol
Addy who is off in space somewhere :eek:
I can't stop laughing

[Franklin'sMum]

Hi friends,

Special thanks to Addy, Sonja, Jeanette and Leslie for our combined birthday wishes (I'll keep the ones for Franklin set aside till February for him ;)).

Franklin's lepto and tick panel results came back negative :D:), and we're scheduled to go see his specialist on 22 November, and will most likely have a repeat UTK panel, ultrasound, blood profile and maybe a urine test. Who knows what else ;) He has been doing really well except for a couple of weeks ago when he wasn't interested in eating, so I stopped the enalapril (for urine protein loss in Franklin's case) for a couple of days. Today he's being picky again :( (unless it's my food or puppy junk food).

I need to update Bailey's thread at the moment

Love to all,
Jane, Franklin and Bailey xxx

[gpgscott]

Sorry Franklin and Jane,

I was out all day yesterday and missed Franklin's birthday.

So Happy, happy ! and many more to Franklin.:)

Scott

[Franklin'sMum]

Hi Scott,

Franklin thanks you for his belated birthday wishes (8 months late :p) or you can consider them 4 months early :). Yesterday was my birthday :o

Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi Friends,

I hope you and your babies are all doing well, and enjoying whichever weather you're having in whatever parts of the world :).

Franklin is doing well, and went to see his new vet last week for some blood tests and a urine protein test. They use a different lab, with different 'normal' ranges, and apparently don't test blood glucose or triglycerides :confused:. However, the vet checked with her glucometer, and his glucose was 5.6 mmol (prev ref range 3.5-6.7) Woo hoo! :)

So, here are the out of range results, and lab notes...
Platelet x 10 9/L 554 (200-500). Red cells and leucocytes normal in morphology. Mild thrombocytosis.
Albumin g/L 38.8 (24-38)
Na:K 27 (25-) (didn't have a second number listed)
ALP IU/L 942 (10-120)
CK IU/L 461 (50-400)
Cholesterol mmol 10.30 (3.9-7.8)

And the urinalysis was from a free catch (not first void of day)
yellow, sp grav 1.017, ph 6.5, protein 3+, glucose and blood -negative :)
Bacteria- 3+ (moderate number of fungal elements were noted).
UP:Cr 4 (0-0.5)
The lab notes say that the proteinuria is due to genuine renal disease and is progressive :(
However, i hadn't given Franklin the enalapril for 3 days before the day before the test. He'd been slow to eat, and really picky. One of the listed side effects of enalapril is nausea, and I thought I'd give him a break from it until he was back to feeling himself.

New vet recommended to give cortate if picky again, instead of discontinuing the enalapril. IMS is currently on her honeymoon, but will be back this coming Wednesday, so we'll find out more then about whether he maybe needs a different medication, or adding an extra, or some other treatment completely. 3 more weeks till his IMS appt.
Also said that his CK being slightly elevated might be due to a bruise. She tried 3 times minimum to get blood from the right side of his neck, but couldn't get the vein to 'pop', then got blood first try from Franklin's left side of neck. Would that few minutes be enough time to create a bruise that would show up on the testing, do you know?

Thankyou, and love and huge hugs to all,
Jane, Franklin and Bailey xxx

[apollo6]

Dear Jan
I don't know if it is a cushing things. But the last time Apollo had blood drawn from his neck, the next day almost half of his neck was bruised. It may be the thin skin.. I applied Arnica cream on the bruise, just like I do when I get a bruise. It did go away.
Will be praying for you, Franklin and Baily.
Hugs Sonja and Apollo.

[littleone1]

Hi Jane,

I'm glad to hear that Franklin is doing well.

I'm not really good at test results, but it would help to know what the reference ranges are.

It's possible that the bruise was caused by the failed attempts to get blood. Many years ago, when I had to have blood drawn, they weren't able to get a sample from my one arm and had to get it from my other arm. I did wind up with a bruise on the arm that they had problems with.

Give Franklin belly rubs from me.

[addy]

I agree, thinner Cushing skin and a bad draw would produce a bruise. Just a bad draw of blood can produce a bruise. Cush pups bruise more easily.

Hope everything is okay with Franklin.

Belly rubs from Addy:)

[Harley PoMMom]

Hi Jane,

Glad to hear that Franklin's glucose is normal!!! YAAAA!!!! :D:D

Na/K: your lab 25....
The normal serum sodium /potassium (Na+:K+) ratio in dogs and cats lies between 27:1 and 40:1.
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6584&O=Generic


Would that few minutes be enough time to create a bruise that would show up on the testing, do you know?

I really don't think the shot in the neck vein would cause the (CK) Creatine kinase to elevate, if in the muscle, yes, but I am not an expert.

I did, however, find this article (human oriented) that connects elevated Creatine kinase with kidney disease: http://www.ehow.co.uk/facts_5477270_creatine-kinase-kidney-disease.html

Give handsome and sweet Franklin hugs and kisses from Harley and me.

Love and hugs,
Lori

[mypuppy]

Hi Jane and little precious face,
I'm not good with the test readings either but wanted to send a little kiss for the little boy's neck booboo--poor thing. As for you, a great, warm, tight hug. Luv ya both. Xo Jeanette and Princess

[Franklin'sMum]

Hi Sonja, Terri, Addy, Lori, Jeanette and all,

Thank you for all of your inputs, Franklin quite often bruises at the site of his draw within minutes. I was curious if that bruising would show up (as elevated CK) in the successful draw a couple of minutes later.
But yes, you're right- bruising and thin skin are signs of cushing's.


Franklin loved his belly rubs, hugs and kisses :). My mum bruises incredibly after a blood test, about 2 inches around the spot :eek: lovely shades of purple and blue. The reference ranges are listed before the results, after the name of the test. Odd place to put them, I know.

Lori, that first article about Na:K ratio was 98% over my head :o, but I thank you sincerely for your research. The CK info was mush easier for me to understand, but worrisome none-the-less. And absolutely Woo Hoo!!! on the glucose result.

We went to our new vet today for a pre- weigh (before beginning Franklin's new diet). He's woofering at me now while it cooks. Anyways, IMS isn't too worried about the 4.0 UP:C because of the 'fungal elements' found in the sample, so he'll be having a cysto on Wednesday for a culture and sensitivity.
She didn't have any enalapril at the moment, so wrote a script. The chemist sticker says 'Franklin The Dog' :D That will go into his birthday card and Christmas card box :):p

Thank you all so much for the love and hugs, right back at you my dear friends :)

Jane, Franklin and Bailey xxx

[marie adams]

Hi Jane,

It is so nice to cruise along for awhile and not really have to think about the Cushings thing, but then testing comes around and it is in your face full blown. Or some little things comes up and we think oh darn is this related....:confused:

Sounds like things are GOOD with Franklin and You!!!:) We are at the 4 month maintenance testing and the numbers are up:( and I am getting a new vet--it was too stressful dealing with trying to get the results and me knowing more than the vet--they certainly over promised knowing about Cushings.

Have a wonderful weekend!!!:D

[Franklin'sMum]

Hi Marie,

Yes, we do seem to be cruisin' :), (touch wood) pretty much the only things are the blips on blood tests, and even then, they seem to alternate :confused:.

Wishing you the best of luck with your new vet. Do you have one yet, or are you still searching? I so hope that your new vet's knowledge is at least on a par with yours :).

You have a great weekend, too.
Hugs to you and Maddie,
Jane, Franklin and Bailey xxx

[addy]

Hi Jane,

Was thinking of you today and wanted to say hi. Hope Franklin is doing well.

Happy New Year!!!!!

Addy

[Franklin'sMum]

Hi Addy,

Thank you for thinking of us :) Franklin is doing well :D. He's been on his special home cooked diet for a couple of months now, and is really enjoying it :). He's also lost a half a kilo (about 2.5 lbs). The IMS wanted him to lose a bit of weight due to the elevated trigs/cholesterol.
Protein loss has improved, and she mentioned 'minimal change nephropathy' as a possibility for the cause. His trigs seem to be more of a mystery, though, sometimes great, and then the next test they'll be a little elevated.

Aside from that, Franklin is getting brown eye boogers, but otherwise is his usual happy, kissy, snuggly, kicking self :);). Thank you for asking, dear Addy, and hope you and yours are well :)

Love and hugs,
Jane, Franklin and Angel Bailey xxx

[Franklin'sMum]

Hi friends :)

It's been a long time since I gave an update on Franklin, so here goes. He's doing well, and has just finished a 3 month course of Ursidiol for his gallbladder sludge. The IMS wanted to get rid of it before it solidified, but was still fairly smushy on his last ultrasound. He's been on melatonin and lignans since last July, and in about a month and a half will be going back to IMS for another u/s and adrenal panel test.

Franklin is currently eating commercial food rather than his diet, due to a recent family medical situation requiring Franklin to be boarded for a few days. (And me not having enough of his food prepared to go with him) but will start cooking for him again as soon as the butcher has supplies.

He still remains on enalfor (enalapril maleate) for his proteinuria, and we haven't had any recent bloodwork or urinalysis performed.

Recently, we found a very nice memorial for Bailey's resting spot. It's a plastic rock that can have a photo inside. We all miss him like crazy, but it's slowly getting easier.

Love and hugs to you and yours,
Jane, Franklin and Angel Bailey xxx

(Administrative Note: Hi Jane! I've taken the liberty of copying this reply from our May "Checking In" thread and also adding it here to Franklin's original thread. This way, it will be easier for folks to reply to you directly about Franklin's progress.)

[addy]

Hi Jane,

Stopping in to say hi and send hugs:)

Glad to hear Franklin is holding his own:D:D:D

Finding a nice memorial for Bailey will bring comfort to you. I think we miss them forever. My grandaughter is starting to drive:eek: My father taught all of us how to drive. I keep looking up to heaven asking him can't he come back for alittle while to help out?;);)

Love,
Addy

[Franklin'sMum]

Hi Marianne,

Thank you for copying and adding here, much appreciated :). Hey Addy, thanks for your hi and hugs :).

Bailey has a nice spot in the garden where he loved to people watch from, and it helps that when we put him to rest he so looked like he was sleeping. We do miss them forever when they're gone, they have our hearts fully. They are one of the main reasons (if not the reason) that our heart's sing.
I think, our people are our people (whether they're human or not), they make us who we are, and help us to see life in all it's glory.

Hugs to you my friend, and belly rubs to Zoe and Koko,
Jane, Franklin and Angel Bailey xxx

[Harley PoMMom]

Hi Jane!

So happy to hear that Franklin is doing so well and I'll be looking for his test results in the coming month. :)

I am so sorry to hear about your family emergency and I do hope that everything is ok.

Love and hugs,
Lori

[littleone1]

Hi Jane,

I'm also glad that Franklin is doing good. I'm glad you gave us an update.

I'm glad that you found a nice memorial for Bailey's resting spot. I'm sure he really likes being in his favorite spot.

Sending lots of hugs to you and belly rubs for Franklin.

[Squirt's Mom]

Hi Jane!

SOOOOO good to hear from you and especially with such a good report on sweet Franklin! :D

I am sure Bailey is watching all the plans with pride and deep love for you all.

Much love and many hugs,
Leslie and the gang

[mypuppy]

hi there Jane,
You are right, it has been a long while since we've heard from you, but so happy to hear the little sweet face is doing well. I am sorry to hear about your family emergency and hope that it is nothing serious.

Please give that little boy Franklin a belly rub from aunt Jeanette and some licks from cousin Princess, and please take some very tight hugs for yourself, and please say a small prayer for your sweet and missed Bailey at his Memorial.

We love you both dearly.

Xo Jeanette and Princess

[Franklin'sMum]

Hi everyone!

It's been a long time since we've checked in, and a lot has happened in that time. There's been a few family situations, which are currently under control (for the most part.)

As you might remember, Franklin stopped taking the trilostane a couple of years ago, after having his diagnosis changed to atypical cushing's. He's been on melatonin and lignans since.

His proteinuria became sky high earlier this year, a up:c of 9 EEK! After a change of diet, and increasing the fish oil frequency, his up:c is now down to 4.1.

In February this year, Franklin started having grand mal seizures, and in late February had 6 in one day. He started on phenobarbitone, and didn't have any more seizures. The MRI was clear of anything that could cause them. At the time, we were using a monthly flea tablet called "Comfortis" and about 6 weeks after beginning the phenobarb, the sales rep was at our vet's, and mentioned as an aside that it can lower the seizure threshold. Due to Franklin's liver enzymes being more elevated than usual, the vet agreed that we could discontinue the phenobarb.
Since then, he's had a few more seizures, and another cluster, so now is back on the phenobarb.

His cortisol has risen, (241 / 478 nmol or 8.7 /17.3 ugdl on 16 Feb) and our vet wants Franklin to begin on traditional treatment. So we will shortly begin the Lysodren journey. HELP! I've been through the files again, and would someone mind clarifying for me, please?

One article (textbook vet internal medicine) says to get the stim done as soon as he seems to be loaded, another says to wait a couple of days without giving any more lysodren.
Which is the more common protocol? My vet isn't familiar with the waiting. I won't be starting him on it as soon as I pick it up, I'm going to wait til his appetite has returned to normal, the phenobarb has increased it.

Is either ok, as long as he's been stimmed, and his numbers are ok to start the maintenance dose, and there's a couple of days between the last loading dose and the first maintenance dose?

Franklin is drinking about 750ml per day, it's our winter, I'm on night shift and we haven't been walking this week. The appetite monitoring will be more difficult, we all eat a bit more when it's cold, and he usually looks at me a few times as he eats. Although there have been times when he's tried to snatch my food out of my hand, while it's on it's way to my mouth.

Are there any tips, tricks or something you can share with me?

Thank you all so much,
Biggest love and hugs,
Jane, Franklin and Angel Bailey xxx

[frijole]

Jane, Welcome back!

I am off to work in a few so will be brief. It is common see atypical cushings turn into regular cushings. (cortisol elevated)

My biggest concern is the use of pheno and hopefully another member can provide greater details but it can be tricky if I recall. (sorry I don't have time to search the site for other cases)

You are wise to wait until the appetite has returned as it is hard to monitor lysodren. The reason it is recommended that acth testing be done 48 hrs after the last dose is because it continues to work for that long after ingested. That is why you never give a pill if you think your dog is loaded... you can't take it back and it will continue to lower cortisol/erode the adrenals.

Here is a link to loading instructions that helped me greatly. I'll check in later. Kim
http://www.k9cushings.com/forum/showthread.php?t=181

[lulusmom]

Hi Jane,

When did Franklin go back on phenobarbital and did he have cushing's symptoms prior to phenobarbital and did cushing's symptoms continue after you took him off? Unfortunately, the side effects associated with phenobarbital are identical to the most common symptoms associated with cushing's, being excessive drinking and peeing and voracious appetite. For not having been on treatment for a year, Franklin's last stim test isn't that high so if Franklin's appetite returns to normal before starting Lysodren, I would question whether he needs to be back on cushing's treatment. Additionally, Lysodren and Phenobarbital are not a good combination as the Phenobarbital greatly effects Lysodren's absorption, requiring that larger doses be given. Please discuss this very important information with your vet before you start loading Franklin.

With respect to timing for the acth stim test, lysodren has a cumulative effect so the optimum time for testing is 48 hours after the last loading dose. I hope this helps.

Glynda

[addy]

Hi Jane,

I cant help with advice but I can say: hugs and love" and that I am here for you and Franklin.

I thought Glynda had wonderful input and I am sorry to hear about Franklin's seizures. I hope and pray you get things straightened out and I just know it will all turn out okay.

[Harley PoMMom]

Hi Jane!

It is good to hear from you but sorry to hear this news about sweet Franklin.

I agree with Glynda that his post stim number does not suggest starting any Cushing's treatment. Here is a link to IDEXX with a chart that shows the normal ranges for a dog (post between 6-18 ug/dl is normal): http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/cortisol/cortisol-acth-stimulation-protocol.pdf

So hoping those seizures settle down and give our precious boy some gentle hugs and kisses.

Please do keep us updated, and again, so nice to hear from you!

Love and hugs,
Lori

[Squirt's Mom]

Hi Jane! :)

Don't know how I missed this post yesterday but it is really good to see you again! :D

I, too, think the post is within normal range and I wouldn't start treatment just yet, especially with all the rest that he has been facing lately. The stress could be the cause of the elevation in cortisol. ;) If I were you, I would keep an eye on him and when, if, his signs become strong and he hasn't had any extra stress on his system, then you know it's time to start the Lyso.

From what I know and how we do it, Squirt is tested 36-48 hours after her last dose of Lyso. She is on maintenance twice a week. When the time comes to start Franklin on the Lyso, you will do just fine, honey. I know you will. We will be right by your side the whole time.

Hugs,
Leslie and the gang

[mypuppy]

Sweet Jane,

How nice to hear from you, but not under these circumstances. I truly wish I can help your precious little boy, but I know someone here will give you something very valuable soon.

For now, I'm praying the button nose little guy feels better real soon.

Always thinking of you both with much love.

xo and those tight hugs coming your way.

Jeanette and my girl Princess

[Franklin'sMum]

Hi again and thank you for all of your valuable input.

After Franklin's appetite levelled out 2 weeks after re starting the phenobarb, he was still drinking about 800ml per day. He started back on it 30 May. Our vet thinks that mitotane could help to reduce the proteinuria, which from what I've read is a possibility.

So the mitotane was ordered and compounded to 375mg. To be given half twice daily. At this point he weighed 7.4kg. I seem to have misplaced his stim results but the post before beginning treatment was 600+mmol and his blood glucose was 17, with no glucose in his uh urine.
He was on the mitotane from 29 June till 2nd July. Went in for another stim test on 4 July and the results were pre 118 post 584mmol (4.27- 21.1)ug /dl.
Blood glucose was 28 and 29mmol and urine glucose was 4+ Eek! The couple of days before this, his water intake had gone up to 1 litre and a little more. His weight was down to 7.0kg and he was feeling bony.

So on Thursday Franklin went in fora glucose curve.
Fasting time 08.50 24.4
Breakfast then 10.50 25.1
3.5iu insulin given 11.00
12.50 15.8
14.50 13.2
16.50 12.1

So, needless to say, cushing's is on the back burner while we try to regulate his diabetes. Argh! I really think Franklin is feeling a lot better, water is 400-600ml, he doesn't have to stand on icy grass for 90 seconds to pee, and he's not feeling so bony. Plus he stays still to be injected.
He'll be having another curve done on Wednesday to see if any adjustments need to be made.
We will keep you updated as to how he's going,

Love and hugs to all,
Jane, Franklin and Angel Bailey
xxx

[addy]

Oh Jane, I am glad to hear Franklin is feeling better. I hope the upward trend continues.

I was trying to picture your "icy" grass as we have been having such a heat wave!!!!!

hugs and love to you and yours

[Squirt's Mom]

Hi Jane,

Wow! You are brave! I would be a basket case....again. :o I'm glad he is doing well with the shots. How are YOU doing with them? :D

"Icy grass"? ahhhh....what a vision. I feel cooler already! :p If it were possible, most of us over here would gladly send Franklin a warm breeze or 30 for one blade of icy grass! :p

Please stay in touch and let us know how he, and you, are doing. I hope your life has become much more calm and settled these days.

Hugs,
Leslie and the gang

[Franklin'sMum]

Hi Addy, Leslie and everyone,

Franklin is doing much better :) and has been drinking 350-500ml daily. I think he would gladly swap the icy mornings for some warm breezes. He'll keep today's puddles though :rolleyes:

I'm getting better at giving him his shots. It's no longer 20 minutes from start to finish, with 45 seconds of that time being the injection. :o I think he's almost back to his regular weight, but we'll find out for sure tomorrow when he goes back to the vet for another curve.

Love to all, and ear scritchies for the babies
Jane, Franklin and Angel Bailey xxx

[Harley PoMMom]

Wishing you both the best of luck with the vet visit and will be looking forward to your next update.

Love and hugs,
Lori

[John II]

Hi Jane!

So much going on down there!
But I'm so glad to hear things are stabilizing.
Scritchies for Franklin & Hugs for you. :)

[Franklin'sMum]

Hi everyone

Franklin began loading on mitotane on Friday 29 June. Weight was 7.4kg blood glucose was 17mmol. Dose was 1/2 375mg mitotane twice a day. Two days later his water intake increased. Last dose was Monday, skip Tuesday and stim test on Wednesday.

Pre 118
Post 584
Locum vet was told by regular gp to check glucose. It was 28-29mmol (non fasted). So we went back on Thursday for a glucose curve. He was down to 7.0kg, and fasting glucose was 24.4. Franklin began insulin that morning. I go to pick him up, they show me how to inject. I ask if the insulin is the right insulin for those needles, was told yes. Wrong!

So for a week, giving his shot was a breeze. Gp vet was back and we go for a curve. I'd been giving a half dose bc the locum vet didn't adjust for a u40 insulin in a u100 syringe. Aargh! With the proper dose, Franklin started to resist. For most of the next 3 weeks I needed a helper. It's been a little over a month now and we seem to be in a groove.
Until last night. He had a big drink and vomited his kibbles from earlier in the day. Then he kept drinking shortly followed by more vomits of water.

His gp wasn't on call, so I rang 2 other vets for advice. One suggested half insulin dose, the other suggested full dose. I went with the half dose idea. Franklin stopped vomiting and just wanted to sleep. Didn't want anything to eat, I tried offering his faves.Three hours after his insulin he woke up and wanted food. :-) At 2.30 when we finally went to bed his bg was at 14.1mmol.

We only started home testing his blood glucose a smidge over a week ago. Went to the blood pressure vet to show me how. With the struggles I've had giving his shot, I thought it would be another struggle. But Franklin doesn't have a problem with the testing. Doesn't like his ears getting poked but is fine with his carpal pads. During the visit, the vet found he had a yeast ear infection. Began 'Surolan' ear drops. Four days later and he couldn't hear very well. Turned out his ears were blocked with the drops.

Franklin seemed to be getting good bg numbers two weeks ago, since then he's gone off the healthy diabetic food and my home testing shows his numbers are higher. Another curve tomorrow to see if any adjustments are needed.

Discontinued the mitotane to get the diabetes under control. Still a work in progress.

Hope all of you and your babies are well,

Jane, Franklin and Angel Bailey xxx
4u caninsulin bid, 3/4 5mg enalfor sid -proteinuria, 3mg melatonin bid, 1/8tsp lignans - atypical cushing's, 30mg phenobarb bid. Refusing diabetic home cooked recipe, eating commercial 'my dog' wet food and some royal canin weight control kibbles.

[frijole]

Jane, Thanks for coming back and updating us. So Franklin now has diabetes.

As you have found out cushings can make diabetes hard to control. I am posting the link to our sister site for diabetes in the event that it helps you. The people there are wonderful. www.k9diabetes.com

Meanwhile keep us posted. Kim

[addy]

Hi Jane,

I am so sorry to hear of Franklin's problems but as Kim said K9 Diabetes Forum can be a life saver. I am sure they can help sort things out and offer great suggestions. We have members on both forums and I am sure some will stop by.

Hang in there.

[Squirt's Mom]

Hi Jane!

You're so brave....diabetes scares me to pieces - not the condition itself but having to give those shots. I would be shaking so badly the needle would be a blur! :eek: I am terrified of hurting them - and I end up hurting them. I've given other types of shots to dogs in the past and it always makes me so very nervous (horses are so much easier!). Folks that deal with diabetes in their pets have allll my admiration.

Franklin is certainly good at keeping his mom on her toes, huh? :p How boring our lives would be without our babies keeping things lively! :D

Good to hear from you as always and hope things go very well for you both on this new path.

Hugs,
Leslie and the gang

[molly muffin]

Wow, what a journey you have been on. I'm with Leslie, it terrifies me, the thought of giving shots. You are very brave. Hope the diabetes can be brought under control soon so life can get back to an even keel.

hugs,
Sharlene

[Franklin'sMum]

Hi all,

Kim and Addy, the k9 diabetes site is amazing, and also full of wonderful people who just like us adore their babies :) Lots of great info, and some avatars from here, too :D

Leslie, I could definitely give boring a go ;) with help from a dap collar, spray and rescue remedy, it's calmed him down a lot. He's no longer fighting me tooth and nail. Franklin still squeaks sometimes though :(

Sharlene, hi and thanks :) we 're still working on getting his sugars under control. It can take some time, but he's happy and I'm taking my cues from him. :)

Love and hugs to all,
Jane, Franklin and Angel Bailey xxx