Poor appetite - Toby is now at peace

[LINDAP1]

I am new to this site and hope someone has some insight to what is going on with my pal Toby. He is a 7 year old shepard/lab mix and is the best family dog we ever had. He has had good health until about 1 year ago when he developed the classic cushion's symptoms-bloated belly,insatiable appetite,weight gain,drinking constantly and urinating in the house. I have medical background and researched info and found out that I thought he might have Cushings. We immediately had the bloodwork/stim test done which was negative and didn't show Cushings but with my persistence and additional testing he finally was diagnosed. He was started on Trilostane which we get compounded from Diamondback drug. He was 120 pounds and now down to 86 pounds. He is on 90 mg once a day and has had the followup bloodwork as recommended-3-6months and it has been perfect. About 1 month ago I notice he wasn't feeling quite right. You know your pet and when they are "off" but nothing drastic, you just know. I took him for a physical and the vet felt he was ok. We did electrolyte bloodwork which was normal also. We did the stim test again and the values were perfect. We also did a complete bloodwork panel and it was weird because looked like he was an untreated Cushing's dog even though he has been treated daily. So swim results perfect but bloodworm looking like untreated Cushings dog. His only symptoms now is poor appetite-does not really care to eat and very very picky and wants to be outside constantly-very cold out. He seems to not be tolerant to the temperature in the house(68-70) yet not panting at all. Very weird and so my vet consulted with a specialist at the Lab who suggested taking him off the trilostane-which I do not feel is a good is a good idea at his point because all his other symptoms will return and/or doing an abdominal ultrasound with he is scheduled for this week. Any ideas because I am going crazy!!! I do not want to wait until he stops eating all together. I read that trilostane can cause live issues and maybe the dose should be lowered but has anyone given this med every other day? I would like to try half the dose twice a day instead but right now I just got a 2 month supply(which isn't cheap) and they are capsules so I cannot cut in half. I thought of trying the 1 caps every other day to see if he feels better. What do you think. Thank you from Toby!!!

[LINDAP1]

I am sorry but I see that the auto-correct feature has changed some words but hopefully readers can figure it out..so sorry Linda/toby

[Joan2517]

Welcome Linda and Toby...yes, auto correct can really do a number on the posts, but we're used to it. Toby sounds like a great companion!

I don't have any answers, but others who are more knowledgeable will be along shortly to try to help you with some of your concerns. They will want to see the blood work results, so if you have them, please be ready to post what they ask for. If you don't, maybe you can get them from your vet.

We look forward to learning more about Toby~

Joan

[LINDAP1]

Joan,
thank you! I hope someone can help and yes toby is a love. Thanks linda

[Squirt's Mom]

Hi Linda,

I took the liberty of adding spaces between you sentences so my old eyes could read your post. :D

First, I would ask that you contact your vet and get copies of alll the lab work your baby has had done. Then post all the info from the ACTHs and post just the abnormal values from the other labs that look at things like the liver - it will show things like ALP, ALT, BUN, CHOL, etc. Be sure to include all the little letters and numbers after each abnormal value you post. It will look something like this -

EXAMPLE -
ALP 1551 ug/dl 150-300

The ACTH will have 2 values - a pre and a post number. If you are in Canada it will have 3 values. We want to see all of those numbers.

When you say your baby was "off" can you explain in deeper detail what you were seeing?

Has your baby been tested for diabetes recently and by recently I mean since he started losing weight? Weight loss is a hallmark sign of diabetes, as is loss of appetite, and it is not uncommon for cush pups to become diabetic or vice versa. IF that has not been checked, have his glucose checked asap.

For a dog that is not eating well taking a break from the treatment is recommended. These drugs must have fats to be absorbed so if he is not eating well the drug is not working properly. Also, that is one of the signs the cortisol has gone too low. That can happen at any time with dogs on Vetoryl (Trilostane) even if they have been stable for a long time. So I would probably stop the Trilo for now and see if his appetite picks up. Using this drug every other day is useless because it has a very short life in the body - from 2-12 hours in most dogs. So using it every other day just puts the dog on a roller coaster of high then low then high.... NEVER ever open the caps and try to divide them to use. ;)

I'm glad you found us and look forward to seeing those test results very soon! They will help us help you by giving more meaningful feedback.

Hugs,
Leslie and the gang

[LINDAP1]

Squirt's mom-
thank you for your response. when i say toby is a little

"off" i mean he acts like he is depressed,not lethargic but

very quiet and resting alot. although when i tell him he is

going for a ride he will jump up and follow me because

that is his favorite thing to do. the fact that he always

wants to be outside even in this cold new england

weather is new for him also. as soon i get him inside,

within a few minutes he is back at the door again. i watch

him and he just lays down on the deck. it is not because

he needs to go to the bathroom. we wanted his weight to

stay around 90 pounds but still losing due to his poor

appetite. so taking him off trilostane all together won't

harm him? I am including his labs-

electrolytes were all normal

alk phos 848 iu/l normal 5-131

cholesterol 331 mg/dl normal 92-324

urine ph 8.0 normal 5.5-7.0

protien 1+ normal negative

cortisol sample 1 2.6 <font face-"symbol" verified

cortisol sample 2 2.3 verified

i am so glad i found your website as well. i really trust my vet but worried because you can tell he doesn't feel well and there are so many complications that can occur. this is my fist experience with a cushings dog so from the bottom of my heart....thank you! Linda and toby

[molly muffin]

So glucose was normal, BUN, creatinine all normal and not a lot of protein loss in urine? Was his urine dilute? Cushings dogs normally have very dilute urine.

All blood wbc normal?

Normally the first things we look for with weight loss is kidneys and diabetes, but if the above values are all normal then it wouldn't seem to be that causing an issue.

There can be a bit of time after being on cushings meds when the cortisol comes come that they feel off, but that will normally pass and then they are back to normal.

How is his appetite?

Normally they test at 14 days and then 30 days after starting medication and then if normal range at the 30 day mark, they may wait for 3 months to test, but not usually 6 months as things can change. We expect to see cortisol continue to drop on the same dose for at least 30 days on the same dose.

How long has he been on the 90mg and when was the last test.

The ultrasound may tell you more, as it give a lot of bang for the buck.

[LINDAP1]

Sharlene,
Thank you for posting a response.Toby has been on trilostane. Toby over 1 year and the same dose 90 mg trilostane.He has been doing well on it and no issues.we have him stimulus tested every 6 months.this last test was 1 week ago.His appetite is off and still wanting to be outside in the cold.thank you...Linda and Toby

[labblab]

Hello Linda, and welcome to you and Toby from me, too. I am very sorry, though, that he is having some problems right now. You mentioned earlier that he has an ultrasound scheduled for this week? If so, I do think that's a good idea, and we'll be quite anxious to hear the results.

If the ultrasound doesn't reveal any abnormalities that would account for his lack of appetite, then I think I'd also be tempted to temporarily discontinue the trilostane altogether for a few days in order to see whether that makes a difference. Even though his ACTH result was within the desired therapeutic range, it was down towards the lower end and Toby may be a dog who just doesn't feel as well with a cortisol level that is consistently that low. If you find that his appetite and behavior improve while off the medication, then perhaps you can problem-solve with Diamondback re: a dosage decrease. Perhaps they'd allow you to return the capsules for reformulation, for instance.

But first things first -- so we'll be very anxious to hear about the ultrasound. Toby sounds like a lovely boy, and I surely hope you can get things straightened out for him quickly.

Marianne

[LINDAP1]

Thank you Marianne for responding.That was exactly my thoughts.I even called my vet to suggest taking him off trilosane all together now before the ultrasound but she suggested we wait.She said taking him off the med all together will make his liver enzymes climb higher, which I really dont understand.I think either a lower dose/a divided dose or different medication for cushings might be the answer if the ultrasound is negative.It is nice to hear other opinions so thank you!

[molly muffin]

I'd definitely lower if not just stop for a few days to see how his body does which could tell you if a lower dose would be more beneficial.

[LINDAP1]

Hi everyone,
So Toby had his ultrasound yesterday and it was normal except for his enlarged adrenal glands (which we expected) The specialist feels his Cushings,although his stim looked good, is not well regulated so we are going to a twice a day schedule with a lower dose of trilostane. We are stopping the 90mg for 4 days and will resart 35 mg bid and retest his stim in 3 weeks.Hopefully his appetite will improve.I will definitely let you know.Hopefully this works.This internist has only seen 1 other cushings dog with simiiar symptoms and test result and she travel all over New England.He is a love but a puzzle. Thanks everyone! Linda and Toby

[molly muffin]

That is good that nothing else was seen on the ultrasound and i hope the twice a day dosing will do the trick. Keep us posted!

[labblab]

Here's a message that Linda posted elsewhere on the forum yesterday. I am adding it here, though, so everyone will have access to this update on Toby. ;)


Thank you to everyone for trying to help me with Toby and his issues.He was off the trilostane for a week and seemed to be eating better.Just started him on 35mg twice a day yesterday so hopefully so goes well.I feel releaved that his ultrasound showed nothing except enlarged adrenal glands which we would expect.Thanks, Linda and Toby

[molly muffin]

Checking in to see how Toby is doing. You have him on the 35mg twice a day now right?

[LINDAP1]

He is doing so much better! His appetite had improved and energy has improved.He is almost back to himself.we are scheduled for blood work in 4 weeks.I feel that Toby is back.I appreciate your concern and advice.I will keep you posted.With appreciation, Linda and Toby

[Squirt's Mom]

Great news, Linda! YAY Mom and Toby!! :cool::cool::cool:

[molly muffin]

That is wonderful news!!!!

[LINDAP1]

Hi everyone,

I have posted about my Toby who was diagnosed with Cushings over 1 yr ago.We have had all the required bloodwork, rechecking every 2-3 mos and also an ultrasound because Toby's bloodwork results looked like he was an untreated Cushing's canine. Presently we have decreased him to 25 mg trilostane bid from 90 mg daily.He did not do well on the higher dose so symptomatically he did better in the morning(after med) than later on in the day.Presently his appetite has continued to decrease.I try everything to get him to eat..even changed foods to find the best one with highest protien,grain free and nutritous.My Vet recommended Wellness so he is now on Wellness RawRev.I mix cooked hamburg,turkey,chicken as a topper to entice him to eat.Literally I have to hold his bowl and encourage hjim to eat.I am wondering if he has a mild chronic pancreatitis from his Cushings.When he was treated for his Cushings he was very overweight, ate everything in sight,drinking excessively,peeing in the house, panting and pacing.None of those symptoms are present now.The only negative issue besides his skin issues is that his appetite is so poor.He was 120 pounds when we diagnosed him and we got him down to a heathy 90 pounds. He now is 75 pounds and I am worried.I have another appointment this Sat with my Vet and wanted to know if anyone has been through this?Very worried and frustrated..no other issues.Thank you Linda and Toby

[labblab]

Hi Linda, welcome back to you and Toby, although I'm surely sorry that you two are still struggling with appetite issues. You'll see that I've merged your new post into your original thread on our main forum -- this way we can keep all Toby's info and health history consolidated in one place.

I see that you have decreased his trilostane dose, and I'm wondering how recently he's had an ACTH test. It may be possible that this current dose is still too much for him to tolerate.

Also, I wanted to let you know that we've just now launched a new thread that deals with appetite issues, generally. Here's a link so that you can take a look and see if there some ideas there that may be a help to you:

http://www.k9cushings.com/forum/showthread.php?t=8565

Marianne

[molly muffin]

Hi, it does seem that loss of appetite has been occurring more and more frequently in our cush pups.
In my case it was due to kidney issues popping up, but it can be many things.

Can you post the latest high/low lab work and what date they were done? Maybe that will give us some ideas of what might be going on.

[LINDAP1]

Thank you Marianne. Toby had his last ACTH test about 3 mos ago so he will be due again.However those results appeared strange. They looked as if Toby was an untreated Cushing's dog.My vet consulted with an internist who suggested the lower dose with BID dosing.If we were not giving him a high enough dose of trilostane I would imagine he would be symptomatic like he was before we started treatment. Now it just his appetite that poor.We have an appointment this Saturday and wanted to discuss herbal natural treatments for cushings.I am thinking maybe the trilostane is making him feel ill and not like eating.I read ginko and san mao herbs help lower the cortisol levels naturally but wanted to talk to my vet first.Has anyone had any experience with this route? Thank you

[lulusmom]

Hi Linda,

You mentioned that an ultrasound was done recently. Do you have a copy of the interpretation that you could share with us? Was your vet looking for an gastro intestinal problem that would explain Toby's lack of appetite? I would be very interested to know if there was any mention of the adrenal glands in the interpretation. It is well known that trilostane can cause varying degrees of adrenal necrosis which can be seen on imaging. Trilostane is anything but predictable and unfortunately, the acth stimulation test is profoundly limited in scope when trying to figure out the root cause for the rare and very highly irregular response to treatment. It's no secret that most of the renowned and well published internal medicine experts of the world agree that the acth stimulation test is not optimum for measuring effective treatment of trilostane but until someone comes up with a better idea, it's all we have.

I've attached an interesting case study of "Persistent isolated hypocortisolism following brief treatment with trilostane". I follow Professor Ian Ramsey at the University of Glasgow and have saved many of his research papers over the years. Professor Ramsey has done extensive research and has conducted many clinical studies on trilostane in the treatment of canine cushing's so he is an unquestionable expert on the drug. While Adrenal necrosis can happen at any time in treatment, this particular study involves dog(s) on short term treatment. Adrenal necrosis may not be Toby's problem but his circumstances are certainly similar to those of one of the dogs discussed in this study. It's hard to not leave stones unturned in dealing with this disease so I want to provide you with any plausible information that may be of value to you and your vet in trying to figure things out.

It would be helpful if you could provide us with the actual results of the last acth stimulation test.

954

Glynda

[LINDAP1]

Glynda,

Thank you so much for your information.I do have the report at home(at work at the moment) and I will post the ultrasound interpretation.Hopefully tomorrow.

[LINDAP1]

Toby had his ultrasound on1/19/17 and the interpretation was the following:Mil diffuse hepatomegaly,gallbladder is mildly distended and small amount sludge.No evidence of a mucocele.Spleen-a small 5.5 mm hypoechoic nodule seen,kidneys-NSF, Bladder-NSF, Pancreas-not seen well,Adrenals- bilateral adrenomegaly-left cranial pole-1.4 cm,caudal-1.4 cm and right 1.4,stomach-NSF,Intestine-NSF,lymph nodes-NSF and other-NSF.Conclusions-Bilateral adrenomegagaly consistent with PDH. Normal UCCR is very unusual in a dog with HAC.PU/PD-r/o cushing's, primary renal,DI psychogenic,dietary,other.It is possible that the trilostane does bring down the cortisol levels early ion the day and the 4-6 hr test shows adequate levels but that the levels actually rise later in the day-recommended bid dosing of trilostane.I appreciate any insight and advise. Thank you Linda and Toby

[molly muffin]

Reading the interpretation I can see why they would want to try the twice a day dosing to see if they can keep levels steady.

Did they say anything about that nodule on the spleen? We did have a member, one of our moderators, whose dog has a tumor on the spleen and had high cortisol till that was removed at which time the cortisol went back to normal levels.

Just might be something to ask your vet about.

[LINDAP1]

Thank you for that info and I am taking Toby tomorrow to his vet and will mention it.Interesting how differently the response is to treatment on all cushing's dogs.No definite course of treatment I guess...very frustrating to watch your pal not feeling well and not living to the quality of life he should.Thank you and I will post after we meet. Linda and Toby

[LINDAP1]

Hi everyone,
So we went to the vet on Saturday with Toby and she agreed to stop the trilostane all together. It seems to be making him worse that the original cushings symptoms.He lost another 7 pounds since January.I am going to start him on pepcide-ac bid to help encourage his appetite. I gave her info on the harmony adrenal gold drops(natural way to decrease the amount of cortisol in his bloodstream) and she wanted to research the ingrediants more before I start it. I have another appointment in 1 month to check in.The way he is reacting to the trilostane is making him feel so bad that his quality of life is poor.Hopefully this holistic med will work.I dont know what to do anymore because he has been a very difficult dog to treat...certainly not textbook.Love him dearly! Thanks Linda and Toby

[molly muffin]

Poor Toby. He sure doesn't sound like he is feeling very good. Let us know what your vet says about the harmony adrenal gold drops.

Also let us know if his appetitie perks back up once off the trilostane.

[LINDAP1]

Hi everyone,

We took Toby off everything including trilostane 2 weeks ago and have been giving him pepcid AC to help his appetite. He is eating a little better with much encouragement. We have him on Wellness RawRev topped with cooked turkey/beef/chicken.Normally he would eat all of his food but with him off trilostane, his appetite is probably 50-75%.He is drinking more water so we are seeing signs of cushings returning.Saturday we starting the Adrenal Harmony Gold Natural drops twice a day.He is taking 1 ml BID but for his weight, he should be getting 1.5 ml BID.He is so sensitive to medications so I felt better trying this a a lower dose. Today is day 3 and my husband and I feel he is a little better having more energy.Hopefully this will continue but time will tell. Thank you for all your support and advice. I don't know where I would be without all of you! Linda and Toby

[molly muffin]

I think getting Toby's appetite back and him rebounding in that regard is the most important thing right now, so I hope to hear that he is back to 100% of his normal appetite soon.

Crossing fingers and let us know how it is going.

[liltara]

The worst symptom for my Mojo was the inappetence. He was a thin dog to begin with and not the best eater before Cushing's ... it became really the focus of our treatment once everyone figured out the Trilo was really not helping and quite probably making it worse.

My vet prescribed Mitrazapine eventually and it was the only thing that helped. It is a once a day dose and he ate well while he was on it. It really was a miracle for us ... you can read about Mojo's journey in his thread about his macroadeonoma.

You might want to research the macro possibility - inappetence tends to be a very prominent symptom when the tumor on the pituitary is large enough to interfere with their appetite center.

Wishing you best of luck - the inappetence really was the worst part of this awful disease for me and Mojo. I understand your frustration and also how you are feeling right now ... I spent a lot of time feeling pretty hopeless while I searched for things he would eat until we started the Mitrazapine.

[LINDAP1]

Thank you for your advice.What meds beside the mitrazapine is Mojo on? Totally off trilostane? Have the cushings symptoms returned? Thanks Linda and Toby

[LINDAP1]

Omg, i am so sorry for your loss. I sent the post before I read about Mojo's passing. I feel terrible and sending my apologies and sympathy. Linda and Toby

[liltara]

Hi Linda,

No worries! I took Mojo off trilo completely because it was really just making everything worse.

I will never know if the trilo hastened the progress of the disease or if it was the true cause of his inappetence, but I can tell you that he went inappetent several times during his year long journey with treatment and his appetite rebounded each time he was off trilo.

We believe his tumor was interfering with is appetite gland/area of his brain which is right next to the pituitary. We also believe he had a macroaedonoma which grew more swiftly with the trilostane treatment because the reduced cortisol levels allowed for it to grow vs. the high cortisol acting as an anti-inflammatant.

The last few weeks of his life he was on the mitrazapine and he was eating - not robustly, but eating nonetheless. Eventually, the mitrazapine didn't even help and I knew it was time for him to cross the bridge. But while he was on it he was much happier and so was I. Inappetence was the worst symptom of his illness.

I understand exactly how you feel - there is not much worse than putting down some yummy food, or offering a delicious treat, and having them show no interest. It is truly heartbreaking.

Feel free to PM me if you have further questions.

[LINDAP1]

Again I am so sorry for your loss.I look at Toby and just can't believe how the awful disease has changed his life. Thank you for understanding.I love him so much and am willing to try anything to help him.Good news-today he ate his 100% of breakfast! First time in a long time.I know he will never regain everything he has lost but I want him to be happy for as long as he has. Linda and Toby

[Whiskey's Mom]

We went through the poor appetite problems with Whiskey. It's so so hard. he was always a total chowhound and it grew harder & harder to get him to eat. It feels like such a huge victory when they finally eat. He had a hugely varied diet in his last months of life: treats, people food, you name it (everything but dog food). He would like something one day, then refuse it the next. Looking back, It was a lot of work, but I'd do it all over again if I had to. Best of luck to you, I know what you're going through & would be happy to offer suggestions if you would like.
Annie

[LINDAP1]

Hi everyone,

So Toby is eating well again!!!! I found a holistic vet in my area and scheduled an appointment for Toby.She is so busy that the next appointment is in 5 weeks.I am so happy he is eating well and getting some energy back.I see some of the Cushing's signs coming back...pot belly and drinking more but nothing severe yet.Hopefully going the natural route will make him feel even better.I going to keep him on the adrenal harmony gold drops until we see the doctor.I will let you know how we make out.Thanks to everyone again for your support! You all help get us through this horrible disease. Linda and Toby

[molly muffin]

Very glad to her that Toby is eating again. Let us know what the holistic vet says as we're all curious. :)

[LINDAP1]

Yes, I will! How wonderful is a natural treatment works.I feel encouraged because the herbal drops are helping but not enough.Thank you Linda

[LINDAP1]

Hi everyone,
Still waiting for holistic vet visit in 2 weeks.Toby is eating well but such a big decline in his mobility.His rear legs and hips are so weak and the muscles have really wasted.In researching the disease, the high levels of cortisol in his body is causing this wobbly gait and weakness. I feel so bad because he loves going for car rides but has so much trouble getting into the car. My husband made a ramp but really hard for him. I hope the natural herbs this vet puts him on helps dramatically because if he continues to have trouble walking and getting up....I don't even want to think about it.I look at him and can't believe how different he looks. He was a muscular,energetic and thick coated dog but now so different.Has anyone used anything to help with this hind end weakness???Thank you and appreciate your advice. Linda and Toby

[Harley PoMMom]

Prolonged high cortisol will cause muscle weakness and this especially shows up in the rear legs. Water therapy may help with that but unless that elevated cortisol gets reined in the rear end weakness will more than likely continue.

Is Toby displaying any other Cushing's symptoms? If so, than getting him back on treatment may be beneficial. I know Toby didn't fair well on his previous Trilostane treatment and looking back I do see that he was started out at 90 mg daily, which would of been a reasonable dose for his 120 lbs. However, the results of one study indicated that larger dogs require smaller doses so it is entirely possible that a lower dose, say of 20 mg daily, would be enough to get that elevated cortisol under some kind of control. The one thing I would probably do, if feasible, is to get Toby's cortisol level tested just to get an idea of where it is exactly at.

I am glad to hear that his appetite has picked up!

Hugs, Lori

[LINDAP1]

Lori,
I am torn between restarting trilostane because he did so poorly on it but that is an idea.So just to clarify,when we get the cortisol levels down he will start to regain his muscle strength? The holistic vet we have an appointment with in 2 weeks naturally wants him off all meds but I dont think it would hurt to try a very low dose for a few weeks since his appetite is good now. He is drinking alot of water and restless as far as other symptoms from cushings but his muscle weakness now is a major concern. I do have some trilostane at home from previous treatment so I could try it for a week and see what happens. I seems like we fix one problem and then another starts.Thank you for your advice. Linda and Toby.

[Harley PoMMom]

Even with treatment the muscle weakness takes a long while to improve. Before restarting the Trilostane I recommend having a conversation with the vet letting him/her know that you want to start treatment back up but only at a much lower dose of Trilostane. I also, if possible, would have an ACTH stimulation test performed to see where the cortisol level is at.

Keep us updated, please!

Hugs, Lori

[molly muffin]

I think loris idea of a low dose of trilostane could be helpful. High cortisol causes a weakening of the tendons and ligaments, which can lead and is often seen most often as rear end leg weakness.
So getting that under some kind of control would be worth while I'd think if you can find a low dose that he can tolerate and that brings the cortisol down.

[Carole Alexander]

Hi Linda, I've been following your thread and I just wanted to chime in about restarting the Triolostane. While I think holistic medicine can do enormous good for many of our dogs, I think that lowering his cortisol and keeping him eating would strengthen his rear legs. I hope you will consider beginning at least a low dose of Triolostane. Best to you.

[LINDAP1]

Thank you for all the responses and I think at this point, the major issue is his muscle strength.I did give him 20 mg trilostane starting yesterday and it could be just a coincidence but he didnt eat well this morning. I have enough med for 2 weeks so I am not sure if this will be enough time to see any improvement. If he tolerates the med, hopefully the holistic vet will work with me with diet and lowering his cortisol in a more natural way.Thank you for caring so much! What a great support you all are for Toby and myself.Hugs and Kisses from us! Linda and Toby

[LINDAP1]

Hi everyone,
toby had his visit with the holistic vet yesterday-3.5 hour visit.wow very different! She even did a chiropractic adjustment on his spine and he is walking a bit better.i am now making his food from a very specific list of foods consisting mostly of 50% protein and 50% veggies and fruits and 6 supplements ranging from daily to 4 times a day.omg-today he is perky and feeling better already.he seems calm and relaxed and not restless like he was for so long.he actually took all his supplements without any trouble mixing it in liverwurst!!!he ate 100 % of his food and let's hope things are on upswing.she said he is in very poor condition and wants daily updates.we have a recheck followup in 3 weeks.i will keep you updated and let you know what he is actually on.so happy right now!!!linda and toby:)

[Harley PoMMom]

Happy to hear that Toby is doing better and will be crossing fingers that he continues to improve, do keep us updated!

Lori

[Carole Alexander]

Me too, I hope this works and please let us know.

[LINDAP1]

Thank you! I don't think a total healing will happen quickly but i will take even the smallest improvement.i am so pleased that he appears more relaxed and comfortable.you feel so helpless when those big brown eyes look at you for help and you have exhausted everything. This disease is brutal and devastating so keeping fingers crossed right now and i will definitely update everyone with exactly what he is on when we know more. Thanks again for all your support and wisdom.i could not have gotten this far without this wonderful support group! Linda and toby

[molly muffin]

Great to hear that he is doing so much better. Those improvements mean the world to us.

Did you continue him on the 20mg trilostane for the 2 weeks of meds you had?

[LINDAP1]

I spoke to our vet and she agreed to order 25 mg for daily trial to help lower his cortisol level.However we started the trilostane and after 2 days he stopped eating again and had diarrhea.He obviously can not tolerate that medication.Today is Day # 4 of being on supplements and homemade diet and he looks so much more perky and eating very well.I am amazed because he has such a keen sense of smell that he is eating all his supplements without any problem.He actually gulps it down but it is also mixed in liverwurst.I am very encouraged and it is so nice to see my bot coming back to us! I am not expecting that he will ever be 100% but at least mobile and feeling well. Thank you Linda and Toby

[molly muffin]

Oh geez, yea, it shouldn't have been too much for him and I certainly hoped after being off it for awhile that he'd be able to tolerate it now like he use to.

It is good that he is feeling better now though and eating well.

[LINDAP1]

Hello everyone,

just wanted to post an update to toby's condition.so it has been about 2 weeks, and toby is feeling so much better.he looks alert,comfortable and relaxed.he was previously pacing, irritable and had much gastric distress-diarrhea and some vomiting.as of today, he is on a home diet only consisting of 50% protien and 50% fruit and veggies and 6 suppliments for adrenal health and detoxification.he is going tomorrow for a chiropractic adjustment because of his hind end weakness and stiff gait.he is eating 100 percent of his breakfast and supper.he is taking all his supplements without any problems.his stomach distress is gone and normal stools and drinking has been a little more than normal but not too excessive.i am so happy that he is feeling better already.now we have to try to get his muscle strength.i will update again in a few weeks.so far so good so holistic care is agreeing with toby!!! Thanks linda and toby

[Joan2517]

Sounds great!

[molly muffin]

What a great update. Good to hear that Toby is doing so well.

[LINDAP1]

It is with a heavy heart that we had to put Toby down Monday.He was a good sole with the most beautiful,loving eyes you would ever find.He always wanted to be by our side and even at his worse, he would still find a way to follow us around.We had a bond that can never be replaced and we miss him so much.It was not fair to him to keep going on, we could see it in his eyes.He had given up to this dreadful disease.I was giving him 14 natural supplements twice a day,bathing him twice a week and making him all natural diet and still this disease took his body over.He couldn't get up anymore without help and had large weeping sores all over his body that would not heal.i want to thank all of you who guided me and supported me through this ordeal and want you to know you all have a special place in my heart.He didn't deserve this and at least we know he is at peace.He was the best friend you could ever have and we will never never forget him.With deepest appreciation, Linda, Al and Toby

[labblab]

Dear Linda,

I am so sorry for your loss of sweet Toby. Thank you so much for returning to let us know so that we can offer you our support, and so that we can join you in honoring Toby's life and his memory. From the time you first came to us, it has been clear how much he has been loved, and how hard you have worked to try to help him. Sadly though, sometimes the healing just can't be made, and the most unselfish gift is to grant the peace of release. But what a price we humans must pay when we lose our beloved companions.

So truly, we join you in mourning the loss of your sweet Toby. And we'll always remain here to talk and listen should you wish to return to us. In the meantime, always in loving memory of your precious boy.

Marianne

[Squirt's Mom]

Dear Linda,

I am so sorry to hear about sweet Toby. You both fought so hard for so long. These heart-n-soul doggies leave such a huge hole when they have to leave but I know without doubt he carries all that love you gave him in his heart still and always will.

My deepest sympathies,
Leslie



You'll Meet Me In the Light
Author Unknown

I know that you can't see me,
but trust me I'm right here.
Although I'm up in heaven,
my love for you stays near.

So often I see you crying,
many times you call my name.
I want so much to lick your face
and ease some of your pain.

I wish that I could make you see
that Heaven indeed is real.
If you could see me run and play
how much better you would feel.

But our loving God has promised me
that when the time is right,
you'll step out of the darkness and
meet me in the light.

[Joan2517]

I am so, so sorry for your loss of sweet Toby. I know how much it hurts, especially after how hard you all fought. Cushing's is a horrible disease and our babies are so innocent, it just doesn't seem fair.

[PennysDad]

I am so so sorry for your loss. Sending you positive energy as you begin the process of mourning. Best wishes.

[DoxieMama]

Oh, I'm so sorry to hear of your loss. Please know you are in our thoughts and prayers.

Hugs,
Shana

[molly muffin]

Oh Linda, I am so sorry to hear that you loss your precious Toby. We all know that heartbreak only too well unfortunately.
My sincerest condolences to you and Al.
Please know that you are family here and if you want to talk about anything, we're here for you.