As long as the test is completed within six hours, you're good.
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As long as the test is completed within six hours, you're good.
Happy Thanksgiving to you and Tipper
hugs,
Sharlene and Molly Muffin
Hi everyone:
Just got the results of Tipper's ACTH and wanted to post them , and of course have questions for everyone.
The numbers are:
Pre: 1.4
Post: 8.7
The Vet said due to these numbers her medication will stay the same 10 mg in the morning and 10mg at night.
Now here is my dilemma. I told you about her being hungry all the time, she cries for food, and practically knocked me over one day to get at it. She was eating slightly more during her higher cortisol numbers, as I could not listen to her cry anymore. I gave her veggies, and low calorie things to help her thru the hunger. She still gained almost a pound from it which has to come off. If her number is good, why is she still starving? Do you think the extra food stretched her stomach a bit, and now is still truly hungry? It seems genuine and I don't know what to do. As hard as it is I already started cutting her back. Jack Russells can be a real handful, and when they want something they fully intend on getting it. My Vet is calling the Vet at Dechra about it, but we probably won't hear anything until Monday or so. The extra water consumption may be because she had a bladder infection, or so says the Vet. Not that she is drinking loads of water, but more than her "new normal." So I ran her back to the Vet today and they gave her a 2 week antibiotic injection. Her stomach doesn't tolerate antibiotics well. The Vet said the report said there were some crystals in her urine, but that it could be from sitting in the refrigerator in that morning which can also cause crystals, so next Wednesday he will run a test in his office to see if his also has crystals. I will get the urine first thing in the morning and not refrigerate it, and go straight to his office. Well I know I am rambling on here so I will stop. Please everyone tell me what you think about this situation, I am most appreciative for the time you have all spent helping Tipper and I get thru all this stuff. Hope all your babies are doing well. Tipper and I say prayers for all of you. We are getting ready for our first snowstorm of the year, so Tipper will be delighted if we wake up to the white stuff. She has always loved the snow. It would be nice to see her happy!!
Glynda:
I know it is the start of the holiday season and you are probably busy. If you have a few extra minutes to read my last post I would appreciate it, I need your opinion.
Thank you and God Bless all of us and our babies.
Hi, jut a couple quick questions. Did you hear back from the Dechra vet? You said your vet was going to call them and ask about the hunger and the numbers? Did they do another urinalysis and did it show crystals? Did taking the anitibiotic shot help with anything? Did they confirm a urinary infection?
Sure optimally we'd like to see the post number down under 5 for control, but that doesn't always happen. For instance Zoe, Addy's baby, goes up and down. Based upon what Dechra ends up saying, perhaps talk to vet about doing a 5 mg in evening, 10 in morning dosage, or 5/5 even to see if that helps. You would need to get that from a compounded pharmacy, but it is certainly an option to talk to them about if you feel like the hunger is out of control, that Tipper is truly miserable, etc. How has the peeing been? Is that under control at all, or is Tipper having accidents with the increased water consumption?
Some of the questions I am sure that Glynda would want to know too, based upon your last update.
hugs,
Sharlene and Molly Muffin
Hi again from me! Like Sharlene, I am wondering whether you've heard back yet from Dechra. I would think that a dosage increase would be in order, so I'm curious as to their recommendation. Tipper has now been on her current dosing regimen for close to two months now, right? So if she is exhibiting symptoms and her cortisol is still hanging up there around 9 ug/dl, I would think it would be time to up the trilostane a bit. If you stick with Vetoryl, the logical increase is from 20 mg. to 30 mg. in terms of a daily total, but I know you're currently giving a split dose of 10 mg. twice a day. So adding another 10 mg. to either the morning or evening dose will make things really expensive for you unless you switch to a compounded product. I don't know whether Dechra might consider going back to once daily dosing, and giving Tipper a single 30 mg. Vetoryl capsule in the morning. I'll be interested to hear what they recommend.
Marianne
Oops, sorry about that, I don't know why I thought Tipper was on 10mg, once a day. (Whew Glad Marianne knew the real dosage!) All my questions still stand though! Inquiring minds want to know!
Sharlene
Thanks everyone for the help. Tipper is going to the Vet's tomorrow to have an in house urine test- to make sure there are no crystals. She has never peed in my house. Even when she was drinking "gallons." Before Tipper got sick if I had to go somewhere for a long period of time I would put a pad on the floor. Never once did she use it, she has always been like that. She is drinking more water than usual, but not nearly the amount as when this first started. It could be too, that I am not used to seeing her go to the water bowl so often, as when she did not have cushings, and it seems like a lot to me. It is too hard for me to measure because I have 2 cats and 2 dogs. They all go to various bowls. The antibiotic shot is probably helping her- she showed no symptoms of an infection, it just showed in the urinalysis. I don't know exactly what the report says as I will get my copy tomorrow and let you know. The Vet said he was calling Dechra about this hunger- but, he unfortunately has to be prodded all the time to do what he is supposed to. I will get on him tomorrow. I do not want to go to 30 mg 1 time a day- the Vet at Dechra said not to go up anymore the last time I talked to him. I do not want to use a compounding pharmacy, as I do not believe the dosage is reliable. I will see what they say tomorrow. Even though the split dose is more expensive I prefer it, as it is better for her. If need be I will use 2 -10 mg in the morning and one at night if that is what they suggest. It will be very expensive, but Tipper is very sensitive to things and my Vet and I are worried to give her a 30 mg capsule may cause a reaction in her. I am wondering if the hunger is just Tipper's Jack Russell behavior. It is hard to determine. They want food all the time even when she didn't have Cushings. Could this be a habit from me giving her extra things to get her thru to the next meal when she had severe symptoms?? I am scared 10 more mgs may crash her. I will let everyone know when I get back tomorrow. Thank you all for your help.
Hi everyone:
Again thank you for the help. Just got back from the Vets and had to get on his case about talking to the Vet at Dechra today ,and finding a solution to the hunger issue. Tipper is on Vetoryl and she previously started out at 27 Post on 10mg.then down to 11 Post on 10 mg in the morning and 10mg at night, and is now 8.7 Post on the 10 mg one in the morning and one at night so I assume it is still too high. At 8.7 if she is given 10 more mg in the morning what do you think the chances are of her crashing??? This scares the hell out of me. I will let you know when the Vet calls me today what Dechra says.
The urine test results were:
Bilirubin- 1+ this is high but barely- and I read it can be because of the infection. Reference range- negative
WBC- 6-10 reference range 0-5HPF
Crystals 4+ CA Oxalate (>10) The Vet gave her another test today as he said when you send it out and it sits in the refirgetator in can form crystals from that. He is doing one in house that I took with me and had not been refrigerated. I will post the results when he calls today.
Pleas let me know what you think of all this, I am lost and need some help figuring this out. Thank You all in advance.
She still seems genuinely hungry to me and cries while I get her food ready.
Of course I would defer to Dechra's recommendation, but if they do suggest a dosing increase, I would not be too worried about Tipper crashing. Of course, that is easy for me to say since she is not my dog :o. But if she WERE my dog, I'd want to get the optimal benefit from the Vetoryl treatment, and it doesn't sound as though you guys are there yet.
When you added the extra 10 mg. last time, it only dropped her cortisol level from 11 to 8.7. Since the lower level of Dechra's desired therapeutic range is 1.45, you still have quite a ways to go before Tipper's cortisol falls too low according to their protocol. So if they suggest a dosing increase, I'd give it a try if it were me. ;)
Marianne