Tess, radiation therapy (Tessie has passed)

You aren't showing up as logged in... I am hoping you are conserving battery... please let us know how you are as soon as you can... Kim

Prayers for strength and healing thoughts flowing around you both.

Hi Dottie,
I hope things are going ok. Let us know as soon as you can.
Jenny

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Ok this has me concern. How do I find out what medication do I give Tessie. I thought it would be Vetoryl, but the more I find out about cushings the more confused I get of what to start her on.

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I think I mentioned this in an edit to one of my posts yesterday afternoon. Prior to re-starting the vetoryl, I would have an abdominal ultrasound & the UTK full adrenal panel done. The full panel is the only way to determine if Tess is Atypical. If that might be the case, vetoryl is not an appropriate medication for an Atypical pup.

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With functional adrenal tumors having random secretory patterns involving one or more of the adrenal steroid/sex hormone, wouldn't it be ill advised to treat with Trilostane?

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When Glynda refers to adrenal tumors in this question, she is referring to ADH, adrenal cushing's, vs. PDH, pituitary cushing's. With ADH, there is actually a tumor present on the adrenal gland. The only way to 100% determine this is with an abdominal ultrasound

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With functional adrenal tumors having random secretory patterns involving one or more of the adrenal steroid/sex hormone, wouldn't it be ill advised to treat with Trilostane?

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This is really going to have to be your decision, with input from your vet. I believe several of us have indicated our concern about inadequate diagnostic testing being done, along with the fact that Tess is your vet's first trilo patient. We have seen it on these boards, literally dozens & dozens of times, a pup gets into trouble when a vet is not Cushing's savvy, does not follow protocol for using either drug, lysodren or trilostane, & then the pup pays the price. IMHO, if I had been in your position, with either of my Cushing's pup, & my GP vet who is pretty Cush savvy wanting to make one of my boys his first trilo patient, I would have refused. I would have told him, "My dog is not going to be the guinea pig for you to learn how to use Trilo."

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Enlarging macrotumor as opposed to a drug reaction.
Ok how do I test for this before I but Tes on any drug for cushings?

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The only way to determine the presence of a macroadenoma in the brain is either by a CT scan or an MRI of the brain. An MRI is hideously expensive, several thouand dollars, but I believe you can probably have a CT done for <$1000. Imaging of the brain can be done at any time during treatment.

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Do you have concerns about prescribing Trilostane for dogs that have significant elevations in intermediate steroid/sex hormone levels? In those instances, do you recommend an alternative treatment?

Also would like to know the answer to this.

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I can't answer for Dr. Bruyette. The one thing I can tell you is Palmer's Mom e-mailed Dr. Jack Oliver at UTK who is probably the foremost expert in the world concerning the use of trilostane with Atypical +PDH pups. His response was that the trilo would help control the excess cortisol due to the PDH, but eventually trilo will elevate intermediate sex hormones causing a retrun of symptoms.

I wanted to answer some of these questions to the best of my ability for you, because none of us know how long it may be until Dr. Bruyette may respond. I know that you need information now, not a week or two from now..

Dottie, you have done a tremendous job keeping things together since last weekend when you came to us when Tess was in such bad, bad shape. I really give a pat you on the back, because you have had to learn about Cushing's in the worst way possible, when your pup's life is at stake. Please keep posting, asking questions, reviewing the important information section, & by all means, be the "terrorist", & let all of Tess' vets know you expect answers to your questions, & answers that you can understand, not in "vet/medical speak".

Debbie

Dottie,

I'm staying tuned with the rest of the bunch. Looking forward to getting the latest on sweet Tess.

Glynda

Hi Debbie and everyone else. Just need to keep chatting. I am at the same E-VET that said to me that her cushings had gone to Addison's, which is now back to cushing per My Vet yesterday. Seems like its taking a long time to get the blood work done. The E-VET has Tes records from her OD on Sunday/Monday morning so I am covered there. I was up tell 4:00 am researching and reading about cushings, Addison's and cancer.

Ok doctor came out. I recored what she said. Is there any way to post that? if not bottom line. She feels we are dealing with two problems. They found a tumor were she goes poop. From my E-VETS experience these are always cancerous. Her glades in the low legs and under arms are swollen. If the tumor is cancerous, then you all know what that means.Tes Blood work was fine. I will post them when I get home. The tumor is not blocking her from going poop and her stole is normal. I am having them run a in house full panel and will compare it to the one My Vet will do on Monday to send out to the lab that I will get back on Tuesday. They are giving Tes a shot for vomiting, and sending me home with medication that will coat her stomach this is to be given at 3:45. its 2:37 pm late after noon, she said around 5:00 offer Tes food ( warm Chicken and white rice ) if she vomits or does not want food then I am to bring her back for IV fluids.

So the electrolytes are OK? Is that what I am reading? They have no concerns about the overdose or any lingering effects from the overdose?

Did they do a needle biopsy of the tumors or are they planning to do any biopsies?

Are the glands swollen due to infection, from the tumors, or what?

Did they give her any antibiotics, if so what for?

And, for heaven's sake, why aren't they keeping her for IV fluids now? For as much as she has been through this last week, I don't understand that at all. I think I would be stomping my foot and demanding they keep her til she was able to eat and drink, and they had some more idea of what the plan was. But that's just me. :o

keep your chin up! Like Debbie said, you are doing a fine job under terrible circumstances.
Hugs,
Leslie and the girls

OK paying the bill and will read all the post after I get home ty all for being there for me a Tessie XXOO Dottie

I am not sure how to link a recording.. maybe someone else knows..

You said we are dealing with 2 things - you mentioned the tumor. What is the other? Tell us exactly what this vet said when you get back home...

We will be here. Hugs to dear Tess. Kim

Hi Dottie,

Please let us know how Tess is when you get home, ok?

Sending healing thoughts and prayers your way.

Lori