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Hi Gina,
Sorry to hear about Lucy's GI issues. Hope she is feeling better soon. Serena is having some minor GI issues so I am wondering if it occurs in dogs who have had radiation or surgery on their tumors. In Serena's case she has loose stools and her appetite has fallen off a little bit. Otherwise she is acting normally.
January and Serena
Hi Gina,
I don't know what you should do about the meds, but here are a couple sites that suggest what you should do if your pup vomits...
http://www.peteducation.com/article....2+1571&aid=265
http://www.geocities.com/petsburgh/zoo/1224/vomit.html
One says to "Never give a dog vomiting blood oral medications.", but you hadn't mentioned any blood.
They both say to withhold food for a certain time. Don't allow her to drink large portions of water - that's hard to do if you're not there... I have several small travel size water bowls... when I had to make sure Wylie didn't guzzle down water (after his gall bladder attack), I replaced his big water bowl with several small bowls, each with about a 1/2 cup of water.
-Susy
I'm wondering if a big part of Lucy's problems - low energy, seeming achy and sore, a tendency to diarrhea and now lack of appetite couldn't be related to the very low dose of pred she is on. I'm not sure how much she weighs now - but I guess she is a bit over 50lbs (around 22 - 25kg)? If she's on 2.5mg per day then that is around 0.1mg/kg per day and the usual physiologic dose (that is the dose that provides cortisol replacement sufficient for normal, non-stressed daily functioning) of pred is around 0.2mg/kg. How much a particular dog needs is an individual thing and it seems that older dogs sometimes like their cortisol level maintained just a tad higher than younger ones, too.Quote:
Originally Posted by lucygoo
What Lucy has now, after her pit surgery, is what is called Secondary Addison's. Here's a link to an article on Addison's that mentions the usual dose of prednisone - you can skip over the stuff about mineralcorticoids because that isn't an issue in Lucy's case, and go to the para headed "Glucocorticoids". It's got info on fine tuning the dose and also on the importance of giving more when the dog is stressed in some way either by illness or psychological stress. http://www.addisondogs.com/addisons/medlab.html
I know that appetite is usually regarded as the best indicator of whether the cortisol/prednisone level is adequate but I have noticed that some dogs seem to get "used to" very low levels if the level has come down very gradually over time and their appetite can remain normal despite having other symptoms of low cortisol such as weakness and diarrhea. I've seen a few dogs here have this happen and my own dog did this once when she went low during the course of her Cushing's treatment (she'd been on treatment for over a year at that stage): One evening she was walking around looking weak and miserable and had diarrhea but still wanted her dinner! A dose of pred had her trotting around happily again within the hour.
Alison
Hi everyone...
Thank you all so much for your help. Dr. Bruyette did e-mail me this morning, and said to give her a little bland food and a pepcid with her pills. I tried giving her a little W/D but she would have no part of it. She did have a few bites of her regular canned Innova Senior. I got home and she's acting completely normal so far....had a few cookies, and is running around excited that I'm home.:)
January...Lucy's always had a bit of a nervous stomach her whole life, with intermitten bouts of diarrhea and vomiting, but the diarrhea has definitely increased since her surgery. She ALWAYS has loose stools now. The only time she didn't was when she was on the I/D after her surgery, but of course she'll have none of that now. I was reading something about dogs that have this surgery (not sure about the radiation, but I would imagine it's the same) have trouble digesting fats...Lucy doesn't have a pituitary at all anymore, so maybe that's why.
Scott...No, I haven't given her the carprofen yet. She seems to be doing okay so far without it. I've only given her two doses in total about a month ago. I also get nervous about giving that and the pred together, but she's on a pretty small dose of prednisone.
Alison...We've been playing around with her pred. dose. I noticed her appetite dropped off a little a couple weeks ago, so Dr. Bruyette increased it to 5 mg. per day. The water drinking and panting and staying up all night were out of control, so he decreased it to 3.75 mg/day. That seems to be sort of a happy medium so far, if there is such a thing. The appetite is weird. She plays this game where she hops up on the couch and I hand feed her a few bites, and then she eats the rest out of the bowl. We're in that sort of "if it's not one thing it's the other" picnic. She definitely pants more now than even when she had cushing's, but she doesn't seek out cool places anymore, i.e., bathroom floor. It's really odd. If I give her a drop of the anti-diuretic at night it helps a little, but she still gets me up at least 1 to 2 times a night...and that's on a good night! So I really don't know what the answer to the pred. dose is. I guess it's one of those things where it's nearly impossible to get to that perfect dose.
Susy, I did check for blood, and there was none. I remember that from when Lucy had pancreatitis a few years ago.
Nathalie...I'll definitely check out the slippery elm. Maybe that will work better than the lactobacillis thing I have her on.
Thank you all so much, as always, and will keep you posted on how Lucy's doing:)
Gina and Lucy
You mention staying up all night - could her thyroid med levels be a little too high for her, I wonder?
I think "running hot" can by a symptom of hyperthyroidism too.
Alison
Alison...
Not according to her last test, when she had her follow-up MRI about a month ago. That was my question, too, but Dr. Bruyette said they were fine, and wants to keep her at that level. I noticed that when we increased her pred to 5 mg., she was REALLY up all night, and just acted agitated. Now that we've lowered it, it's helped a bit.
I've read in quite a few posts here that a lot of people use melatonin...do you think I could use that for Lucy? I'll ask Dr. B, of course, but I don't see why not. I also have tramadol, but I know that causes panting, too, and I don't want to increase the panting.
Thanks,
Gina
I just thought of something that may have caused this...and it's all my fault:mad:
Lucy's on .4 mg of levothyroxine every 12 hours...I'm usually pretty good about the timing. She gets it around 8 or 9 a.m. and 8 or 9 p.m. THe night before last, I realized to my horror at 1:30 in the morning that I forgot her evening thyroid dose:eek: So I gave her one then; and then she got her usual morning dose, and her usual evening dose last night. Maybe some kind of toxicity built up??:eek: It was either that or the bite of cat poop she ate last night...she hasn't done that in years.
So far she's acting fine, so I'll see how she eats tonight.
Thanks again,
Gina
Gina, you sound like me. So guilty for everything! I take thyroid meds, and I'm sure that's not what caused a problem.I know dogs are different than people, but once on a trip, Nikki got my thyroid meds and ate them all out of my pill container. I was sure she would die and called the vet. They said it would not affect her at all and it didn't. She will recover from this, I'm sure. Hang in there, you're doing great! Sharon
Hi Gina,
I have been unable to post before, but have read your thread about sweet Lucygoo.
I just wanted to share my experiences with pred and soloxine dosing.
We had a difficult time finding the correct dose of pred for Misty and as it turned out, it was a bit higher than most. (She weighed 8 pounds and 6 ounces).
I tried more than once to reduce the pred dosing but she would let me know quickly that she needed more. We settled on 1 mg in the morning with meals and 1 mg in the evening with meals, giving her a balanced 24 hour coverage and it seemed to be perfect as long as she didn't become extremely stressed. If she did get in a stressful situation, I would then give her an additional 1/2 of her total daily dose. However, most of the time she would just sleep it off.
I also learned that Soloxine caused the pred to exit the system faster. So we developed a plan to give her adequate amounts of each med on a continuing basis. 3/4 of .1 mg Soloxine and 1 mg pred with morning meal and same with evening meal. She also was given 3/4 of a carafate pill an hour before each meal to coat and protect the stomach. This worked really well for her for the past year.
Another thing I learned from experience, and a good vet, is that too much pred can cause basically the same symptoms as too little, so it is definitely a fine line to follow.
I don't know if any of this might be beneficial with Lucy (Misty didn't have surgery), only Atypical/Secondary Addison's caused from too much ablation of the adrenal gland. Her electrolytes were never an issue, so all she had to take was prednisone.
If any of this has already been covered with you, please disregard. :)
I am not advocating any of my experiences would work for Lucy.
Only your doctor can determine that, but I think sharing experiences sometimes sheds a little light on a situation.
Hoping for happy and healthy days ahead for Lucygoo and you.
Shelba and Suni
I wouldn't think the one-off change in timing of the soloxine dose would have made a difference - but ya never know! I guess time will tell. Remembering to take or give meds at the right time is something we all have trouble with - setting a reminder in your cell phone could help and if you give a treat with the pills you'll probably have Lucy jumping up and coming to "remind" you when she hears the alarm.
Shelba's experience with Misty's Atypical Addison's is very relevant to Lucy's situation as the two types of Addison's are basically the same in that the mineralcorticoids/electrolytes that you get with "typical" Addison's aren't an issue - just the glucocorticoids.
In the course of my research I've come across quite a bit of info on human addison's and it's treatment and it appears that some people find some glucocorticoids better for them (as an individual) than others and some even use a combo of two or more preparations at different times of day to fine tune things. I don't think you'd ever need, or be able to, do such fine tuning with a dog (because they can't talk) but I guess it could be worth a try switching to another preparation like cortisone or dexamethasone (dex is slightly longer lasting and can be more even in its effect, I gather) if you just can't seem to find the right pred regime for Lucy. As Shelba said the timing of the dose can matter too.
I think the melatonin sounds like an excellent idea and many here have had great success with it especially for night time restlessness, but like you said, run it by Dr. B first. I wonder if the tumor or the surgery somehow did something that affected her sleep/wake cycle and (as you mentioned before) and the fine tuning of her body temperature regulation.
Alison