Jasper (12 yr old Mini Schnauzer) is now at peace

oh my gosh. Poor Jasper really has been through the ringer. Well, both of you have.
Hope he is feeling better. Everyone says that Pumpkin is the thing to try for the "runs". I'd go with Kim's suggestion and try it. I wish I'd known about it back in March when molly got the runs so bad.

hugs,
Sharlene

Thanks Everyone! Jasper is hanging in there, again. He continues on the hamburger and rice home cooked diet, and has been eating that well. He will have that through tonight and then tomorrow I am supposed to start mixing in a bit of the canned i/d prescription food to see if he will eat that. Then gradually increase the canned food to taper him off the home cooked. Then we will look at what food he will eat for maintenance. My vet said she will be handling him with kidd gloves since all of this has happened. We will be taking it very slow. The diarrhea has resolved with the diet and metronidazole. In fact he is pooping less than normal, I hope now he isn't going the other way! He has a history of getting backed up from time to time in the past. I hope that doesn't happen now from all the rice. I have noticed that his drinking has decreased significantly over the past 4 or 5 days also. I imagine that is related to the diet.

The urine culture came back negative, so now my vet has sent urine for a urine protein creatinine ratio test (?) which she said will quantitate the amt of protein in his urine, since an infection is not the cause. (I think that is how she said it). We don't have those results yet. I am kind of worried about that.

Tomorrow he has a previously scheduled appt to have blood drawn to check the electrolytes again, as it will be 25 days since the last Percorten injection. He will also get another injection. He also continues on the prednisone at 5 mg daily.

He seems to be feeling much better overall, and I am very grateful for that. It seems that this is all very complex and it is a very fine line to keep things balanced and to keep his little body feeling good and with some level of stability. It sure doesn't take much to rock the boat anymore.

I hope everyone's pups are doing well, and you all are enjoying the weekend. :)

Hugs to all,

Tina and Jasper

Great update. Fingers crossed for good results on the testing and weaning. Keep us updated! Kim

Sounds like your vet is doing a good job keeping an eye on Jasper and trying to figure out what is going on with him.

Hugs,
Sharlene

Hi Everyone,

Sorry for being absent, I had a pretty rough time with work last week.

Jasper had his appt last Monday and had electrolytes drawn. He also had another Percorten injection. The vet decided to decrease the dose by a little, 10%. The dose he gets is 1ml, so that decreased it by 1/10 ml. She decided on the decrease since he has continued to have increased drinking and urinating, and this can be a side effect of Percorten if the dose is too high.

We got the results of the electrolytes the next day, and both his sodium and potassium were wnl. So that is great news! The results of the urine protein creatinine ratio came back at 1.27. I don't have a copy of the lab report, but my vet said < 1 is normal or a good result, > 2 indicates that further evaluation needs to be done and that treatment is needed. An in between result warrants monitoring and is kind of a gray area. She said she was a bit concerned by this result and isn't sure if the protein is increased because of the Cushings (even though it is controlled now), or if there is something else going with his kidneys, and if treatment should be considered.

We have one IMS in town (actually in the whole state, I think), and she said that she wants to work up a case study type of report on Jasper and send it to him to review to see what he thinks and maybe get some recommendations. She wants his opinion specifically regarding the amt of protein in Jasper's urine, what might be causing it, and if he feels treatment is needed. She also wants his opinion as to why Jasper has continued with such increased drinking and urinating even though his cortisol is so low. She said that he is real good about giving consultations, but that sometimes he wants to see the dog himself. Of course I will do whatever they recommend. I appreciate so much that she is willing to take the time and effort to do this for Jasper, and that she wants to make sure that she hasn't missed anything, and also that her treatment plan is the best plan. He has been through a lot, and it has been very complex. I am sure it won't be easy or quick to get it all in a report.

Jasper is now transitioned completely to the canned prescription i/d food, and beginning Tuesday, I will start mixing in a little of his regular dry food to start transitioning him back to that. His appetite has been real good while getting the canned food, I am hoping that continues once I start mixing back in his regular food. He continues on prednisone 5 mg daily. My vet said we will try to start tapering that down once we get him back on his regular food. One change at a time so we can keep a very close eye on things.

He seems to be feeling good with how we are managing things now, but I know he can't stay on that high dose of prednisone, or the canned prescription diet. He has been through so much, I just get a little anxious to start changing anything. I have noticed for about the last 10 days or so, his water intake has been decreased. Still a bit higher than normal, but much better, and some days has actually been about normal! Not sure why that would be happening now. The vet is aware and she isn't sure either. It would be nice if it would continue, I have actually gotten some sleep for a few nights!! :D :cool:

So I will wait to hear what the IMS thinks about everything. I am so grateful that my baby boy is feeling better. And fingers are crossed that he is on the road to some level of stability now!

Hugs to all,

Tina and Jasper

Tina, Thanks for the update. Yes, that IMS is out of Kansas State's vet hospital and if you have to go there they will work with your vet closely. I ended up going directly to K State (long story) but I was very very impressed with them. You're in good hands. Take care and keep up the good work. Kim

Hi, good to hear from you Tina. Totally sympathize with the busy work situation. I'm glad that Jasper seems to be feeling good these days. It's always so stressful when they aren't.
I think it's usually beneficial to have an IMS consulting with your vet. I love it when a vet suggests the consultation themselves too. :)

hugs,
Sharlene and molly muffin

Hi Tina, I am not sure if this is relevant but my non CUsh pup Koko had a physical with these results- vet was mentioned could be Addisons or the start of kidney disease and that I should watch him and retest him.

Bun is marked 33 normal is 7-27
Creatinine is 1.7 normal is 0.4-1.8
Specific Gravity is 1.025
PH is 7
no protein in urine

I think consulting with an IMS is a great thing. I hope you and Jasper have a good week and work is not so hectic for you:):)

Hi Tina! Hope everything is going well with you and Jasper. Not working too hard I hope.

Hugs,
Sharlene and Molly Muffin

Thank you Sharlene, Kim and Addy for checking in on us and for your comments. I made it through another somewhat wicked week at work. My immediate co-worker has been out due to a family illness, and then on funeral leave :( , so it has been a little rough on the work front. Things should be improving in the coming week, I hope! Thank goodness Jasper hasn't had any emergencies or critical issues during the past couple of weeks!!

I started transitioning Jasper back to his regular dry food on the morning of 11/6, slowly mixing in a little with each meal. Well darn it, by 11/8 am, he had a loose stool. Of course I immediately feared that the colitis was going to flare again. I put him back on all canned prescription diet immediately, and he did not have any more loose stools thankfully!! Now I am thinking that maybe he is not going to be able to tolerate going back to his Blue Buffalo food, even though he had not had any problems with it before (other than not wanting to eat it!). Talked to my vet, and she recommended that we transition him to the dry version of his prescription canned food and see if that will work to get him off the canned. It is Hills prescription diet i/d low fat GI restore dry food. I am not too thrilled about it, and I know how some of you here feel about Hills/Science Diet and I can't say I disagree, but I am going to try it. I talked to my vet about it and she understands my feelings but said that she really does like their prescription diets. So far he is willing to eat it (yesss!!), and tolerating it just fine. I started mixing it in yesterday morning. My vet said we don't need to keep him on it forever hopefully, but need to get him off the canned food for a time, and then can think about trying the BB again.

We also discussed the consult with the IMS and his feedback and recommendations. She asked him about two issues, the protein in Jasper's urine, and his continued increased drinking and urinating.

1. Protein in the urine: The IMS suspects that it is caused by a combination of Cushings and the steroids and is not an indicator of another problem. (Yay!!) He suggests to monitor it for now, and recheck the protein-creatinine ratio in a month or two. He said that frequently the urine protein will stay high in dogs with Cushings, even once the Cushings is controlled. He also said as long as the steroid dose is high, protein will continue to spill in the urine, so it may be related to the increased steroid dose.

2. Increased drinking and urinating: The IMS felt it could be related to the Percorten injections. He said some dogs are sensitive, that it is not common but is possible. He also said it could be the steroid since Jasper is on an increased dose. He feels that the 5 mg dose is above a physiological dose for Jasper, which could be causing the increase in symptoms. He suspects that is not a function of underlying disease but a function of one of his meds. (Another yay!!)

He said that he is not convinced that Jasper needs the Percorten injections since his electrolytes have not been really highly abnormal other than the time he was in the crisis and was so dehydrated. He wonders if Jasper has a glucocorticoid deficiency but not a mineralocorticoid deficiency.

The only way to determine this is to not give the Percorten injection when it is next due, but check the electrolytes at that time and then again in 10 days, and then in another 10 days. We would need to watch for Addison like symptoms to return.

He also said that we should try to decrease the prednisone and see if Jasper continues to feel well. (This was already in the plan). If he can't tolerate that, then the IMS said to consider another steroid such as dexamethasone. He suggests to see if we can decrease it to the 2.5 mg daily dose. (This was the dose he was on for about 3 1/2 weeks before he had the last episode of not wanting to eat and the colitis flare).

Conclusion: My vet and I were very relieved that he didn't identify a bunch of things that should have been done differently, or that were missed. :) ;) And also relieved with his opinions that he didn't think there were additional problems going on that were causing either issue.

The plan is still to get him transitioned to a dry kibble diet, and once that is stable, consider trying to decrease the prednisone dose if everything is going ok. We will discuss whether to give the next Percorten injection or not, depending on where we are at with tapering the prednisone. Right now, his next injection is due the day after Thanksgiving, so I don't know if I want to try to rock the boat then. Plus, we haven't been able to try to decrease the prednisone yet because we have had set backs with getting the diet stabilized. Of course, it won't be any more convenient in a month, closer to Christmas. We will be discussing it to see what we feel is best.

So that is where we are at. SO sorry this is so long, but it helps me to get everything documented in once place for my records also!! I don't know how many times I have gone back to my posts to see when something happened, or a timeline for something, so that I could report accurately to my vet.

Jasper seems to be feeling pretty good overall. I am keeping my fingers crossed. Thank you all SO MUCH, and hugs to anyone who takes the time to read all of this!! As always, I greatly appreciate any feedback, comments or suggestions! :)

Love and hugs to all,

Tina and Jasper