Down the Cushings Road Again -- Abbie, 15 year old beagle is now at peace

Oh gosh, Judy, I'm so sorry nobody noticed your question on Tuesday!! What ended up happening, and how is Abbie today?

I agree with the advice that Lori just gave you...

Marianne

Hi, Lori & Marianne! Absolutely no need to apologize--being an administrator of an on line beagle forum, I know what it is like trying to keep up with everyone & this forum is a lot more active than ours.

Love the word "zestful" to describe a beagle's appetite! I gave Abbie her pepcid ten minutes ago and she has been "talking" at me for the entire time, trying to convince me that it is dinner time. Tuesday her water intake went back up and fluctuated around the 25 oz. mark until today when it drpped to 19 oz. The only other change I see is that she is sleeping very deeply. Her appetite is still strong. Her stools are normal--I was concerned about the Lysodren bothering her stomach but the pepcid, flagyl and probiotics seem to be working.

My vet called Tuesday night and I left a message for him yesterday that all was the same. I called this evening and asked tech to find out if vet wanted to do ACTH tomorow or Monday. Tech called back to say he wanted to wait until Monday to see if appetite lessened. I am okay with that as I will definitely stop the Lysodren if I see any more changes. Vet wants her fasting which I think will raise her stress level but I couldn't find anything technical to back me up.

Question: after ACTH, do I stop Lysodren until results are back? Results took 2 days last time. Vet takes Wednesdays off so will have to ask him to have someone else call me with numbers.

The "norm" is to stop the Lysodren until the ACTH stim results are known, the maintenance dose is dependent on: the loading dose, how long it took the dog to load, and the ACTH stim test results.

Regarding the fasting, according to Dr Peterson, a dog does not need to be fasted:

Quote:

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Preparing for the ACTH stimulation test: Does the animal need to be fasted?


The dog or cat does not have to be fasted overnight, and lipemia does not appear to “clinically’ affect serum cortisol values. However, having a nonlipemic sample may be better in some situations, especially if serum cholesterol or triglycerides are being measuring on same sample.

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What's the Best Protocol for ACTH Stimulation Testing in Dogs and Cats?

Thanks, Lori! I'm going to make one more attempt tomorrow to change my vet's mind.

Ugh, I wish I had more knowledge when it comes to lysodren, but I think you definitely know more about it than I do. :) So, I'll just offer my full support.

hugs

The simple fact of the matter is, you can tell the vet when you will bring Abbie in for the ACTH. This is YOUR baby and YOUR money and YOUR stress to deal with. ;)

Leslie: I know you are right. I woke up at 5 this morning, worried about Abbie's treatment. That said, my vet has been there for me during years of Maggie's very complicated medical road and has gotten Abbie through significant surgeries since I adopted her. I would much rather work things out together with him. I am going to print out a copy of Dr. Peterson's blog and drop it off at the vet along with a note that I want to bring Abbie in after her normal routine is completed, including breakfast, in order to reduce her stress as much as possible for the best possible test results.

Thanks to you and everyone for your support!

Success! :D I talked with the office manager/head tech with whom I have become friends with over the past 10+ years. I gave her the print-out with my note on it and explained my thought process. She said she would be happy to discuss with the vet and would call me. I got back home from our mid-day walk and there was a message from her -- vet says fine to not fast and that a 10:00 arrival would also be okay (which is what I asked for). I am feeling much better!

After I wrote last night's post, Abbie ended up guzzling down some more water and ended up at 23.5 oz. for the day (with 22 oz. being the "Feldman" cut-off). She is about at the same pace today and definitely no change in eating -- she enjoyed a couple of crispy worms on our recent walk!

Thanks again to everyone -- you helped boost my confidence!

Aww, that is great! Having an established relationship with the vet and team certainly makes things a bit easier when in the midst of cushings.

So, she is probably doing okay on the load right now, as water food intake would suggest anyhow.

Doing good!
hugs

I'm so glad to know that someone else's pup likes crispy worms and frogs. :) Hoping to see some good numbers from the vet visit Monday! :) I'm glad Abbie is feeling good.

Thanks for your replies, Sharlene & Suzi! Abbie continues to feel good. She is a really good girl--I was even able to convince her to wake up from a deep sleep at 10:30 last night to go out and pee in the rain! Getting her out at that hour eliminates a middle of the night event.

Suzi--I learned the hard way to never try to take a dead frog out of Abbie's mouth. She was experiencing freedom from the dreaded cone of shame after one of her surgeries and grabbed a very large crispy frog. I had previously taken various things out of her mouth and this frog, even though quite petrified, was very large. I pried open her mouth and stuck my finger in to get the frog. Abbie proceeded to chomp down and her incisor tooth went through the frog and my finger! :eek: To make a long story short, cellulitis set in and, after many weeks of heavy duty antibiotics, my finger survived. About six months later I was able to move the joints. The doctors told me that they rarely see infected dog bites and, even though the frog was dead, that that was probably the cause of the infection. Abbie even has a "rap sheet" with Animal Control! :D

wow, glad you healed, something for all to think about:)

O.M.G.! :eek: I can't help but giggle a little but that is awful about your finger! There are always a few small frogs that live on my carport during the summer eating bugs and stuff from the lights and Dixie always wants to get at them. I know shes "tasted" them when she starts sneezing and shaking her head. There are always some that end up flattened and we battle over them with me saying "drop it, drop it, drop it" and her giving me the stink eye. I know if she gets in the house with them, up under my bed to her hoarder's cave that stinky frog will go. So far I've managed to not let her get in the house with them. And the worms too. Lord, the dried up worms on the car port all end up in her belly. These cush babies will eat anything!

My vet has assured me that the dead worms are just extra protein! ;) We have frogs here in Florida that emit a poisonous liquid so I am glad that Abbie has no interest in the live ones. She will even spit out the worms if they are not crispy enough! I have always thought that Abbie probably developed her palate because she was a "street dog" for an unknown period of time.

I'm sure you are right Judy. Abbie learned to survive and if it had to be crispy worms and flat frogs then I'm glad she ate them. I'll bet that dried frog she bit you over was her filet mignon during her street days! :)

Dixie doesn't have a good excuse. She's just a piglet!

Hi, all! Abbie had her ACTH this morning and I am trying not to be too optimistic but she actually walked away from her breakfast this morning after eating about half of her food. She did go back to finish up but it was definitely a change! The cortisol injection really made her a wild girl and, on her first walk back at home, I could definitely see that her worm/frog compulsion had been greatly reduced over the past few days while on the Lysodren. My back and arms are aching from trying to drag her away from the road kill! Unfortunately, she has gained 1 1/2 lbs. during the last three weeks so her big belly is definitely not all due to the Cushings. I think part of the gain is that I am wrapping all her meds in her canned food. I need to get that weight off but am sure she won't be happy about a reduction in her food!

I don't expect to get results until Wednesday so keep your fingers crossed for us!

Awesome, it does sound like she is loaded. Now just to wait for the test results and hopefully smooth sailing ahead on maintenance dosing. Crossing my fingers.

I know they are something after that injection and cortisol dump aren't they!!

hugs
Sharlene and molly muffin

Crossing fingers and paws for great test results. We do that drill (ACTH) Wednesday and then the wild dog will be my little one. *sigh* I'm sure glad I have you folks to discuss things with. The friends with "normal" dogs just don't get it, do they?

paws crossed. That's so funny about the hoarders cave. I would find all kinds of things under the bed, his favorite were undergarments:)

Hi, folks! I just got off the phone with the vet who had great news: Abbie is loaded!! :D I am very glad that I stopped the Lysodren when I did as her numbers were at the low end of the range:

Pre #: 1.8 ug/dL
Post #: 1.9 ug/dL.

Abbie has really been a "textbook case" which has made it so much easier for me to deal with. I will be keeping her on the 500 mg. of Lysodren a week, split into two doses, one on Thursday morning and one on Monday morning. Unless she has any increase in symptoms, we scheduled her next ACTH for 12/12.

The vet said that he is not concerned about Abbie's weight gain and to keep everything the same in terms of food and meds (pepcid, flagyl, Denemarin and Fortiflora). It is our hope that her on-going digestive issues will even out after a few weeks of treatment.

Questions: 1) Do you usually re-check liver enzymes at the 30 day mark? 2) Do you continue to measure daily water intake?

Thanks for your finger crossing -- it worked!

Yes I think at the 30 day mark and then if that is good, you get a nice break of a few months, like 3 and then recheck again.

Wonderful news!

hugs

I wouldn't recheck her liver enzymes levels until her chemistry blood panel is due to be done. For some reason there are dogs whose liver levels never do normalize, so don't be alarmed if this happens with Abbie. Also, I wouldn't bother measuring her water consumption, I feel certain that you would be able to pick up on any signs that Abbie's cortisol is dropping too low.

The ACTH recheck on 12/12 sounds perfect to me, however, if Abbie would show any adverse signs of her cortisol dropping too low than an ACTH stim test would be needed ASAP, I'm sure you already know this but thought it was worth repeating . ;)

GREAT JOB JUDY!!!!!

Hugs, Lori

Thanks for guidance! I was thinking I would be keeping an eye out for an increase in cortisol, i.e., increase in water/food, and had not considered symptoms indicating a drop in cortisol. With low normal numbers on ACTH, a drop in cortisol does seem more of a risk.

Abbie's post-ACTH wildness was significantly less by this morning. We had a good 30 minute walk; I take her to an area nearby where lots of folks walk their dogs so Abbie is more interested in smells than eating worms. Interestingly, she has always been very wary of large dogs and tries to act aggessively when seeing them. This reaction had dramatically increased over the last few months and then diminished when we started the Lysodren. I am thinking that the changes in cortisol level influenced her behaviorally. Curious if others have seen similar types of changes ...

Great News! I had faith that you could do this and you did it perfectly! Go Abbie! Sounds like it will be significantly easier from here on out.

Cosmo's mom - oh yes. Underwear is a staple for the hoarder's cave. hahaha!

I think the aggression thing can certainly be part of the cortisol package deal, as we have heard that before.

hugs

Good job Judy and Abbie!:)

Hi Judy :) Abbie is sooo pretty! I hope her illness is easily controlled, I do not know much about Cushings my beagles have pheos :( so I am not knowledgeable on advice for Cushings but will keep Abbie in my thoughts and prayers for all to go smoothly with her treatment.
arooooooooooooo! from my beagle boys Snuggles(turned15 years old in August) and Brando (will be 15 in March God willing)

Thanks, Vicki! It boggles my mind that no one came looking for Abbie in the kill shelter but I definitely ended up with a wonderful girl. So far, she is handling the Lysodren maintenance dose without any issues -- probably better than I do. I still watch her like a hawk on the days she gets a dose!

Amazing isn't it that someone wouldn't come looking for her. She's such a sweetie and so pretty.
Course our Molly came from a high kill shelter in Quebec, and that still boggles my mind all these years later.
I figure they just don't any of them know what they missed and in the end it is us that wins, as we have them in our lives each and every day.

Huggers,

Hi, all! I gave Abbie her Lysodren maintenance dose this morning. She was coughing a bit after swallowing it and I am wondering if the canned food wrap didn't stay on long enough to prevent irritation. I wrap all of Abbie's pills in her canned food and, since she was used to that, decided to do the same with the Lysodren. She has became adept at eating the food and spitting the pill out--at least she didn't do that with the Lysodren. Also, Abbie's first poop was normal but then had a small soft one and a third one with just liquid (all after Lysodren). I will definitely be keeping track of that. This was Abbie's 4th maintenance dose and she has been fine with other doses.

I know that some of you wrap pills in peanut butter or cream cheese but I think Abbie could easily unwrap those. Has anyone used pill pockets for Lysodren or Vetoryl? I am thinking that the pill would stay enclosed all the way down.

Hi, all! I try to only be away from the house for short periods of time on dosing days (Mondays and Thursdays) and am thinking ahead to Thanksgiving next Thursday. Would there be any problem with changing Abbie's dose to Friday? I realize this would shorten the time frame until the next dose the following Monday but I will be out for a longer time frame on Thursday.

(Note: I did see a reference to using pill pockets on another thread; will be trying that out tomorrow. I got the larger capsule size just to make sure it was big enough.)

I don't think that would be an issue, Judy. As long as Abbie is getting the correct weekly dose and it's spread out a bit she should be fine. ;)

Thanks, Leslie! Using a pill pocket this morning was a fiasco. :( Abbie thought it was meant to be chewed. As she was chewing away, the Lsysodren popped out. Abbie beat me to it, picked it up and swallowed it! She seems none the worse for it and the pill pockets went in the garbage. Back to wrapping in her canned food ...

pill pockets worked great with Cosmo until he quit eating altogether. I only used half so he would just swallow and not chew. Good luck.

molly would eat the pill pocket and spit out the pill.

hugs

Could you wrap it in a piece of cheese? I know some members did that.

Addy--my concern is that Abbie will try to chew the cheese ball also. I think I'll go back to using her canned food and just make sure I use enough to surround the pill.
I am really pleased with Abbie's response to treatment. She definitely has more energy (and our cooler temps help in that regard). She is also much less obsessive about food and has actually passed right by some crunchy worms on our walks. Definitely drinking less water; I am going to measure tomorrow just to get an accurate read. No soft stools at all the last couple of days.

The key is to have another very small piece of cheese in your hand that she sees. This makes her swallow the first piece so she can get the next one. Usually works with anything she really likes the taste of.

Hugs

Sharlene--great idea! You are very clever. :D

I'm impressed Abbie passed on crunchy worms- that's like us passing on chocolate:):):):):):)

Good to hear things are coming along.