Joined Today (Orlando has passed)

norocarp/carprodyl is very cheap too. [ tasty pills]
i buy 20x 50 mg pills for 8.50 euro[=10$]
i have smaller dogs but it is cheaper this way. i break them in 4 equal pieces.
that is very easy to do.
no side effects after using them 1 year together with vetoryl.

Orlando had his ACTH test and the numbers were greatly improved. He is now on 50 mg of trilostane per day and I am happy with his current state. He is peeing much less, eating normally, less lethargic, and less arthritic. We are still walking less than we did in the past, but the distance is increasing each day. My vet is going to a meeting this week with other medical professionals regarding Cushings and has told me that she will contact me when she gets back with any further information or changes in dosage. Over the years she has expressed an interest in alternative medicines and therapies and actually trained to become a professional veterinary acupuncturist. When the whole Cushings dx first came up, she mentioned that there were new alternative therapies, but I assumed she meant products like Adrenal Gold and Cushex which do not interest me. If she wants to try melatonin and lignans, where do you stand on that? Have people had success? I did read the abstract from the U of T about it;parts were confusing to me, some were not. In your opinion, it is given with trilostane or does it replace it?

Melatonin and lignans work on the intermediate hormones - Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone - which are involved in Atypical Cushing's. Atypical pups have NORMAL cortisol but elevations in one or more of these five hormones.

Melatonin does have the ability to have a mild effect on cortisol but it cannot cope with the massive amounts in our cush babies bodies. It works on temporary elevations from stressful situations or things like jet lag. Lignans, spruce (HRM) or flax (SDG), do nothing for the cortisol that I know of. They will not replace Trilo. ;)

Complimentary and integrated medicines use things like herbs (both western and from other approaches like TCM - Traditional Chinese Medicine), diet, supplements, acupuncture, and so on ALONG WITH pharmaceutical medications like the Trilostane or Lysodren. This is more than likely the approach your vet is talking about.

The most important thing about using any of these approaches for our cush babies is keeping up the testing to see what the cortisol levels are (the ACTH). Herbs, diet, etc. CAN make the signs better, but they can also mask the underlying issue so it is vital that the cortisol continue to be monitored if a pup is taken off the traditional meds for another approach to be sure that approach is working as well as the drugs. ;)

Thanks so much. I am not inclined to take him off of the trilostane at all and appreciate the clarification of what the other two treatments can and cannot do.

I have my fur kid on Trilostane. She also gets supportive therapy from a Chinese medical vet who also practices western vet medicine. My personal belief is this is what has her here with me today. Like it has been said this is only to support the western stuff, not replace it. She gets regular testing too.

Angela & Shasta & Family

Orlando is still on trilostane, 50 mgs, after the last ACTH test. He should be up for another one in mid July. I have not used any other supplements and noticed that with the lowered dose of trilo that the arthritis was less noticeable. We continue to be very happy with Diamondback and their service; they are very easy to communicate with and are very professional.

Great to hear that Orlando is doing well on trilostane.
Yes. Very one has good things to say about diamondback. Glad to hear that is working out well for you.

Orlando is holding his own and will go back in for the next stim test in a couple of weeks. I wanted to double check the time frame between giving the last dose of the trilostane and the administration of the test. How many hours should the med be given before the test?

The only issue we seem to be having is a lot of panting. Admittedly, it is hot out here in LA, and it has been humid, a condition to which we are not accustomed. However, I do have fans running all day, and central AC which comes on periodically. Is the panting indicative of anything related to Cushings? Orlando has not lost any weight with the treatment, and our exercise is lessened quite a bit, especially due to the heat. He just does not want to go very far, even in the cooler parts of the day.

You need to have Orlando to the vet's office 3 to 4 hours after his morning dose of Trilostane. Make sure his dose is given with food.

Panting is definitely a symptom of cushing's that does improve with treatment but it can take a while. My little Pom, Lulu, sounded like a freight train most of the time but it was especially worse on warmer days. Dogs with cushing's have various stages of muscle wasting which contributes greatly to the exercise intolerance. That can take a while to improve as well so just like everything else you've experienced so far in this cushing's journey, you can expect your patience to be challenged for a bit more. Coming here and talking about it helps so keep checking in with us.

Glynda

What a cutie Lulu is! Thanks for the answer. I will definitely watch the time frame of the trilostane before the test. O is a GSD grazer and absolutely will not eat much except on his own time frame. That has been an issue with the meds, but he will take his favorite chicken jerky with them. It is reassuring about the panting as he does sound like a freight train at times.

Orlando had his last ACTH on Wednesday, along with the geriatric blood panel. He will remain on the 50 mgs of trilostane once a day, which is fine with me. He does not seem to have any serious issues with it and I was glad to see that it has remained the correct dose. It was funny as the receptionist in the vet's office, who is probably in her 20s and not that experienced, made a point of telling me to fast him before the test. When I got in, I told her what I had done, which was to give him the trilostane within 4 hours of when I felt they would do the testing and to give him a light breakfast....as I have said he is never one to rush over to food in the first place, so it was not a huge amount. I told her that I did not want some high false reading which would put him back on a higher dose and then here we go again. She told me that apparently she should have been asking me the questions, with which I agreed completely. So thanks to all of you for keeping the info updated on all of this.
I believe that O is still somewhat arthritic. He is no where near as bas as he was with the high dose of the trilostane, not even reacting as if he is in pain, but still slow to walk and disinclined to go very far. The vet has ruled out the NSAIDs due to his high Alk Phos numbers which are now down to 430 which is a drop of almost 200 points since the last test. I am fine with that as I have always had issues with them from years ago with another dog. What do you recommend in terms of natural arthritis supplements, or even meds like Adequan? Currently he takes no supplements for this.

A good supplement is Glyco Flex. It comes in 3 strengths and my dogs love them like treats. Adequan is good. Also look into Dasuquin and Cosequin. Hydro therapy,cold laser therapy, and acupuncture can also do wonders.

Glad Orlando is doing well on the Trilo!

I use the glyco flex III for my dog. It does help her.

Good job on following proper protocol for the testing even when told wrong by the vets office. :)

After some thinking, I remembered that I had purchased some Phycox a while back for Orlando, but he did not like the taste and would not take it. This time around, I decided to break it into little pieces and give it like a pill, which was reasonably successful. Just in case anyone would be interested, the results were amazing. After two days he willingly went on his old walk, played tug of war after his bath, and remained much more up and alert....right up until his mommy figured out that the COX part of the name means that it is a COX2 inhibitor. I am going to look into the Glyco Flex, and in the mean time found another formula at a privately owned pet store which has most of the desireable ingredients without any NSAIDs. But I do have to say that the results were shocking for anyone whose dog can take NSAIDs.

Orlando has continued to do well on the 50 mg dose of trilostane. The cold weather has helped him to feel more energized and we are walking a little more, which he seems to enjoy. However, a new issues has arisen. The vet who has treated him as moved to another veterinary hospital a few miles away.While I am on very good terms with the remaining vets at the old place, I would like her to keep treating his Cushings. Orlando is very much afraid of other dogs, probably stemming from the fact that he was taken away from his mom at 3 weeks old and never had that learning time with her. He ironically loves to go to the old vet, loves everyone there and has not had any trouble being left there for the time that the Cushings testing takes place. I think that this is because as a little sick puppy he was taken there early on and bonded with them However, it is out of the question for him to go to a dog park, Petsmart, etc without complete panic setting in. I intend to take him to the new hospital for a trial run in the near future, probably about a month or so. If he completely panics, would it be a good idea to leave him for the stim test? Can the cortisol level be raised or can a false reading result if he becomes hysterical? I can try to insist that they let me stay with him, but I don't know what their policy might be about that. I do basically trust the vets at the old hospital, but would prefer that he see the same vet if possible....but I don't want to mess with the level of trilostane that he is taking if it is not completely necessary.

Panic can cause cortisol to raise, whether it would be enough to completely skewer the ACTH test or not I don't know.
I definitely would not have his first trip to the new vet hospital be for the ACTH though.
It might be getting the ACTH done by the regular vet hospital he is comfortable at would be the better option, while slowing introducing him to the new hospital. You can get the results and then decide what you want to do after you know the results and even call your regular vet or have the results faxed to your regular vet. I do think you need to do a gradual transition though if panic is an issue.

Thanks so much.....I do plan to bring him to the new place for a trial run before I would even schedule the test. That might answer some questions, but you have a good point about having the test done at the old hospital and then taking the results to the previous vet. I am trying to recall....are test results legally mine or could they give me a run around? I don't think that the parting of the old vet was on good terms, although I am not suggesting anything like malpractice.

Did you or do you have a plan for Orlando getting his ACTH test yet?

Sorry to be away for so long. Orlando and I made the trip to the new hospital last month and while he was uncomfortable to some degree, he did not react as much as I expected. The vet agreed that he could stay in the waiting room with me for the duration of the ACTH test, not be put in the back or in a cage, and I think that is probably a decent compromise. He continues to be stable and for that I am thankful.

Now I have another question. Do you advise not giving vaccinations to Cushings dogs? This was something that I was told by a coworker who had a Cushings dog at one time. I am not an anti-vaxxer, having had a puppy years ago who barely survived parvo, and an acquaintance whose dog died of distemper after she had run titres and believed he was safe.

Welcome back, and I'm so glad Orlando is doing well!

As far as vaccinations, as I'm sure you're aware, many people have strong opinions. What I can offer you is simply my own opinion. I don't believe vaccinations should be given to anybody, human nor dog, during a time period of acute illness. However, dogs with Cushing's cover a broad spectrum, from those who are newly diagnosed with highly elevated cortisol and concurrent infections or vulnerabilities, to dogs who have been stabilized with treatment and enjoy controlled cortisol and are otherwise doing well. In the former situation, I would want to withhold vaccination. In the latter case, I would opt to vaccinate based upon the advice of my vet and the individual risk factors that are pertinent for my dog (prior vaccination history, age, lifestyle, geographics, liklihood of exposure, etc.).

For vaccines that seem appropriate for my dog, I would definitely try to obtain the longest-acting version that is available and that is allowed where you live -- for instance, 3-year rabies and 3-year distemper/parvo combos. And finally, humans and animals with compromised immune systems may be advised not to be injected with any "live" virus vaccines. Since the elevated cortisol of Cushing's does suppress the immune system, this can be another issue or consideration to discuss with your vet.

As I say, this is only my personal opinion based on my own reading and conversations with my vets, and you may hear from others here who feel differently. But whatever you decide, I'm really glad that Orlando is doing well!

Marianne

Great to hear that Orlando is doing well! Good news.

Molly gets what is absolutely needed in our area, and the longest possible, so as not to have to repeat too often. We get kennel cough (yearly), rabies/parvo, for example, usually every 3 years as Marianne mentioned.

Thank you both so much. I will look into the three year parvo/distemper shot, but will probably continue to vaccinate at this time since he appears to be very stable.....fortunately...and we do go out every day for walks. I live in an area with good animal care and control, so we are not encountering animals on the streets; however, with the CA drought, coyotes are prevalent in the neighborhood and I am going to ask my vet if they can be a vector for dog related diseases.

I live in an area with racoons and coyotes, so I do get vaccines to protect molly from anything she might catch.

This is the latest on Orlando. We did go to the new hospital so that he could be with the same vet, and they have been very nice to us. When we did the last ACTH stim test, I waited in the room with him between the blood draws. However, right before that he went into what I would call a crash...no appetite, lethargic, no desire for activity. I called the vet and she said to stop the vetoryl and bring him in as soon as possible. We were able to make it until Monday as opposed to going to the ER and he remained stable, but in the same condition. She did a full blood panel including the T4 and the stim test, even though he had not been on vetoryl for two days. His pre test reading was 6.8 and his post test reading was 5.1. His T4 was 4.2 and his ALP had gone back up almost 200 points....almost 600. I have kept him off the vetoryl now for 2 weeks...his appetite came back and I initially thought that the cortisol was rising again, but now he is less inclined to eat, although eating enough to get by, not necessarily urinating excessively, or drinking excessively, and it has been hot here. I can tell if he is urinating because he stays inside when I am gone and he uses the blue backed pads. The vet wants to perform an ultrasound as she thinks that something is going on with his liver and I can see her point, just need to get the money together for it. He looks very good, great coat, no skin issues, not pot bellied, but something is going on and I do believe that he still need to be treated on some level for the Cushings. Can you think of any other tests that I should be considering when we go back to the vet next week?

Hi and welcome back! I went back and reread your thread and saw that Orlando has had a few ACTH stimulating tests, however the results of those tests were not posted. Could you please post those stim test results for us and is he still on the 50 mg dose of Vetoryl? Having these answers will give us a more complete picture of Orlando's health history....thanks

Lori!

I think an ultrasound is a good idea, it can give you a lot of bang for the buck.

The previous stim test was 7.9 and I will get the readings of the others from the vet when I see her next week. He was on 50 mgs until the latest dip and has not been taking any vetoryl since, nor has a recommended new dose been suggested. I have had ultrasounds before on my dogs and know that they can give a lot of information, so I will go ahead with this hopefully within the next couple of weeks.

I have not been here for awhile due to various circumstances, but Orlando is doing well. His Cushings has responded to the Vetoryl and he is suffering no side effect related to Cushings, except to be very sensitive to the SoCal heat. However, something else has arisen. About two weeks ago I noticed him licking his paw, suspected a granuloma, and took him to the vet within the week. He does not like his paws touched, but on closer examination by her it appeared to be a cancerous growth. Needle aspiration and biopsy have been done and it is melanoma. It was not possible to get clean margins and it appears that a stalk is extending further into the leg. I will get conclusive results of the biopsy in about 5 days. At this point, the idea of toe amputation and radiation are on the table. Not only do I have concerns about those, but also about the use of anesthesia which is what caused me to lose my first Cushings dog about 15 years ago. A local was used for the biopsy because my vet was sensitive to my fear of anesthesia which might not be completely necessary. Do you have any advice going forward about Cushings dogs and oncology surgeries and treatments? The vet was not happy about the biopsy and what she is seemingly worried will be the result and held my hand while she was talking to me, so maybe this is worse than I even know at this point.

Jeez, I'm so sorry...poor Orlando.

You have done an extraordinary job of caring for Orlando over the years, in spite of the Cushing's and arthritis. Is your vet recommending that you see an oncologist? Perhaps I read too fast but I'm unclear about next steps. Obviously, surgery to remove what they believe to be a melanoma is very serious in light of Orlando's age. Please let us know how you both are doing and whether his vets are recommending treatment. Best to you.

Carole

Thanks so much for the replies. I was waiting to see the oncologist which I did yesterday. She recommends amputation of the 3rd phalanx, radiation at least 4 time, the melanoma vaccine Oncept, but not chemo as it is not effective with melanoma in dogs. Because of Orlando's age and because I lost my first Cushings dog to anesthesia years ago for another type of tumor removal, I am not comfortable with radiation since it requires general anesthesia. At this point I am seriously considering amputation as recommended to be done at a special surgery center with 24 hour doctors on duty and hopefully the would weather the anesthesia well under those circumstances. The pathology on the biopsy came back as low mitotic rate on the cells that were found and staining showed what they called low grade melanoma. I am unsure about the use of the vaccine. The oncologist says that with treatment given his age and Cushings and melanoma that he probably has a year to a year and a half. Cost is up to about $5000 or so without radiation included at this point. Today another question came up when I spoke to his regular vet. She does not want to give him his next rabies shot because of everything going on. Has anyone gotten a waiver on rabies shots, should I just lay low and let it ride? Any advice or questions about the course of action is greatly appreciated.

My dog, Skippy, was due for Rabies vaccination in early June. I am lying low on the issue but will secure a waiver if need be. Sick dogs should not vaccinated period. This is a tough diagnosis and I wish you both the very best. Please let us know how it goes.

One more thing regarding Oncept: I didn't do an exhaustive search regarding this vaccine but I did make my way through three articles; I must confess one was way too dense. The research is mixed with some researchers reporting that it extends the life of dogs with melanoma, other say not. Here's what I looked at:

http://www.petcancervaccine.com/vacc...s/default.aspx
http://onlinelibrary.wiley.com/wol1/...vco.12057/full
https://www.researchgate.net/profile...89a3ad4199.pdf

Hope it helps as you consider your options.

I'm sorry that Orlando is having these problems. :(

We have had people who have had waivers for vaccines due to age and medical issues.

Thank you so much. I did find that LA County has a waiver for the rabies vaccine and about 50% receive it, so that gives me something to fall back on. Immunotherapy is one reason that they give a waiver.

I had been trying to research the vaccine as well and, as you say, a couple of those articles are dense, but I did get the gist I think. Not a hugely great survival rate and I also found one article elsewhere which questioned how the studies were done...not that they were dishonest but that they were not normed correctly and the care of the various dogs depended on how much the owner could spend and other factors which really could not be documented with 100% certainty.

I'd get the waiver for sure then. If they accept waivers, then I'm sure orlando qualifies. How is he doing?

We are going to see the surgeon on Tuesday for a consultation only. Orlando is comfortable but quite lethargic which I think is partly due to the heat we are having. I have not decided on a course of action yet and hopefully the surgeon will be able to answer a few more questions.

Heat everywhere right now it seems. Wishing you and Orlando the best in your decision about next steps.

Thank you all again for your help. I am going ahead with toe amputation on Thursday at a special facility with a very reputable surgeon. On the hopeful side, we may get clean margins which will allow me to make a decision about further treatment. On the other hand, I have observed Orlando licking at the toe despite stitches being removed two weeks ago and a very clean job done by his vet. If the lesion returns and infiltrates the bone we will be looking at a palliative amputation at the least and one done with he is further down the road.

Hi. Know that our hearts will be with you and Orlando on Thursday and we are all hoping for clean margins and a successful recovery for Orlando.

Let us know how things go! I hope there is no spreading and you can move on from this specific issue.