Tipper - adrenal tumor/breathing issues

I don't know, but it sounds scary to me. I am worried about Tipper having these low pre numbers. I am afraid to take her off the Vetoryl right now as she just started thyroid meds and some of those symptoms as we know are the same,and I don't want to be wondering what is causing what. I need a good plan here??? It would seem their information is so contradictory. I really don't want an Addison's crisis either as Sharlene said some vets don't even know how to treat One, and my vet would probably be in that category. I do have a question in light of all of this. Since blood work has to be sent to a lab, when your dog has one of these Addison's crisis, how can they balance the electrolytes right away if they don't know what is high or low? Is it just assumed the potassium is high and the sodium low until results come? I am wanting to know this in case I would have an emergency with Tipper that I am able to over see things are done correctly. Very scary stuff. Blessings
Patti

This is just me chattering away based on nothing, but it seems to me that a person really needs to take the whole picture into consideration and not just the pre in isolation -- meaning the post as well as the pre. If my Cushpup was registering a post higher than 5, I'd be hard pressed to think that I couldn't stay the course even if the pre dropped a bit below 1.45. I mean, that just doesn't make sense to me -- that a dog with that high of a post is suddenly going to become oversuppressed. But of course the other piece is looking at patterns and trends -- has the pre stayed pretty constant or has it suddenly dropped. All I can say is it sure was a lot easier when nobody seemed to care very much about the pre at all. :rolleyes:

Marianne

Patti, can you do me a favor? Can you give me a quick recap on Tipper's last two or three acth stim tests where her pre was less than 1? Can you also tell me what dose she was getting at each of the stim tests? Did you inquire about this with Dr. Bruyette?

Glynda:
I did ask Dr. Bruyette about this. I asked him quite a few questions and that is probably why he has not replied yet. Here is a run down of what was going on with Tipper.
August 13th 2012 - Vetoryl 30mg -ACTH pre- 0.7 Post 3.0 Off the Vetoryl until August 17th restarted on 20mg

August 28th not controlled went to 10/10 split dose morning and nite.
Septmeber 9th gave 10mg morning and 10 mg 8 hours later to see if that helps
October 1st gave 20 mg Vetoryl morning and 5mg trilostane nite
October 27th went to 20 morning and 7 mg nite
December 4th gave 27 mg dose in morning
December 18 gave 20 vetoryl and 8 trilostane in the morning
She has been on the last dosage up to this current Acth
January 30th ACTH .9 pre and 5.0 post
I have dropped her down to 20 mg Vetoryl and 7 mg trilostane after these results so that is what she is on now. This was all done in an effort to try ad control her symptoms, and was done by consulting Dechra.

I am wanting to know if you think I should stop the Vetoryl and wait a few days start her back on total of 27 again then gradually drop down to 25 total? If so I need to order 5mg. I thought starting back on the 27 would not the cortisol down enough that maybe 25 will be adequate then? I really am not knowing what to do as my vet never called as usual. Anyone with any perspective on this or ideas pleas help.
Tipper seems better at nite with the thyroid medicine. Last nite she had a lot of seizure activity, one shook her whole body. It is so scary to watch, so I kept waking her. I was going to with hold her Vetoryl for a few days, because of her low pre number again, but her symptoms were so bad from the thyroid I don't want to do it unless I have no choice. I am so worn out trying to figure the right combination out.
Blessings
Patti

Hi Everyone:
As you can see I am working hard with Glynda ( or should say Glynda is working hard to help me with Tipper's dosing.) I am trying to get her to a place where she is not exhibiting symptoms and her pre number is not low. I can tell you Glynda is miraculous at all this, and big hearted to take time to help me. I honestly don't know what I would do without this forum and it scares me that there are people out there dealing with this on their own, it's sad. I am going to feed Tipper only twice a day and see if that helps with the hunger. I am thinking of a way to get her exercise in this weather. She would not do well on my exercise bike! I need to get her a treadmill or something. I will work on it. A friend that lives near me may no someone for Grace. I am waiting to hear. I am calling the Cat Expert in Pittsburgh tomorrow as I had a lot to do for Tipper today. I will ask his opinion on this. Tipper did ok last nite but still had some seizure activity. She did sleep better but up at 4:30 and I made her lay down till 6:00. She seems to be doing ok on the Soloxine and her heart seems ok and not racing. It is a mild dose and I am glad, that is what I wanted in case things went south.
She is not panting, and whining anymore so maybe it will help her. So with some help maybe I can get her straightened out here. She seems to have a better attitude today, and happier. Blessings
Patti

i can not help you, since i don't do the tests with ian. he is doing well on 2 mg/kilo and that is ok with me.
in a way i am glad i don't have the money to pay for those tests, because worrying about the numbers/results would drive me nuts i quess.
besides ian will suffer a heart attack if i would take him to the clinic for this. he is so frightened!
hope you and tipper will have a quiet night.

Glynda has a lot more knowledge than I do when it comes to cushings and dosing. I wonder though if the way the results have been, low pre and in rangeish post is because she has the adrenal tumor now and that is a lot harder to control.
Hopefully the thyroid medicine will start to kick in and help control the symptoms too and then you'll know better what you have to do with the vetroyl.

Hang in there! You ARE doing good, even if it drives you nuts sometimes. :)

hugs,
Sharlene and Molly muffin

Glad you noticed some improvement with panting and racing heartbeat..that's a positive sign. I hope that tonight Tipper has a good, relaxed sleep.
It is so hard to deal with getting these pups their exercise between the extreme cold and the snow which is has an ice shell over it.
Trixie and I met up with a friend and her dog and took a walk to a playground area that has fenced in ball courts. We let them run around and a puppy came in and they were all going crazy chasing around. Trixie hasn't chased like that in a long time but I was so afraid she would slip and hurt herself on the ice.
I guess she really needed some good exercise, especially as we have another storm starting tonight so she won't be out much tomorrow.
Hoping you're having a good night with all your babies.

Barbara

Barbara,
awwww, that sounds like such doggy fun!

Hi Everyone:
Not too bad for Tipper last nite. Some early seizure activity and it seems to happen a lot when she first goes to sleep. I have decided to have an online consult with Dr. Dodds about Tipper's thyroid. I wanted my vet to use her in the first place if you remember and he wouldn't do it and insisted on Michigan. I believe as other so that she is the top expert and can find things over looked by others. I need to cover all my bases here and makes sure Tipper is safe and getting the correct treatment. My vet was supposed to call Dechra 2 days ago, now he is off till next week and he had never called me. He just simply does not care about Tipper, that is why I always have to go to outside sources for help. I am working with Glynda to help Tipper and she knows a gazillion times more than my vet so I am better off without him. It's just the idea of paying him all this money and he feels he has no obligation to do anything for it. He knows Tipper is low and could go Addisons and still no calls. Thank God for this forum as my Tipper would not be here if I had not received all this help. I do try to pay forward whenever I can. I am consulting with the Cat specialist today on Grace too. It will be a busy day. It is supposed to get nice next week in the high 30's and Tipper can walk which will make her much happier. I will be in the hole so far after this consult I will need a ladder to get out. I need to do this for my girl so I will bare the burden of it for her gladly. I am wanting some opinion on this subject. Tipper was at 28 mgs one dose in the morning when her pre went low again. 20 vetoryl and trilo. I am wondering if I go to 5mg trilo and do 15mg in the morning and 10 mg at nite. That gives her a split to even the cortisol all day and drops the dose down by 3mgs to let her pre come up a tad. Please I need some feed back. I am wanting to do this because I am afraid she is close and can slip in Addisons and want to lower her post without lowering her pre. I welcome some ideas. Again her pre was .9 and her post was 5.0. Blessings
patti