Tipper - adrenal tumor/breathing issues

Hi Everyone:
Tipper has a decent nite. She has already walked this morning and is happy. I just got off the phone with the vets office. As I thought Tipper's cortisol is up. She had a pre number of 2.4 which was .9 before, and post of 9.3 which was 5 previously. I called Dechra and we hashed over the numbers she has been having. We know Tipper feels better with less clinical at 5 or under on her post. We also know that every time we get her post there that eventually the pre drops under 1.45. They feel Tipper's cortisol is really fluxuating during the day . She is sensitive to any hike in her post above 5. There is no happy medium here so they feel we have to look at the dosage she was best controlled on, which was 30 mg once daily, then down to 28 mg once daily which produced the low pre at .9 and the post of 5. They want me to discuss this with the vet, and see what he says!! I said good luck with that, as he never called you back the last time. I told them I cannot keep making this dog go thru testing every 2 weeks, and who can afford that? I am on my own again so I need some opinions. Tipper has done better in the past on once a day dosing. I have 7 and 8 mg trilostane on hand. Should I go to a 17 or 18 mg in the morning and 10 at nite or 27 mg once a day??? I need to get this 9.3 knocked down, but don't want the same situation where the pre goes low. I don't know if 1 mg is enough difference to make her not go low??
She just does better with lower cortisol. A normal dogs pre is OK at .5 to 5.5. They said she may have to run a low pre number in order to feel OK and not have clinicals. I am really burned out from trying to get these numbers to work.So that's it what would you do? If I give her one dose of 27 mg she will feel better, but I run the risk of her dropping low and never knowing if It is coming unless I test more which is not unacceptable as it would make her crazy. If I give her the split 17/10 she will still probably be symptomatic, and drinking a lot and hungry, but she would be safer with her numbers. This is like a catch 22. Please help if you have an opinion or idea I would be grateful. Blessings
Patti

Patti,
Just my thoughts when looking at all the different things you have tried. I am just wondering about the once a day dose. You said she does better on it, but you have had trouble with her at night, hunger and restlessness, so that's not good. When you do a split dose you never do an even split, do you? I think it's worth a try to do an even split dose. You could do a 14 twice a day. Won't an even dose regulate her better? She would be getting 14 in the morning and when it begins to wear off or her cortisol spikes another 14 to get her thru the rest of the night.
She's not very low right now..in fact she came up quite a bit, so I'm not sure why you are worried about the low pre. You will see the differences if she is starting to show signs of going low. She would never be getting a bigger dose all at once. I think a consistent dose may help her be more even over the 24 hours.
Did starting the thyroid medication have anything to do with these numbers? I don't know if it has any bearing but just wondering.
Hope you can figure something out to get these numbers to drop some.

Barbara

Barbara:
The reason I am worried about the pre number is it has a history of going low when she is getting enough Vetoryl to control her post. For some reason Dechra has not wanted her on an even split. This is just like a chess game! I will just have to give something a try here as my vet is clueless and depends on Dechra for guidance. Since he never takes the time to call them I am virtually alone in this as the vets usually don't get on the phone unless it is another vet calling. What a predicament! Blessings
Patti

Hi Everyone:
Tipper is having a fit. She watched the weather forecast and they said snow tomorrow!! Can you believe it? I have to go out to get her Vetoryl too. She is very tired from her 2 walks as she is not used to that now. She is on my bed relaxing, and Toby is tired too, he is passed out already. I did some more on Tipper's hair cut. We are making real progress this time. Tipper did not get blood pressure done yesterday as there was a yapping dog in the kennel and she would have a false high reading. She must get one next week as her last two were high and that worries me. There were things going on though when they were taken. I am sending this snow up your way Sharlene, cause I know how much you like it!! Blessings
Patti

errrhmmm, gee thanks Patti. :) We now have no water on our street due to a broken water main on the other side of the street from me.

I'm ready for spring. oh don't forget clocks change this weekend!

I don't know what the best call is for Tipper's vetroyl. Maybe just going up one or 2 mg will be enough to make a difference.
Strange they don't want her on an even split, since that makes sense to me too, but who knows what is in their minds.

hugs,
Sharlene and molly muffin

i am glad that you were able to walk the dogs twice.
i would try an even split of 14/14 too. ian gets his whole dose [30 mg] before he goes to bed at night. it works best this way for him.
it must cost you a fortune all these tests and tipper a heart attack i quess
my ian would have died from stress by now!.
more snow again? hope the forecast is wrong!
i am watching crufts right now. do you know this brittish dogshow?
it has a livestream all day on the internet.
i think sharlene prefers the dutch weather right now.....18C!!

Hi Everyone:
Quick post this morning. I started Tipper on one morning dose of 27mg. One mg lower than the dose that caused her pre to go low. I woke up at 2am with the room spinning. I am having awful dizziness, barely got the critters fed and Tipper her meds. Feeling really bad, took an antivert and will see if that helps.
Blessings
Patti

Oh No! Patti, vertigo is horrible. I live with it for 48 years. I hope the antivert helps, it never really helps me though, but some people it does. You need to rest. Feel better quickly!

Patti. This is not good. What did the doc say the last time? Is the meds breaking up that stone? You have not been feeling well for way over a week or more now. I don't like the sounds of this

Hugs
Sharlene and Molly muffin

I'm with Sharlene. Please take care of yourself at least half as well as you do Tipper. ;)