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According to IDEXX laboratories the NSAID Monitoring Panel tests the levels of the ALKP, ALT, AST, BUN, and CREATININE. This panel is usually ran when a dog is being treated with a nonsteroidal anti-inflammatory drug.
http://www.idexx.com/view/xhtml/en_u...jsf?SSOTOKEN=0
What I am thinking is your vet wants to monitor Hannah's liver and kidney functions without doing a full Chemistry panel.
Love and hugs,
Lori
Hi,
You had asked about my Zoe's licking so thought I would stop by and answer. She has chewed her front feet ever since we adopted her. It stopped for awhile but came back when she was diagnosed with colitis. It seemed at first corn was the culprit. She is on raw turkey diet now and since her Cushing diagnosis, she has increased her licking and chewing. She wants to lick me or my husband all the time. She chews and chews on her Kong toy sometimes for an hour at a time then licks her front legs and sometimes will chew her front pads and dew claw. The last 4 months she has started to want to lick the tile in the bathroom. She has always licked on our sheets and pajamas if she has the chance. The licking and chewing has gotten worse the last six months. Zoe is a reactive, anxious dog, afraid of strangers and thunderstorms. Since her estradiol is now normal, she is less reactive in public.
Sorry to write you a book, just wanted to give you info;) If Hannah is chewing front and back legs it could be allergies.
Hang in there and I am glad you found us.
Hugs,
Addy
Hello,
Hannah is almost done with her two months of Anipryl and my vet wants to do another blood test this week to check some of her values. I am curious to see what they are, regardless, but for some reason, I was under the impression that even if Anipryl works that I wouldn't see a change in her blood work, and instead that I would be looking only for a difference in symptoms-eating, drinking, urinating, etc. Is that incorrect? Will there be a difference if it is "working?"
I am having a hard time telling if anything is different, so I'm not sure where we will go from her. Considering that her ultrasound was totally normal a few weeks ago, we figure she is in the early stages, with only slight symptoms...so I guess I'm not quite sure what to do. There seem to be people who tell me to wait until symptoms are worse and not to do any major treatment until then, and people who tell me I need to do something early, before any more damage is done. Any input about the Anipryl and suggestions on where to go from here would be great!
Thanks!
Julie (& Hannah)
Hi Julie.
It is true that bloodwork in the way of an acth stimulation is not necessary with Anipryl but I believe your vet may simply want to do a complete blood panel so see if liver enzymes and other prior abnormalities have improved. Whatever the tests are, please be sure to post the results here.
If Hannah is not overtly symptomatic yet, then I personally would wait until she is before treating with more effective treatments like trilostane or lysodren. If you aren't seeing any improvements with anipryl by now, chances are you never will. Only a small percentage of dogs with pituitary tumors in the pars intermedia lobe will benefit from anipryl.
What is going on with Hannah at the moment that would prompt people to tell you that you need to start treatment right away?
Glynda
Thanks so much for your reply. I am curious to see if anything has changed with her blood work since early March. We also talked about getting her on a liver supplement (Denamarin or one of the other ones), so I bet he wants to see what her ALKP level is now. (It was 1770 in March) and that was the only thing that was really high. We also decided to try Anipryl alone first before adding anything to help her liver. As I said, her ultrasound earlier this month was normal, so he felt that was a really good sign. The adrenals and liver were not enlarged and looked good. She needs a dental done and he said he was not worried about doing it, even with the abnormal liver value, but after seeing the ultrasound, he said he feels even less worried about any complications.
Had her blood work not been abnormal in March before what was supposed to be her dental, I may not have really noticed anything was terribly wrong. I had noticed that she was pushing into my other dog's bowl more often and was eating a little more quickly. I also noticed a couple of days when she was urinating more and thought about getting her checked for a UTI (she has had struvite crystals in her urine in the past and a couple of UTIs, but it has been well-controlled for a few years on Royal Canin Urinary SO dog food). The other behavior that was new (but probably going on for the last 6 months) was this pawing/barking/vocalizing at us in the evening after she had eaten, been outside, etc. Now I am thinking that is probably her begging for more food. That is the one thing my husband and I definitely agree has lessened just recently-in the past couple of weeks. She may be eating at a slightly slower speed. She doesn't really have any other signs-no panting, no back end weakness, no hair loss (although I had to trim a tangle out of her ear while I was brushing her a couple of months ago and the hair has not completely returned, but she is growing some of her tummy hair back where they shaved her for the ultrasound), no weight gain. She might be growing hair a little slower and loves to eat, was drinking more (for her, but she used to drink very little, so it's not out of control), and seemed to be urinating more-having a couple of house accidents (but she holds it all day while confined to the kitchen with no problem).
Some people tell me that Cushing's is an insidious disease, and that I should not wait for things to get worse since we seemed to catch it early. I think my vet feels that we should be seeing stronger symptoms before he wants to treat with something more. Also, she is currently on 5 mg of Anipryl per day and she weighs 12 lbs. I believe he said we could increase the dose-maybe to 10mg per day and he might want to try that before giving up on it.
Thanks again for your help!
Julie
Hi again,
Thanks for the additional information. It really sounds as though not only does Hannah not have any concerning symptoms at the moment, you are seeing some improvements. Regrowth of shaved belly coat usually does not happen in an uncontrolled cushdog so that's pretty impressive. I'm very interested in seeing what her new labwork looks like so please be sure to get copies of the results and and post them here.
If I were you, I'd keep doing what your doing and not worry about treating with anything other than anipryl until you see a marked increase in symptoms.
Glynda
I totally agree with Glynda, since Trilostane/Vetoryl and Lysodren/Mitotane are very serious drugs I would not treat unless Hannah was displaying some strong Cushing symptoms and her test results confirmed a Cushing diagnosis.
Please keep us posted ;):)
Love and hugs,
Lori
WOW, this story sounds FAMILIAR!!!!! :)
So Hannah has been on 5 mg of Anipryl (she weighs 12lbs.) for 2 months now and we had her blood values checked yesterday. My vet did agree that often we don't see a change in lab values with Anipryl, and usually need to go by symptoms, but he said occasionally it can help so that's why he wanted to do it.
Anyway, there was good news. Things have improved! Last time her ALKP was 1770 (and normal is 23-212) and yesterday it was 689. Her ALT was fine last time (normal) and I don't remember the number, and this time he said it was even lower. Normal is 10 he said and hers was less than 10, but he said that was not a concern, and that he was only concerned if it was high. Therefore, we are going to stick with the Anipryl for now, since we have seem some possible improvements in her behavior and now this improvement in her blood work.
He said he would check again in 3 months to see where she is (and I should monitor symptoms and let them know if anything changes), but didn't think we even necessarily had to do something to support her liver right now. I am going to schedule her for her dental soon (while I know what her values are). I feel great about the change, obviously, but still would like to hear your thoughts. The only thing I am wondering now is if something should be done to help her liver, since 689 is still high.
Thanks again for your help!
Julie & Hannah
Such a great update! I am so happy that Hannah is responding to the Anipryl so well. As far as her liver is concerned, since her ALT level was normal, which is more specific to the liver than the ALP, I would not worry about starting any liver support supplements.
Please keep us posted! Great job!! :)
Love and hugs,
Lori