Nikki may need re-load (update: I had to let Nikki go)

And can you refresh our memory on how you re-loaded:

-stim results before reload
-maintenance dose before reload
-dosage for re-load & how many days
-stim results after reload
-maintenance dose after reload

-Susy

Thanks, Leslie,she hasn't been tested for atypical because her cortisol in the beginning was post 50, although I suppose she could have hormone problems. I just printed out Dr. Felman's protocol about splitting doses of lyso into as many doses as possible, and I'll show it to her vet tomorrow when I take Nikki for her stim. She'll probably get really mad, but I feel like if the dose is split more,it can be more controlled.I know she will get mad, because when I asked about splitting the dose, she said it wouldn't make any difference, that all that matters is the total for the week. Oh, well, mad she will have to be!

Sharon, as Susy has already mentioned, we need those reminders about loading dosages, especially. We, also need Nikki's current weight.

I respectfully disagree with your vet about max dosage for lyso. Dosage is based on 25-50 mg/kg body weight. Some pups do better at the higher end of that range, some at the lower end, but each pup is an individual. Harley recently dropped 1.4 lbs. for no apparent reason which bumped his maintenance dose over limits at 54 mg/kg, his GP vet cut the dose immediately. Yes, some dogs do ok with posts >5, but that is really the exception to the rule. Harley, who always seems to be the exception to the rule, has been running a post in the low 7's on his last 2 stims, & feels fine, totally symptom free. With his pre-existing gallbladder/GI tract issues & being 14, my GP vet does not want to attempt to take him lower, as long as he remains SYMPTOM-FREE, which is the key.

Debbie

PS- Dr. Feldman is probably the foremost authority in the world on Cushing's, & he has advocated splitting the maintenance dose into as many doses a possible during the week for a very long time. If you vet wants to argue with the expert, then, perhaps, you may need to consider getting another vet. When it comes to splitting the dose, Harley gets his 250 mg., split into 3 doses during the week.

Sorry, Debbie, I always feel like I'm repeating myself and boring everyone! Nikki weighs 15 pounds and is currently taking 200mgs twice a week, which I know is too high. If her number comes back high, like I know it will, the vet wants to increase it even more after a reload. Nikki does not have symptoms like thirst or hunger but her legs are very weak and she moves really slowly and sleeps most of the time. She eats and drinks normally.

Sharon, we also need the last loading dose when you did the last re-load. This is important, so we can offer input on what may be a more appropriate loading dose, if you do another re-load.

Debbie

Hi Sharon,

So, did you do a re-load or mini-load, or did you just keep increasing the maintenace dose? I don't recall...I only remember the orange dye thing:p.

-Susy
(Sorry...can't wait for a response...gotta go tend to Wylie.)

Last loading was a "miniload", 200 twice a day for three days. Her acth after that was 4.7, I think, but my vet forgot about me, was gone for several days and by the time I started maintenance again at 200 twice a week it had gone up to 5.7.

Nikki, we will be praying for you. Let's hope that your vet listens to your mommy, because I totally agree with Debbie:

Quote:

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Dr. Feldman is probably the foremost authority in the world on Cushing's, & he has advocated splitting the maintenance dose into as many doses a possible during the week for a very long time. If you vet wants to argue with the expert, then, perhaps, you may need to consider getting another vet.

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and you don't need to deal with more frustration around your baby's health.

And BTW you are not boring anyone.

Choco kisses flying your way.

Marcela & The Choco labs

Good news for Nikki. Her post yesterday was 7.1 which the vet thinks is good for Nikki since it was 8.7 beginning of April with no change in meds.Seems really strange but I'll take it. She has agreed to letting me split doses into three/wk so maybe that will help some with stomach gurgling and GI upsets. She also said if I ever have to leave her again to have the caregiver give her 1/4 pred per day for stress.I should have done that.Anyway, I was really afraid to give her the printout from Dr. Feldman about splitting doses, but she was great about it, all things considered.I enclosed a note with it and was very careful with the wording. I said "please read this and see what you think. Since you said it makes no difference, maybe we could experiment with Nikki by splitting her doses and just see what happens." She actually asked me how many doses I would like to give per week. I think I'll try 3 for 3 months and see. So she will stay on 400/week for three months. I have learned that you cannot predict what that post number will be by the way they act. I was sure her number was high because she seems more energetic than she has for a while. Anyway, I am happy!:) Thanks for all the help! Sharon

Hi Sharon,

Great to hear the good news. Really great that you have a vet that is open to treatment options and gaining new experiences.

HAPPY FOR YOU AND NIKKI. :):):)

Keeping fingers and paws crossed for continued improvements.

Good job!:D:D

John (Roxee's Dad)