Jasper (12 yr old Mini Schnauzer) is now at peace

Tina, Once again Jasper has me scratching my head. Just like before when he went so low .. he wasn't eating and was lethargic which are clearly signs of low cortisol yet he's drinking and peeing alot? That isn't typical of a dog with low cortisol. If Jasper were loaded you wouldn't be seeing that still. So this is making me wonder if something else is causing the drinking and peeing.

But before I go there... please define drinking and peeing alot. Are you measuring water intake? If not, please do. A normal dog drinks an ounce of water per pound of dog. (for reference) Mark a bowl so you can easily each day fill it to that point and at the end of the day measure the difference. If you have the dogs separate is easier but I did it with my two as the other dog drank normal amounts I could tell what the 'net' intake was of my cush dog.

How frequently does Jasper go out?

I know you ruled out diabetes and think you did hypothyroidism as well.

I have to go outside and mow right now but later today I am going to re-read your entire thread to see if I am missing something. Maybe someone else w/lysodren experience will do the same. Keep a journal of everything along with dates... it comes in handy. KIm

Hi Kim,

I have been cleaning my carpet all afternoon and just checked and saw your post. When my vet called on Friday with the results of the stim test being so low, I asked her about Jasper drinking more and having the accident in the house the night that he got the prednisone (8/29), and why would he be having those symptoms with his cortisol being so incredibly low. She said he was having side effects from the prednisone, and made it sound like that is still possible even though his cortisol level was so low, and that is what was happening. She said he is sensitive to the prednisone also.

As far as his increased drinking and peeing, I have not been measuring his water intake as both dogs drink out of the same bowls. I didn't think to subtract what Shelby should drink in a day (~13 ounces), to get Jasper's net intake. You are so smart! I have been monitoring how often he goes to the bowl and about how long he drinks each time, and it has significantly increased. This morning he was drinking about every 20 min or so, and for about 10-15 seconds each time, sometimes longer. I do know that today, I think he had drank about 24 ounces by noon or so, just by what I know I put in his bowl, and Shelby was confined for a lot of that time so couldn't get to the bowl. He weighs about 25 lbs.

Shortly after noon I decided to get out a bigger bowl and make more of an effort to measure. I put 48 oz in the bowl and marked it like you said so I can fill it easier. I will measure what is left before we go to bed and add to what I think he drank this morning.

As far as how often he needs to go out, well today since I am home he has been going outside about every 2 hours or so, and sometimes more frequently than that. And he pees a large amount for a long time each time, at least 20 seconds or more each time.

He will get another dose of prednisone tonight, and I am worried about when I go to work tomorrow. He will not have access to water or to go outside constantly. He typically can hold it all day while I am at work, that has never been a problem. But he typically doesn't have access to water either.

Yes, diabetes and thyroid issues have been ruled out, as well as liver and kidney issues.

Thank you Kim for taking the time to re-read my thread, and for your insight and advice. I have been keeping track of things and dates, labs, behaviors, etc. It is kind of disorganized, and I had planned to work on getting it all into a notebook/journal this weekend but got sidetracked with everything that happened.

I am going to see if I can get him to eat supper now and will check back in a bit.

Hugs,

Tina and Jasper

Jasper's reaction to lysodren has me stumped. He went as low as 0.5 in 5 days of loading at what is a normal dosage. You stopped and it shot up to 6.74 in a short amount of time.

Then you did MAINTENANCE at 500 mg level and went to from 6.74 to 0 in 4 weeks. This is a bizarre swing for a dog on maintenance.

You started maintenance on 7/27 and on 8/15 you said the drinking had increased and you were concerned. 10 days later he isn't eating so you give him prednisone and he's at 0 on the acth.

There are too many swings going on that just don't add up. That's why I asked about the other diseases wondering if something else is causing the urination. The only remaining disease that I can think of is diabetes insipidus.

I am pretty sure they only make lysodren in 500 mg tablets so it can't be a dosing error. Either Jasper is extremely sensitive to lysodren or something else is going on.

Regarding the prednisone... I'm shocked that with practically ZERO cortisol in the system Jasper reacts so quickly to it. That would explain the urination but again... logically it shouldn't happen so quickly. And if he is peeing I would think the hunger would be back as well as the energy level.

I hope another experienced member can see this and come up with what might be going on.

In the meantime... cleaning the carpet...:( I so remember that. If he's confined you might see if these will help. I bought them for Annie and she did urinate on them (vs carpet) and these pads suck it all up and you don't smell it! You wash them and reuse them. Google: pooch pads. I bought mine from Amazon but I think Petco has them.

Sorry if I confused you more... just know this is not usual. More hugs, Kim

Tina, I hate to make things more difficult for you, but I am afraid it may not be safe to restrict Jasper's water tomorrow while you are at work. I think to do so may risk harm to his kidneys (I will try to come back with a better explanation later). Is there any room or area of your house where you can leave him with plenty of water, and where peeing would not do a great deal of damage? :o

Marianne

OMG Marianne, great catch. Tina, she's right. As much as the urination is a PITA - Jasper is drinking because he is dehydrated from urinating - not peeing from water intake. He has to have access to that water.

Kim

Thanks Kim and Marianne,

Yes, I am gathering that Jasper is not a usual case. My vet said that she has never had a dog where the cortisol bottomed out as low as Jasper's while on maintenance. She has said that he is showing to be extremely sensitive to the Lysodren, and still seems confident that we will get him stabilized, but on a MUCH lower maintenance dose. This conversation took place on Friday after we got the stim test results that the cortisol was soooo low. I will have to see what she thinks now that he ended up in the hospital and everything that happened Saturday.

Marianne, thank you for your advice about not restricting his water while I am at work tomorrow, I was wondering and worrying about that, and meant to ask it in my last post. You read my mind. I really don't have anywhere I could leave him unless I closed him in the bathroom that doesn't have carpet, or tried to barricade him in the kitchen. He normally stays in a wire crate when I am not home. He prefers this and tends to get anxious if he has the run of the house or if the routine changes. He is comfortable there, and automatically goes there when he knows it is almost time for me to leave for work. Do you think it would be ok to just put a water bowl in the crate with him? The only thing I don't like about that is if he pees, then it will be wet. He normally lays on a couple of thick soft folded up towels in the crate, he has never liked those sheepskin foam crate pads. At least that would be somewhat absorbent.

You know, I haven't done anything different with the water up until now, I hope I haven't hurt him! Omg. :(

And as far as cleaning the carpet, it was from all the vomiting on Saturday morning. :( He really has had only 2 accidents in the house, the one in May which prompted all the tests, and then last wednesday night after the prednisone.

Please let me know what you think about the water bowl in the crate, I think that may be my best option since he is most comfortable in there. He did eat his supper tonight with considerable coaxing, and had his prednisone tonight. He seems a little more perky, but still not back to normal.

Love and hugs,

Tina and Jasper

If there is room in the crate for the bowl then give it a try.

Fingers crossed - if it doesn't work then try the bathroom or kitchen. Good luck!

Tina, yes, I think the water bowl in the crate sounds like the best option, too. Hopefully this will just be a very temporary issue. Is there any way you might be able to check on him at lunchtime (to let him out or replace the towels), or is that just not an option? I totally understand if it is not, because I have always had really long commutes myself. :(

Marianne

Yes, there is room in the crate. It will make it a little more crowded of course, but he still has room to stretch out and lay down. Hopefully he won't spill it. My Lab would always spill the water in her crate. :rolleyes:

It is possible for me to take a long lunch and run home on a temporary basis, however it is not ideal. I was already considering it for tomorrow at least and maybe for a while until he is feeling better and we have things more under control. I will just need to talk to my manager about it and hopefully it won't be a big deal.

Kim, thanks for the tip on the pooch pads, I am checking them out now on Amazon. There are lots of good reviews. I think I have seen something like this at Petsmart or Petco.

Tina

What about putting the crate in the kitchen, leaving the door open so he can go in and out, and putting a couple bowls of water in the kitchen for him, with some pee pads, just in case. Try to barricade the kitchen off is possible. Otherwise, something similar in the bathroom if it is big enough?
The crate would be available for him to feel comfortable in, but being open if he wanted a drink he could get it and not risk becoming dehydrated, still have some other area than where he sleeps to pee, just in case. At this point, he is a tricky case.

Hugs,
Sharlene

Hi Sharlene! Yes, I am thinking about that too. My kitchen is pretty open, one side of it would be tough to barricade, but I might be able to do it. I still have some of those disposable pee pads from when Shelby wasn't house trained yet that I could put in the kitchen. I don't know if he would use them or not.

I just need to think about this, and what would cause him the least stress. I have never left him in the kitchen before, so that would be something new, and I am concerned he would be anxious about it. He is very into his routines, and gets pretty anxious with any deviation. But I would feel better if he had more room in case he does need to pee.

Hugs,

Tina

Hi Tina,

They make water bowls especially for crates that hook onto the wires so the bowl is not on the floor of the crate where it can be knocked over and spilled. I have bought them at PetCo in the past.

Hugs
Leslie and the gang

Also, as an extension to Sharlene's suggestion, here's something we've done in the past when toilet-training puppies. Our house is mostly fully carpeted and the kitchen hard to barricade. When we wanted to leave the crate right where it is in the family room, we bought a big plastic tarp and an exercise pen. We put the tarp down on the carpet with the crate on top and the pen surrounding it. That way, there was room for a water bowl and pee pads outside the crate. When we were away from home, we left the crate door open so the puppy could go inside to sleep and rest, but the puppy was not forced to soil the inside of the crate. If the water bowl spilled or the pee pads failed, it was not a disaster because the tarp protected the carpet.

I know this set-up was too involved for you to get into last night. But it is just a thought if you have to make longer term arangements to keep Jasper comfortable. I agree with Kim, he's got me scratching my head as far as what is really going on with him and the Lysodren. It is definitely a puzzle...:confused:

Marianne

Great suggestions everyone. I came home for lunch to check on Jasper and let him out. I can view the forum but can't post from work. I decided to try his crate with a bowl of water. He definitely drank some while he was in there this morning, he has drank a little more than 3 cups so far today (which is about his whole day's allowance), but I would say over half of that was before I left for work. The crate was dry, but because he was holding it. He peed for over 45 seconds when I let him out, that is so long. :(

I believe he drank around 8 cups of water yesterday, which would be about 64 oz. Yikes, that is a lot! I am trying to get an exact amt of intake for this 24 hr period, so far have kept Shelby to her own water bowl.

He ate breakfast with coaxing, but did finish. As far as energy he seems about the same as yesterday. Not great yet, but better than the weekend.

Back to work, will check in later. I can't tell you how much I appreciate the support here, thank you all so much for your kindness.

Love and hugs,

Tina and Jasper

Well, it was a struggle to get Jasper to eat tonight, even with coaxing. He just seems uninterested in the food, and everything else for that matter. He will sniff at it, maybe eat a couple of bites and then walk away. I finally just got him to eat most of it by hand feeding a little while ago, but even that was touch and go. So frustrating. I feel kind of like we are back at square one, before we ever started the Lysodren, except his appetite and energy were good then.

I keep looking at him trying to figure out what is wrong, what could be going on with him. He is nowhere near himself and it makes me so sad and worried. I keep racking my brain trying to figure out why he is drinking and peeing so much with the prednisone, but his appetite and energy are so poor. He looks at me frequently like he is trying to tell me what is wrong but I can't figure it out.

I am trying to be positive, but I am feeling discouraged, and very worried about my little boy. Maybe I am just tired after all the stress when he was so sick over the weekend. I will be talking to my vet tomorrow, hopefully she will have some insight.

Tina

I hope your vet will have some insight too. I know you are stressed out and I am sure Jasper is stressed too. There doesn't seem to be any reason why his appetite wouldn't return, but you just never know, as any dog can react to medicine in a strange way. Some definitely go off food it seems. Are there any special things that he likes that maybe would entice him to eat? What about some chicken or something of that nature?

Hugs,
Sharlene

Tina, after going so very low on his cortisol, I wonder if Jasper could possibly need even more prednisone than he is currently getting. Although it does not occur as commonly, dogs who are Addisonian can also drink/pee excessively just as do dogs with Cushing's. And all the rest of Jasper's symptoms right now defintely still sound Addisonian to me.

Do you know if your vet is planning to do some more bloodwork today? I know you probably hate for Jasper to get poked again, but it might be a good idea to double-check his electrolytes. And if not another ACTH, even a resting cortisol reading might help indicate whether or not his level has rebounded to a more normal point on this current dose of prednisone.

Marianne

Hi Marianne, thanks for your comments and suggestions. No blood work is planned for today. I have not talked to my vet since I picked up Jasper from the hospital on Sunday, so she has not been updated as to how he is currently. Maybe she will suggest that I bring him in today for more labwork, I don't know. I will ask about the prednisone dose, and checking the electrolytes or resting cortisol. She initially prescribed that he take the prednisone 2.5 mg for 3 more days, that ended last evening, which would correspond to probable follow up today since she is in the clinic today. I am scared to stop it at this point, even with how much he is drinking and peeing. I left a message last evening for her to call me today, though I imagine that is on her list for follow up today.

This morning he would not eat anything on his own, I got him to eat only about half his breakfast by hand feeding and that took a long time. That is only about 1/4 cup. I can't get him to eat the rest. He drank a grand total of 9 cups of water in yesterday's 24 hr period, 72 oz. Energy is still low. I will see what I find out today. Thanks so much for your support, I am very worried. And now I have to head in to work. I really don't want to leave him.

Tina

Given your description of Jasper's behavior, I agree that it is imperative that you get additional prednisone on hand, even if in only the dose that you are currently giving him. I would be very afraid of stopping the prednisone at this point. So if you do not hear back from the vet in a timely fashion, I really do think you need to call back and insist on an extension of the prednisone until he can be thoroughly re-evaluated. What I had meant to say above (but probably was not clear about), is that I wonder if he might need even a higher dosage than he is currently getting. But even a continuation of what he's getting now would be better than nothing.

Marianne

Tina, I think Marianne is spot on. Prednisone is inexpensive and there is no reason for the vet not to give you a refill that includes many weeks worth of doses. I'm sure as soon as the vet knows what you have shared here that they will agree. Keep us posted. Hugs, Kim

Hi Tina,

Jasper should have started rallying from his recent illness by now, I would think. So my concern is the same as Mariannes - the cortisol is not being naturally raised so he needs more pred for a longer time, his electrolytes may well be off and need to be checked. If those levels - cortisol and electrolytes - are ok, then something else may be going on and running full blood work may be in order.

Let us know how things are going...and I would keep calling the vet until I reached her. ;)

Hugs,
Leslie and the gang

How is Jasper doing?

hugs,
Sharlene

Hi Everyone,

I am up in the middle of the night because I can't sleep. Haven't meant to be MIA, I have just been too upset and overwhelmed to post. I did make an appt with my vet for Jasper on Wed 9/5, she kept him for the day to get more labwork and check him out. I will give specifics of all that was done later but just want to check in so you would basically know what was going on.

Within minutes of getting him home Wed evening, Jasper had diarrhea and there was blood with it. He has had colitis before, but never with blood. We went immediately back to the vet and he has been in the hospital since. He apparently has hemorrhagic gastroenteritis (HGE). This can apparently be caused by many things but most likely due to stress, which he has had an incredible amount of recently. And along with having such a low cortisol, his body just couldn't handle everything.

On the Cushings front, we did get a baseline cortisol which was still incredibly low, 0.4 ug/dl (normal is 2-6 at this lab). The electrolytes were normal. So Marianne, Kim, and Leslie, you were right of course. There is much more to all of this which I will post later when I have the energy. I just wanted to check in with a quick update. Last night when I visited Jasper in the hospital, he seemed quite a bit better, but still not great. I will be in touch with my vet this morning.

I am exhausted, overwhelmed and scared to death with this latest development. Please keep my baby in your prayers.

Tina

Hi Tina,

Prayers rising and healing white light flying Jasper's way. Please let us know how he is this morning and know you are not alone, honey.

Hugs,
Leslie and the gang

PS. I know how scary that was to see the blood in the stool. My little Trinket has stress colitis and when her's first flared up, it was very bloody and very terrifying. She weighed just under 5lbs at that time and to see that blood was just awful. She is much better today, over a year later has had very few flares and no more blood, thankfully.

Dear Tina,

Hoping so much that you'll get good news about Jasper this morning!

Like Leslie, I'm sending huge hugs your way and keeping your sweet boy in my thoughts and prayers.

Marianne

((((((HUGS))))))
Hoping Jasper woke up this morning ready to come home all recovered. Prayers for everyone!! Keep us posted.

I hope Jasper is better this morning. Colitis can be very scary when it involves blood and with everything else going on.

Sending love and hugs and prayers for some good news today.

Tina, Do keep us posted. I am throwing this out there just in case it is helpful. Should you feel like Jasper's situation requires the eyes of a specialist (IMS) there finally is a local option (I had to drive to K State). There is a vet clinic that has K State IMS working there. Your vet would need to refer and could work right along with them.

I don't have the name of the clinic. You can call Tonya McLinay's office in Omaha (Veterinary Eye Specialists of NE) - she is a K State grad IMS specializing in eye care that I went to. She is the one that told me of this new option.

This new clinic has access to the staff at K State without having to go there. I have never used them but since your situation is unique and sometimes a new set of eyes on the case is helpful...

Sending love and prayers, Kim

So sorry to hear that you & little Jasper are having such a hard time. I hope things are on the up swing today. Saying prayers for you both.

Oh Jasper....hoping for a speedy recovery!

Just thinking of you guys. Sending love. Kim

Hi Tina,

How is Jasper doing? Let us hear from you when you can, sweetie.

Hugs,
Leslie and the gang

I'm checking in as well and wondering how you and Jasper are.

Thinking of you and sending hugs

Good morning All,

My precious boy is home!! :D My vet decided he was doing well enough and let him go home last evening. I was just too wiped out to post last night, I am so sorry if I caused worry. I know he is home with me now because of all the prayers that surrounded him from all of the Angels here. I don't know how to thank you all.

He is MUCH better, but still not back to normal, which would be expected after he had so much going on. He is getting Hills i/d low fat prescription diet, which he is eating!!! It is so good to see him eat what is in the bowl and not just sniff and walk away. The vet said I can start mixing in his kibble in a day or so, but I am going to wait until he has a completely normal stool before I do that.

He is still having blood, which the vet said would take a few more days to clear. I don't like that of course, but as long as it continues to improve, I will deal with it. He is on Metronidazole 250 mg 1/2 tab twice a day. He has taken this many times in the past, he used to have a problem with colitis, but had not had an episode for more than a year and a half since we switched his food to Blue Buffalo. And never had any blood before, so this was quite scary.

He had another injection of Percorten while he was in the hospital since his resting cortisol is still so low, and his prednisone has been increased from 2.5 mg to 5 mg daily. Again, Marianne, Kim and Leslie, you were spot on about that. Thank you SO much, all of your questions and suggestions prompted me to ask my vet. I asked about getting the resting cortisol to see if the current replacement dose of prednisone was enough since his cortisol had dropped so low, and she agreed it would be a good idea to check it. When it came back still so incredibly low, she said "you were right". I thought, "no, Marianne, Kim and Leslie were right!"

He is also getting Zeniquin 50 mg daily, she decided to start this in case he has a UTI, which if he did, may be contributing to his increased drinking and peeing. Since UTI's are common in Cushpups, and difficult to diagnose with the dilute urine, she just decided to treat. It was started while he was in the hospital so this morning is the third dose.

Now here is the strange thing - I have noticed that since we have been home, he seems to be not drinking very much. It is hard to tell if it is really more like normal and just seems like not enough because he was drinking SO much before, or if it is really not enough. I hope it is nothing to be concerned about, but I will be measuring today. He has only gone to the bowl once since we got up, and that was for just a very brief drink. And last night he just drank a few times. The peeing seems much more normal also. Seems odd since the prednisone was doubled, I would think those issues would be even more increased, and vet said they likely would as well.

To avoid having this post become the next installment of War and Peace, I will post a little later. I want to let you all know what all happened on Wednesday before he was hospitalized.

Again, I don't know how to thank all of you wonderful Angels for all of your love and support. I don't know what I would do without this forum.

Please keep Jasper in your prayers, he has a ways to go, but I am hopeful he will continue to stabilize from this setback and we can continue to work on treating the Cushings and get that stabilized next.

Love and Ginormous Hugs to you all,

Tina and Jasper

Yeah Jasper.... go boy go! Tina, we become very attached as you can tell and it is delicate at times when we have to urge people on... since we are sort of 'strangers' having never met... so we understand any hesitancy people have at taking our advice. LOL Just know our hearts are in the right place and we have seen so much over the years.

I am just so happy and relieved to hear from you... I was getting quite worried last night. I see you have been using Blue Buffalo so I assume that the fat content is fairly low on that food. I meant to mention that sometimes when dogs aren't responding to lysodren we tell people to give it with cheese or other fatty sources because fat somehow helps the lysodren absorb more quickly and be more effective. You might take a looksy at any treats you are giving just to make sure they aren't high in fat given Jasper's sensitivity to lysodren.

My Haley was a walking food machine - she lived for it. (and beer - she loved the smell of it!) Anyway over time I couldn't even give her a tiny piece of white chicken - she'd vomit it right up. It's a cushings thing. Fat intolerance.

OK... enough from me... just so very happy! Time to go put on my red for that game tonight! GBR!!! Kim

Great news on Jasper.....woohoo!!!

yay.. such good news. In fact on my bike ride this morning I said a little prayer for you & Jasper. :)

Woohoo, Jasper!

So glad he is home and hope things settle down very soon!
Hugs,
Leslie and the gang

Thanks so much everyone for the good wishes and continued prayers. My Little Man is hanging in there today so far. He has been eating the prescription diet just fine and has kept all his meds down. Woohoo!!! You guys are so funny, I have always said Woohoo when I am really happy or excited about something, and through the years it has rubbed off on all my friends and they all say it now too. I love it that you guys say it also, it sure gets the feeling across!!

Kim, as far as Jasper's regular food, it says "crude fat 14% min". I don't know if that is necessarily low fat or not. For treats he gets Old Mother Hubbard biscuits. I don't think they are high fat, they are all natural. His soft treats, that I also use to give him his pills, are called Lean Treats. They are labeled as low fat, and I get them at my vets office.

And just so you know, I consider you and others on this site my friends, even though we have never met. The kindness, compassion, caring, and support that you and others have shown Jasper and I can only be considered friendship as far as I am concerned. Not to mention the deep level of understanding we all share when it comes to our furbabies. You guys all "get it", and that is so reassuring.

Ok, back to the game for me. Got my red on too. :D. Go Huskers!!!

Hugs,

Tina and Jasper

Hi Everyone,

Just want to give an update on Jasper. My little guy is hanging in there. He is still not quite back to normal, but is much much better. I got a little worried late Saturday night into Sunday morning when he started to pass more blood again. My vet said to not worry too much about that if it happened, unless it increased significantly, but it is still nerve racking. I stayed home with him all weekend so I could keep a close eye on him. Hard to leave him to go to work today. :(

He seems to be steadily improving each day and I am so thankful. He continues on the prescription food, which he is eating enthusiastically. (Yay!!). :D :) :D :). Tonight I mixed in a bit of his regular food so we will see if he tolerates it ok. His drinking and peeing have decreased to about normal, I am not sure how to explain that since he is continuing on the increased dose of prednisone. He drank an average of about 20 oz of water per day for the last 2 days. He weighed 22.6 lbs at the last check (he has lost about 3 lbs through all of this). He was drinking a whopping 64 to 72 oz per day before he was hospitalized, so I really am at a loss as to why it has decreased so much, but I feel it is a positive sign!

My vet checked in today for a report, and we are going to continue everything as is, including the prednisone at 5 mg daily. She will reassess on Friday, and right now my goal is to have him continue to stabilize and not need to call her before then! She thinks maybe he has has a UTI going on and since we are treating it with an antibiotic, his drinking is normalizing.

I think on Friday she will decide if we should taper him off the prednisone and look at scheduling another stim test to see where we are at with that. I have to be honest, I am scared to death about taking him off the prednisone. I am trying to not think about it, but he has just been through so much with his cortisol bottoming out so badly. I guess I will just have to wait and see what she says.

I appreciate everyones continued prayers for my sweet boy.

Love and Hugs,

Tina and Jasper