I will definitely keep you posted.
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I will definitely keep you posted.
Orlando came through the surgery successfully and without the need for CPR to save him. He is recuperating at home and being seen by his regular vet who handles the Cushings and the surgical team at the specialty group. We had a rough time with the Duragesic patch which had to come off one day early and the tramadol has made him constipated and lacking in appetite, but we are trying to decrease the does and wean him off of it in a few days. Since I can't determine if he is in pain as he is so stoic, I don't want to deprive him of pain meds if he needs them. No biopsy results yet and I have not made a decision on the vaccine.
Hoping for the best!
When are the biopsy results expected to come in?
so glad he came through surgery like a trooper. How is he doing?
There was a delay with the results and they just came a couple of days ago. Orlando is doing well, all bandaging is off, and has a strange looking peacock type foot now, but is happy and back to normal We do a stim test on Thursday as I certainly can't drop the ball on the Cushings after he has been treated so successfully so far.
The biopsy showed that the melanoma was contained in the toe and the resections were also clear. However, it was in the nail bed as opposed to the digit itself and so the doctors are recommending the Oncept vaccine because melanoma is so agressive. I have done a lot of research and can find no serious side effects to it and have joined a couple of support groups for amputee animals for advice as well. At this point I am inclined to do the vaccine despite the high cost.
Orlando is in a little bit of a gray area with a low mitotic rate and clear margins, but most dogs with subungual melanoma who are stage 2 only survive about 5 months after surgery without the vaccine it seems.
I'm glad to hear Orlando is doing as well as he is. Whatever you decide about the vaccine will be the right decision because you make it from a place of love and hope for him. And whatever you decide, we are behind you all the way. ;)
Keep in touch and let us know how your sweet baby boy is progressing.
Hugs,
Leslie
Thanks so much and I will keep you posted.
I can see why you are leaning towards getting the vaccine, that 5 month rate isn't great to read.
What is the longevity of dogs who have the vaccine with stage 2?
First, to answer your question.....one year is the time usually attained with the use of the vaccine. They say that some dogs do better than that.
We just received the new stim test results today. A creatine level was 26...a couple extra readings were requested by the vet. The stim test was 1.6. Pre was .6 and post was 1.6. The meds were administered according to the way that you describe in the group before the test. The vet mentioned that this might show adrenal necrosis or a move into Addison's and wants to lower the vetoryl from 20 mg to 10. Orlando seems to feel well, recovering from the surgery, but seems hungry, seems to be drinking more water, and is peeing more than usual. His first immunotherapy vaccine is scheduled for September 2.
I see why the vet is concerned with those ACTH test results, they are too low for my comfort too. Were the electrolytes checked also? I don't want to worry you needlessly but increased thirst and urination are symptoms seen with Addison's, if he would lose his appetite you may want to take him to get checked. Did the vet give you any Prednisone?
That stim result is too low for my comfort also. It needs to come up a bit.
Orlando seriously just needs to catch a break somewhere and have some good days with no worries
A year is better than 5 months for sure, and if possibly longer, that would be even better.
Thank you both so much for the replies. Orlando will have another stim test within 2 weeks or so if everything remains stable. The vet did tell me that the drinking and peeing are consistent with Addison's but his appetite is very good right now...in fact, he is eating more than he usually does and even sneaks some dry cat food at night which is something that he has not done in his entire life. I will call the vet and ask about keeping pred on hand; my first Cushings boy who definitely went into an Addison's crisis was on a regular dose of it and I don't think that Orlando is in that area yet. Do you have a link on the website to information about Addisons?
I found this site about dogs with Addisons: http://www.addisondogs.com/addisons/
I have also found 3 facebook groups for Addison dogs
https://www.facebook.com/groups/2347518387/?ref=br_rs
https://www.facebook.com/groups/addi...ogs/?ref=br_rs
https://www.facebook.com/groups/10322336355/?ref=br_rs
If he is eating well though, it doesn't sound like he is Addisions, as usually they don't tend to eat very well. Still it doesn't hurt to get up to speed on anything that might come up or what to watch for.
It sounds like he is doing pretty well, especially considering everything that he has been through recently.
An UTI would cause a dog to drink and urinate more. Was an urinalysis done?
Lori
Thanks so much for the links. At this time, Orlando is still eating well, so that is something. He did have a urinalysis and everything was normal. His vet is careful to think of those outlying issues that might need checking, fortunately, as his mommy is not thinking that clearly anymore.
That's good that no UTI, so that can be eliminated. And yay for good eating!
Despite the concern about Addison's, Orlando is eating very well, seems hungry. With 110 degree heat he is of course lethargic despite the AC running for him. He had his first injection of Oncept today and the oncologist explained to me that it is not immunosuppressive so there is no reason not to give the rabies vaccine and in LA County he is not eligible for a waiver based on the use of that therapy. She recommended that he not take the rabies shot for the two months that the Oncept is being used however. I am going to lay low on this and see where it goes, as I am not anxious to give him the shot anyway.
I understand that. I wouldn't want to give him the shot either, especially while under treatment receiving the Oncept shots.
How is he doing? Yes it sure has been hot out there!
The heat has subsided a little, by LA standards, which means it is now just hot and will be for the rest of the month, and in a bad year, in October as well. But O is holding up, eating well, seems himself, still on the lower does of the Vetoryl. I can see no side effects to the Oncept at all. At this point I am not going to go looking for trouble and will just continue to lay low about the rabies. Even if local AC has the manpower to approach me, I am sure I can stall them until the vaccine series is over.
Glad to hear Orlando is doing alright! I think many times just being in the moment with our babies is more important than anything else. ;) Most of my babies don't get vaccine due to health issues so we also lay low often. LOL
In many ways that is all our babies want is for us to be with them to be happy being in their company.
I am sorry that I have not updated for so long but did want to let you know that Orlando is still holding his own with good readings on his last stim test, in fact the best they have ever been. His liver numbers have risen a little bit, but we are watching that. I had my vet do the 6 month chest xray and send it to the oncologist...it was clear and he will be scheduled for his next Oncept injection in April. Last October I was dxed with breast cancer, caught early on a mammogram, and had a lumpectomy in December and a re excision in January. I am about to finish radiation in a couple of weeks, fortunately the medical oncologist did not feel that I would need chemo based on a clear sentinel node and a decent score on the Oncotype DX test. So Orlando and I have faced this all together and he has been there for me as much as I ever was for him with his melanoma.
Hi! Good to hear from you again and especially good to hear that Orlando continues to so well! :cool: I am sorry to hear about your own cancer diagnosis but very glad it seems to have been caught early and pray radiation puts an end to it! Please drop by when you can and let us know how Orlando and YOU are doing.
Hugs,
Leslie
“Ditto” to everything Leslie just said!! Thanks so much for taking the time to stop by to update us. We’re all wishing you both the best in your recoveries!
Marianne
Great news about Orlando continuing to do well, but I'm very sorry to hear that you have had to go through cancer too. Two peas in a pod you and Oralando. It seems you are doing well and on the road to recovery. Keep it up!
Thank you all so much....I will stay in touch!
Orlando appears to have an arthritic shoulder, not rendering him immobile, but cutting down on our walks. I also suspect that the amputation site, while completely healed, has left him with an odd feeling in the foot. The toes must splay a little when he walks and it might be causing some discomfort. He is overly sensitive to any discomfort but I wanted to ask what a safe pain reliever is for Cushings dogs, any type. Thanks so much!
Tramadol and Gabapentin are two that I can recommend. I take Gabapentin for my nerve pain and it does help. With both of those meds you need to watch out for loopiness, when I first started the Gabapentin it was a 300mg dose twice a day and it did cause me some uncoordination until I got used to it, I now take 600mg twice a day without any issues.
Thank you so much! I do have tramadol on hand from his amputation....lots of it, so that might be the answer.
Orlando's primary care vet has been very careful to maintain his foot with the missing toe, so he is doing okay in that department. We have not had to go to any regular medication for pain, thankfully. However, we are having, as are many of you, a miserable summer. I have central AC, 5 ceiling fans, and 6 tower fans in the house, but he continues to pant and seem generally uncomfortable. Cushings is under control, and this seems like a reaction to heat and not a new medical issue. I put him in the tub and keep him wet which seems to help, but wondered if you had found that one brand of cooling pad was better than another. When I went to Amazon, there were very mixed reviews. He may be "weird" and not lay on it, but what is another $50 at this point if it might help him.
I bought mine from Petco and Gable uses it all the time.
If he doesn't like the cooling mat maybe a cooling vest/collar will work?
I have not posted for a while, and this is where we are right now. Since July 30, Orlando has had 5 stim tests, all fine by me. The situation became that his numbers moved into a very close to normal range and he appeared to be possibly showing signs of Addisons. His vet consulted with a specialist in Cushings and they decided that, while it is not done normally, we should give the meds every other day, 20 mgs total in a day 10 AM and 10 PM. Next stim test was similar to the one which prompted that decision but I remained uncomfortable with his outward appearance, especially remembering my last Cushings dog going into Addisons and then needing cortisone to even get up in the morning. Next thing we did was to run stim tests two days apart, the first one without having administered the vetoryl and the second after administering it. He was at 8 without the meds and 5.7 with them. The specialist brought up questions of adrenal necrosis, etc and it was decided to stop the meds completely and retest in about 2 weeks. This test showed pre stim at 6 and post at 11.2, both of which are in the normal range. However, to me Orlando is showing signs of Cushings....excessive panting ( we are still having warm weather out here), thirst, hunger, and lethargy. We are now back on the meds twice a week until the next stim which will probably be next week. His vet said that possibly this reading will show that the levels are back into the Cushings range, or at least equivocal range. I have no issue with keeping him on the meds, but am more or less seeing negative outcomes either way.
I have delayed his next Oncept injection AND the vet has referred him to an optomological specialist because she is afraid that there is a mass behind one eye.
Orlando's issues with the medication were resolved and he has done well for the past few months. He has been on Vetoryl for over 4 years now which is double the life span of my first Cushings dog. However, there is no doubt that he is slowing down and I cannot say that this might all be down to Cushings. His most recent problem has been with arthritis and pain in the shoulder opposite from the foot on which the toe was amputated. I think that he has probably overcompensated or adjusted and thrown the shoulder off. Subsequently he has been on Cosequin, Dasuquin, human glucosamine and MSM, and CBD oil not all at the same time or even in the same time span. I have also used some Tramadol but infrequently. About 2 days ago something happened with his rear legs, left more than the right. The leg seems unstable and he is not willing to put weight on it or senses that it will not hold him. Nothing in the foot and he does not react to it being touched. His mobility is entirely limited and I am using a sling to help him as needed but mostly he is just asleep for hours on end. Is the leg issue, muscle wasting or atrophy, connected to the Cushings? Is this an end stage sign or can it be treatable or reversible?
Boy, I sure wish I could give you a definitive answer as to what’s causing the leg problem, but there’s a number of things that could be wrong. Without a physical exam and possibly some x-rays or other imaging, there’s just no way to know. It could be his hip, his knee, a ligament issue, a muscle bruise, an arthritic worsening, even maybe a back issue. Some of these things could be complicated by Cushing’s, but others could be totally unrelated. My own nearly 11-year-old nonCush Lab has suddenly started favoring her left rear leg, too. She’s stumbling at times, limping at times, and definitely favoring it. This all started for no apparent reason yesterday. She doesn’t react to me manipulating the leg, but something is definitely “off.” So if misery loves company, you and I are both suffering together tonight :-(((.
If it keeps up beyond the holiday weekend, I’ll need to take her in to the vet for assessment. And I’m afraid that’s what you’ll need to do with Orlando, too. For both of us, it may just be a temporary issue that could be relieved with a limited course of an anti inflammatory, for instance. Regardless, please keep us updated, OK?
Marianne
Thanks so much. I have arbitrarily returned to giving him loading doses of Dasuquin and he is somewhat more mobile but the leg is still not right. You are correct in that he has to see the vet about this and that is my next step. Prior to returning to the Dasuquin I had been trying the CBD oil for the arthritis, not Cushings, and I am not sure that it did anything, but that is not a discussion that I need to bring up. I hope that your baby will be okay as well.
I have not been here for a while and Orlando has held his own. He has been on Vetoryl for 6 years now and his readings have been encouraging....but he will be 14 if he is still here on December 10. A few weeks ago his personal vet found a lump in one anal gland. We were referred to the Animal Specialty Group on LA where they did his melanoma treatment. We went and ran all preliminary testing which showed no metastases in any imaging or other testing but did reveal that the mass is very small and cannot be biopsied, so removal was suggested. As time has gone on, he has aged, certainly, and has been challenged with mobility. We added Tramadol and Rimadyl to his regimen and he seemed to feel so much better and was able to move a little easier, relatively to the fact that he is an old, heavy dog who has been affected by the missing toe.
I hesitated on the surgery, but never made a decision. Today I planned to decide what to do but last night he suddenly could not get up. One front leg is affected by the loss of the toe and the stress that has put on his shoulder, but suddenly he could not get his back legs to work. Since then, I have been lifting him with a harness and supporting him when he walks. He is very stiff, cannot squat, cries for me when he needs to get up if I have not gotten him up before that, can stand on the legs but will only walk a few feet. He could not step up on a curb this morning when I took him out. Is rear end limb failure or involvement a sign that the Cushings is running its course? We used Dasuquin and Cosequin for a long time until it seemed as if it had done nothing but failed to relieve the pain he was in. I have used Adequan on other dogs; is that a possibility. I hate to say it, but my GSD before him had degenerative myelopathy and despite having no use of his rear legs he was easier to manage and struggling less than Orlando is now. At this point I am not going to proceed with the surgery. He is very sensitive to pain and between that and the new mobility issue along with 2 hours of anesthesia I just don't think that he will be able to run the gauntlet.
Hello again to you and Orlando. I’m so sorry that you’re both having such a rough time right now. Unfortunately, it’s really hard for us to know exactly what’s causing these new mobility problems for him. It could be hind-end muscle wasting from Cushing’s, but it could also be caused by a different type of orthopedic problem such as arthritis, or hip degeneration, or ligament/tendon damage, etc. For those of us with big dogs, mobility issues such as these can be so very difficult to deal with. Unlike with the little ones, we can’t just pick them up and carry them to where they need to be. So it becomes a huge quality of life issue when they cannot move freely on their own.
Last year I spoke about my elderly non-Cushing’s Lab girl who is still experiencing an overall general decline in her mobility. Before that, we had to make the heartbreaking decision to release her non-Cushing’s Lab sister when her arthritic hips grew so painful that she could no longer walk on her own, even with the help of a harness to try to hold her up. From these experiences, my heart goes out to you as you try to settle on the best path forward for Orlando.
I do understand your reluctance to put him through surgery under these circumstances. I’d probably feel the same way. And as far as the rest of things, I’m sorry I can’t give you a definite answer. But I really can’t guess as to exactly what’s wrong. I’m afraid you’ll need to rely once again on the opinion and advice of a vet who can actually physically examine him and obtain any imaging or other testing that can give you a better idea about things.
We’ll surely remain anxious to find out any news, and we’ll definitely be here to act as a sounding-board if you want to talk over any options that are presented to you. And we’re also always here just to listen. Please give Orlando a gentle hug for all of us here, and we surely hope a solution can be found that may grant you still more good days together.
Sending healing wishes to you both,
Marianne
Thank you so much for your reply. I remember your previous comments on your baby and am sorry that you had to make that hard decision. Orlando is able to boost his upper body up, which is a help, and then wait for me to use the harness to lift him in the rear. Once he is up, he can walk a few steps and with a harness he can be assisted to walk a little further. He made one valiant attempt to stand up when I was in the shower and when I came out he was up, but too exhausted to move. At this point, we have reached a management "agreement" where he knows that he needs help and I am ready to help him, so it is somewhat like my first GSD. I will call the vet on Monday and let you know what I find out.
Miraculously, Orlando is still here a year later. His right rear leg is weak and he struggles to get up and walk, but if he is alive on December 10 he will be 15 years old which is remarkable. I am with him all the time and we have a routine where I help him up and keep him clean as needed. His appetite is great and he had his last stim test a couple of weeks ago. I don't think that he has lot of time left, but he still has quality of life. This is the latest issue. His stomach is very black, the skin very thin and it is starting to split open. These are not exactly pressure sores but almost more like very thin skin as you see in the very elderly which snags easily and splits. However, they are from contact with the floor as he lays down most of the time. I bought pressure sore pads which did not stick, bandages don't stick, so I proceeded to home made wraps which also did not work as these are very low on his distended belly. I have belly bands coming from Amazon today and am cleaning the sore with Hibiclens and using Neosporin ointment. I called his vet and she suggested I try shorts, under pants, or diapers which are in the works. However, I am worried that this is not going to stop with one lesion. Do you have any suggestions for treating this or managing it?