It does have it's moments Vicki.
Leslie, 8 works, Mariannes two and all the others on here help a lot. :) :) Can you imagine if I hadn't posted the jpegs!!!!!!! I'd be a wreck for sure.
Sharlene
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It does have it's moments Vicki.
Leslie, 8 works, Mariannes two and all the others on here help a lot. :) :) Can you imagine if I hadn't posted the jpegs!!!!!!! I'd be a wreck for sure.
Sharlene
Hey Sharlene, good morning!! Add my 4-eyes to the mix :D Just read through the report properly. Had to squint a little but could read it!! Very throrough, I am impressed :)
Sharlene, I know you are anxiously awaiting the results of the UTK testing. In advance of that, though, here's a couple thoughts for you to consider. I don't say what I'm about to say to try to confuse things further, but just so you'll be really prepared to discuss the results with the IMS.Quote:
Originally Posted by molly muffin
This is the thing...Our experience here (and "seconded" by what your IMS has already said) is that I don't think we've ever had a dog with elevated cortisol that didn't also register elevations in at least some of the other adrenal hormones as well. And the big question is, so what does that mean, and how does it really matter????? If Molly had not already exhibited elevated cortisol on the previous ACTH, then I'd be more anxiously awaiting this UTK panel because normal cortisol but elevated intermediates could herald a discussion of "Atypical" symptomology/treatment. But if Molly again exhibits elevated cortisol, I'm really not sure what significance any other elevations really have. Obviously, that's what you'll have the IMS to tell you ;). And I'll be really interested in her take on whatever the results turn out to be. But I do think that, under the circumstances of Molly's previous ACTH, it would be more surprising if she doesn't have other elevations than if she does. And exactly how that might alter a treatment decision, I do not know. It seems to me that the elevated cortisol (if it is still the case) remains the front-and-center-stage issue in terms of clinical control.
Marianne
I don't know Marianne. I mentioned the study that shows almost all dogs seem to exhibit high estriadol that Lori posted. She said that you have to have 2 or more elevated now for them to look at atypical.
I fully expect her cortisol to be high, it was last time, not sure why it wouldn't be this time. The liver is larger, the adrenals are larger.
I don't know what it is that she is looking for either .
I guess the big mystery is that she shows no symptoms of cushings and that the IMS said while one might come back negative on an LDDS, if it is a false negative, that you wouldn't expect all of them to. (although she mentions it as a possibility on the report). I think they might be puzzled too.
I haven't ever pursued treatment because of the lack of symptoms. I don't know if I should have, if I should now, or what. I guess I hope that the UTenn report will round out what is going on inside of molly's body. Maybe it is a matter of which hormones are high and how high. I really just don't know.
hugs
Sharlene and molly muffin
Hey, Sweetie, I don't for one moment question the decisions you've made thus far. There is no doubt but that Molly has been a most unusual girl, and there have been so many unanswered questions all along the way. Like everybody else, I have never been able to make sense of the positive ACTH and the negative LDDS tests. They are in such direct contradiction of one another since a positive ACTH is supposed to have a decent degree of reliability, just as should be the case with a negative LDDS. :confused:Quote:
Originally Posted by molly muffin
I just know there is so much debate about the significance of elevated intermediates, though. And so I worry about the picture getting muddied even further. If the cortisol remains elevated, I'd expect for other intermediates to be elevated, as well, since obviously the adrenal glands are being overstimulated. But what is the cause? That seems to be the million dollar question!
Oh Marianne, I don't think you are questioning what I've done so far, but I certainly am. It's hard trying to know the best thing to do when molly isn't a text book case. :( I have absolutely no doubt that no matter what UTenn shows, that the waters will indeed be much muddier.
Molly isn't moving around much on her foot. She isn't limping but she is laying for the most part. I know it hurts her Somewhere, but I can't find anything at all wrong. I can move the foot and the toes and she doesn't flinch away ,but she also eventually will move her paw out of my hand. I looked between the pads and can't see anything there either.
I think she might need an anti-inflammatory and I am so leery of that. I wonder if what we used on her back would help her foot. That didn't seem to bother her.
I guess I'll have to give her regular vet a call tomorrow and see if I can get any feed back.
hugs all
Sharlene and molly muffin
Hi Sharlene,
I'm the last one that can shed any light on all the variables of these tests but I think you've made very wise decisions for Molly and it can't be easy to figure it all out and especially since she's had no Cushings symptoms. Hopefully the next piece of the puzzle coming from UTenn will possibly hold the key one way or the other.
I think you were smart not to treat. I would imagine without the symptoms as a barometer treating would be a difficult guessing game that could get dangerous.
In the meantime, this paw/leg issue is still going on..poor Molly. :( When we took Trixie to the vet with her leg she mentioned a "not too hot" compress...may be worth a try for the little girl. Hope it gets better soon. :p
Barbara
2000$ for an MRI? :eek::eek:Quote:
Originally Posted by molly muffin
It costs 350 euros (~500$) here...and that's the only positive thing i can think of regarding veterinary practice here...
Maybe you should come for holidays and squeeze in an MRI between swimming :)
Iraklis, the cost is why most people don't do it. Up here (in Alaska) an MRI is about $2,000 as well. We opted for a CT scan for Tobey, and that alone was $1200. So, really, an MRI is not something most people can do.
An MRI cost $3500 where I am! Too expensive for most of us.....:o
The cost in North America is usually at least $2000. and up, which is cost prohibitive for almost everyone. That is why you don't often see us suggest an MRI here on the forum to people. It is too expensive and just makes people feel horrible that they can't afford it for their furbabies. If it was $500. here more people would do it. Very sad really, but that is the reality.
An ultrasound with a high res machine will run around $500. and even that isn't an option for everyone.
Sharlene and molly muffin
I have never had to get Fynn an MRI so not sure, but CT is around $1K :eek:
Sharlene, you up in the middle of the night... sorry I was not here to check you were OK, hope you have gone back to the land of nod! x
Not a good sleep night. My sleep pattern has been off for over a week now. This is going to be a long work day!!! I'm okay, just slept early and then was woken up and work stuff popped into my head. Molly and hubster are sound asleep both snoring upstairs.
I think to get a CT here would have to go to University of Guelph, not sure what the cost would be.
hugs
Sharlene and molly muffin
Tina often pops in about now, the UK girls will be at work so don't see them at this time! You can be an honoury member of the night crew, as long as you do not make a habit of it and have disrupted sleep patterns!!!
I'm here, I'm here! I'm the early bird U.S. eastern time zone! :) :)
Hi Sharlene, sorry you are having a bad sleep week and I hope that improves. Overall, Molly's test results are not so bad. I do agree with Marianne that if Molly's cortisol is elevated we will expect to see to some of her intermediate hormones elevated.
I can tell you in the beginning, melatonin and lignans did normalize Zoe's estradiol. Of course, in her case, her cortisol was so high, I did not see any clear benefit from it but since her symptons were so mild and her blood work not that bad, I tried it first and treated her colitis instead.
Hugs
Sharlene:
Sorry you are not sleeping, I certainly know that feeling. What about laser therapy for Molly's foot. It just rejuvenates the cells and makes them work to heal anything so that may help her, just can't think of anything else. Hope you are both doing better with all this soon. It is a lot to deal with this plus work a
job. Blessings
Patti
I'm sorry that I can't help with the test results - will leave that to the experts
but {{{{{BIG HUGS}}}}} from Henry and I (and take care of yourself)
Hi Sharlene,
I am sorry, too, that you are having a rough time sleeping this week and I hope you are able to get some restful sleep real soon.
Some things that caught my attention on Molly's US are with the kidneys/urinary system. I see that with both US there were decreases in corticomedullary definition, which I believe, is like the filtration system for the kidneys.
I also see that she has a very small stone (renolith .18cm) in her right kidney, I imagine the IMS thinks Molly will pass this?
Is the irregular mucosa along with the mineral deposits (calculi) seen in the urinary tract?
I am wondering what is meant by the "pancreas is mildly mottled?" Does this suggest pancreatitis at some time?
I seen that Molly's BP was mildly high, was this because of "white coat syndrome" or has Molly's BP been elevated before?
Molly's UPC was pretty darn good (.8) and I am wondering if the mild issues she has with her kidneys can be attributed to the .8 UPC and also, maybe the culprit for the mildly high BP?
Sorry I have more questions than answers, and I am sending huge loving hugs to you both.
Quote:
Originally Posted by molly muffin
Oh Sharlene..sorry you had a bad night and not enough sleep. At least it's the weekend and hopefully you can catch up on some rest. A case of the worries can really screw up the night.
Hoping tonight is a better one.
Barbara
Hi Sharlene I am sorry to hear your not sleeping well, I hope tonight you can get a full nights sleep and feel rested in the morning.
Ugh, so of course today was a bad day at work. Of all the days eh. :) I took a 30 minute power nap today that helped a tiny bit.
My vet called me today to talk about the ultrasound and upc results. She mentioned that there was a upc done in January and molly's ratio at that time was UPC .049, so the highest possible within normal range. She thinks that is our main concern right now, in her opinion as it can be a silent problem that can get worse and the next UPC mid/end of may will help us know about that.
I think she has concerns about the kidney leaking protein.
She thought as far as the adrenal tumor goes that molly would have tested positive on the LDDS if it was a functional adrenal tumor. She also mentioned that based on location and if smooth, etc, they can often tell if they think it is malignant or benign. She is inclined to go with benign. She knew nothing about the atypical cushing testing. She also hadn't heard about the new radiation treatment that UDavis is doing (but she got very excited about it) and didn't know about about the pituitary surgery that Dr. Bruyette has done. Was a bit excited about that too and said I was a wealth of information. LOL
I spoke with her about molly's leg issue too and I'll just copy what I wrote on Trixie's thread:
I spoke to my vet today about Molly's leg and she said, that sounds like a sprain, when I explained that it was one day, then later she is fine and then it comes back. She said any wrong movement, causes it to react the same as the original sprain, then they over compensate on one leg and the other one acts up because of the over compensation. Humans do this too, especially with knees and legs. She said 3 days of solid restriction as much as possible, no running, no jumping and no long walks. Compresses can help to, just like for a people sprain.
So she thinks maybe a sprain if there is nothing in the pad and no toe nail problem. If it doesn't clear up, i'll take molly in for her to have a peek at.
I hope I can sleep tonight. Really it isn't anything to be too worried about, a combination of work/molly, and bad sleeping pattern lately, where I fall asleep while reading on the couch and then when I wake up and it's time for bed, I'm wide awake. That throws me way out of kelter and it has happened several times. Plus you know, that is when the mind kicks into full steam ahead.
Well, I've ordered a pizza as I told hubs, cooking is not on my agenda tonight. :) It wasn't on his either, so pizza it is and chicken wings.
Oh and Lori, I wonder if that last episode of diarrhea and tummy upset, wasn't a mild pancreatic attack.
hugs all
Sharlene and molly muffin
We are going to have to track Kim down. She is wonderful at lullabies.
I hope you are finally able to get a good nights rest tonight. I'd sing you a lullaby, but that more than likely would give you nightmares. :D
You are an awesome mommy and you'll get Molly sorted out. You always do. Xxxxxx
LOL Kathy, thanks for the giggles. Just what I needed. Better than a lullaby even!Quote:
Originally Posted by Budster's Mom
hugs
Sharlene and molly muffin
Hey, sorry got here late today so probably missed you all! Hope you are tucked up in bed without falling asleep on the couch! Fingers crossed you have a good night Sharlene :)
Reassuring what you vet said, yes I would have thought it would have a +ve LDDS test with functional. Pheo usually doesn't, but then Kim's Annie was false positive from memory. Flynn negative x2.
That sounds like a good long conversation, two way street too it sounds like you were giving her new information too!
So we are back on the waiting wagon, atypicals and next UPC in mid-May. Oh we are so good at waiting aren't we.... NOT?!?! :D x
Patience. Pfffft
Yep her main concern is the kidneys and protein leakage. Even if mild now. She straight out said that we could recheck the size of the adrenal tumor in a few months but she had concerns for now about the UPC and kidneys.
She does concentrate her urine really well so that is good I think. It's not too high or low. So that is good.
Now I just need to figure a way to put work in the drawer. :(
Heading to bed soon
Hugs
Sharlene and Molly muffin
I am glad to hear your vet thinks the adrenal tumor is benign, that's is reassuring. I do not know what UPC is, but I will keep Molly in my prayers that she does not have protein leakage.
Sharlene:
I feel so bad that you are stressed and not resting like you should. I don't know to much about protein leakage, but I know you will get it straightened out. I hope you have a stress free weekend and rest yourself. Working full time and having to deal with all of Molly's stuff has to be draining. I know nothing seems to help stop the worrying, it seems to come with the disease. You are a tough cookie, and you always strive to give Molly the best. You are always an inspiration to me when I am feeling nervous about Tipper, so it is hard knowing all you are going thru. I pray for each and every one of these babies every nite. Tipper sits right beside me, and I always say she is doing her prayers with me. I pray that there can be some resolve to the issues you are facing. God Bless you and Molly
Patti
Alright young lady, I see you starting some of the same horrid habits I have allowed to ruin my health. You STOP that right now! If you want to read, sit in your chair and enjoy until you start to get sleepy then march yourself to the bed and snuggle in. Lay off caffeine and sugars in the late afternoons, evenings and nights. If you crave a sweet, fix yourself a cup of hot tea with milk and honey or eat some green grapes or a pear. Get more exercise. Spend at least 15 minutes outside every day alone - no Molly, no phone, no iPad, no company - just you and Mother Nature. And stop worrying! I have (WATCH FOR LIGHTNING! :p) so I know you can. Ok, your four-eyed mother is going to leave it at that...for now. :D
Goodness I don't post for a few days and all hell is breaking loose with Molly and Flynn.
A sprain sounds logical for Molly's paw I hope she is feeling better
It is hard to switch off when you have so much running through your head but you do need to try. When things got too much with Woody I would go a walk on my own taking in the fresh air and scenery at least for that little while I could focus on other things. I hope you get your sleeping sorted out :)
Just doing some more research on UPC ratio tests and found thatThis is due to the flunctuating levels of creatinine, I believe Trish has mentioned this before, right?Quote:
The urine protein:creatinine ratio varies by up to 30% above or below baseline as a matter of course. A significant change in the ratio caused by disease progression (up) or response to therapy (down) must be greater than 30%.
Here's a link to the article that I quoted from: Glomerulonephritis
Link to another interesting article: http://www.2ndchance.info/atopica-urineparameteres.pdf
Musing here, with Molly's .8 UPC result I don't think I would be really worried unless it trends upward a lot. I wonder what Molly's IMS would say regarding that 30% fluctuations in the UPC?
I think it is a combination concern of the UPC along with the kidney "mild loss of corticomedullary definitions, cortical speckling" that makes the vet concerned with a progressive pattern developing. They don't want to see that and of course are not planning on treating currently but more of lets keep an eye on that as it is a silent progressive disease.
So, my hubby took his vehicle in for some maintenance today and then called and said come get me, lets go out to lunch. So, since I'd just gotten out of the shower and was dressed, (always a plus when leaving the house) i went to get him, we had lunch and then went to look at some newer vehicles. (he's thinking of replacing his and my winter with just one winter one) So two possibilities, one that I liked more than him and one that he liked more than me. We didn't get either, but now I have my homework assignment. :) So I need to find something that will combine features that we both like and take it from there. :)
Tonight he is taking me out to dinner (after his nap), so this has been a very relaxing day for us. I slept great last night and really long. I'm sorry Leslie I did fall asleep on the couch, but woke up, went straight upstairs to bed and right back to sleep, then still sleeping this morning when hubs was up and ready to leave to go to the mechanic. I wasn't moving out of that bed for anything. LOL Molly didn't get up either, so it was a plus. (no huffing and puffing for me to get out of bed and take her for a walk) Foot was fine today.
So funny Leslie, I don't think anyone has called me "young lady" since my mom passed away. I had to giggle over it. :) :) Thank you. I'll try to behave myself.
hugs all,
Sharlene and molly muffin
So glad to hear you had a long and good night sleep! I hope it continues.
and good to hear Molly's foot was good today :)
Have a wonderful dinner out with your hubby!
Oh, that's what it took. I had to threaten to sing to you, before you could get get a good night's rest. So glad my threat had you shaking in your boots! Lol :D:D:D
Oh Sharlene that it wonderful that you slept well!!!
Good luck with the new vehicle search, in Feb. I bought a 2014 dodge ram crew cab and love it, I just love trucks!!
So pleased the Molly's foot was OK today and hope you had a wonderful dinner this evening.
OH lets me make all of the car buying decisions after he sent me out to get a practical winter car for my third Canadian winter and I came home with an Audi TT roadster :D :D
Hey Sharlene
Hope you and hubs are still out enjoying a tasty meal! You have had quite a day, sounds lovely! I am such a bad car shopper, the must haves for me were a central console for Flynn to stand on. The car guys thought I was mad having that at a non-negotiable :D My car which I bought in 2010 had a couple of things I have never had before, an excellent backing camera and heated seats... I don't know how I lived without them before! They were optional extras but I am glad I shelled out the extra $$ for them both. Wow that is a nice looking truck Lori, just googled it!
LOL at Leslie, now that is a voice I would not mess with :D:eek::D
:p I think hearing "young lady" growing up was worse than when they called my full name out! :p
I am so glad to hear that you got some good rest and that Mollys' foot seems better!
I agree Leslie, Young Lady meant you were in some kind of trouble.
Oh that is funny, a practical winter car turned into the Audi TT roadster!! hahaha
I havve car that I bought last year and I love it. Yep, it has the heated seats too and wow, not sure how I survived Canada for so long with a cold tush!
We have two jeeps currently that we use in the winters mainly. Hubs is a toy, in that he put lift kits on it and steel bumpers and a wench. I use to joke that he just Hoped I'd go intoa ditch so he could come rescue me. hahaha Mine is a grand cherokee, which I've had a grand cherokee since they came out in 1993 in one form or another. Except for the time when I had a mustang and hubs had a firebird. That was a crazy winter!
Now we are thinking that we'll get rid of the two jeeps and get one to replace the two. I'll drive it mainly in the winters, since hubs doesn't mind driving the car in the winter and we'll be set and not need any more vehicles for a long time to come. I love vehicle shopping, some times. LOL
Oh nice Lori! Those Dodge Ram Crew cabs are huge! I was looking at one yesterday since jeep/dodge is the same place. Of course I also kept drifting over to look at a some rather sleek vipers, which is totally impractical and I don't need. hehehehee
The restaurant we went to last night, is down in Port Credit, one of my favorite places to be for anything. Really good food and fun atmospher. The manager came over to say hello, as my sister in california had established an email back and forth with him over the holidays. (she sent us a gift certificate to this place for xmas and with everything going on we hadn't had a chance to use it yet). We'll definitely go back there.
Molly's foot remains okay so far and I am hoping whatever it was, sprain pawed or something else is better now.
I'm not sure if today what we'll be doing this afternoon. Last night was not a good sleep night again. I think it is more work issues than Molly issues at the moment that is keeping me up.
I'm thinking of putting molly strictly back onto her SO dog food for the crystals, dry and wet and see if the UPC responds well to that. She didn't have these issues previously when I had her solely on that, but she went off the food for awhile and wouldn't eat it and I was supplementing it with chicken and other stuff, pasta, green beans, etc, so now I think I'll try her just on that till the test in mid may and see if that UPC comes down and if this is food related at all.
My sister said she thinks my nephews dog has cancer because they found a bump (his wife is an RN) and she seems to be failing. She is a golden retreiver, 11 years old. I told my sister to look into it being a lipoma before writing her off. Do a fine needle aspirate and have blood work done. My family has dogs but for some reason, they only seem to do the bare minimum when it comes to health issues with them. Nothing like me and molly.
Thanks everyone, have a great day.
Sharlene and molly muffin