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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Tina, I'm sorry. I know getting up that much during the night has to just wear you out. I know we've had this discussion before but I do not understand the urination issues. I recall having this conversation earlier and you/the vet believed it was related to the prednisone but at that time the dosage wasn't that great. Did you ever rule out diabetes insipidus? (this is not the same as diabetes mellitus). I know you ruled out thyroid issues. Sending love, Kim
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Mornin' Tina,
No, this is not the end of the world and NO you did not poison Jasper, honey. Some pups are just super sensitive to these meds and we have no way of knowing that going in...you did exactly as you were supposed to.
In parts of Europe, they treat Cushing's by intentionally inducing Addison's by destroying the adrenal glands because they feel Addison's is easier and less expensive to treat, and not as hard on the pup to live with. Jasper has simply gone from one end of the spectrum to the other and you can both live with this. :)
Here are some links about Addison's for you to check out and I am sure there are others out there as well that may be helpful. The next to last link is a Yahoo forum for discussion and the last one offers some other support venues.
Addison’s*
http://canineaddisonsinfo.com/
http://k9addisons.com/faqs/
http://pet-diseases.suite101.com/art...disease_in_dog
http://www.inmetrodetroit.com/pets/d...k/addisons.htm
http://www.vetinfo.com/dencyclopedia/deaddisons.html
http://pets.groups.yahoo.com/group/AddisonDogs_/
http://canineaddisonsinfo.com/Support.html
Oddly enough, Addison's and Cushing's share some of the same signs - excess thirst and urination among them so the Addison's may be why Jasper is having to pee so much. But I would look into the Diabetes Insipidus just in case. It is a rare form of diabetes but we have seen several cases of it here. DI is not caused by sugar imbalance but rather with how water is processed in the body.
Links to DI info -
• Polyuria, Polydipsia and Diabetes Insipidus
http://www.vin.com/proceedings/Proce...A2002&PID=2556
• Diabetes Insipidus
http://www.petplace.com/article-prin...y.aspx?id=3258
• Diabetes insipidus
http://www.provet.co.uk/health/disea...sinsipidus.htm
• Diabetes Insipidus
http://www.merckvetmanual.com/mvm/in...m/bc/40507.htm
Now that you have your homework assignment for the day you should have no trouble keeping your mind busy. :D But, hey, if you get bored just holler - I gots lots more links to all kinds of stuff...some are even important! :p
You are doing a great job, Mom, and you have done nothing wrong so don't let those nasty ole thoughts get you down.
Hugs,
Leslie and the gang
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Dearest Tina, Sorry to hear about little Jasper. Bless you both.... I know it's hard and very stressful on you and I certainly understand about the lack of sleep. We have to get up every two hours to let Maya out and she still pees on the carpet. Last night she just stood up in her bed and started peeing, so that was me up at 2.45am cleaning up and getting her a fresh bed sorted out!
Now that you know that Jasper is Addisonian, things should improve, because the vet knows exactly how to treat him now. It's the not knowing which causes all the ups and downs. Addisons is a very treatable disease. I know a dog who had it since he was 4 and he's 10 now. It's a lot more common than you think. My vet was telling me that he has 17 patients on his books with Addisons and that they are all doing well. He, himself has an Addisonian poodle! He said that once they are stable it is quite easy to treat them as long as you keep them monitored. In fact, he said it's better to Addisons than Cushings and there is substantial evidence to support this if you do a bit of research on the net. I know this is very upsetting for you, sweetie, but hang on in there-you'll get things sorted...
Sending lots of hugs your way, from me and Maya
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina,
Everyone seems to say that Addisons is much easier to deal with than Cushings and is completely manageable. Dogs can live a very long time with it.
I think some sleep and getting an idea of how Addison's is treated will make you feel much better.
hugs,
Sharlene
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Judi, Kim, Leslie, Leah, and Sharlene,
I don't know how to thank you all for your comforting words and support. I had myself a good old cry after reading your posts, and am so appreciative of all of you, your help, and your kind words.
Leslie, thank you so much for all of those links. I have done a bit of reading, but hope to hit the "homework" hard this afternoon after I get some more cleaning done.
Kim - no, we have not ruled out diabetes insipidus. This has not ever come up with my vet. I have done a bit of reading on it, and will ask about it when I talk to her next. That should be some time this coming week when we go over the current treatment plan.
Jasper's drinking continues to be excessive, along with the peeing. Other than that he really seems to be feeling pretty good now. Words cannot convey how thankful I am for that. I am seeing some glimmers of his old self come out. It has been months since I think I could say that. I am hopeful that it will continue! :D :D
Thank you all again for the encouragement. At the risk of sounding like a broken record, I don't know how I would be functioning at all without all of you and this forum. What a blessing.
Much love and giant hugs to you all and your pups from me and Jasper. xo
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina,
I did a bit of research on Percorten and increased drinking/urination is listed among the side effects.
Quote:
Occasionally, dogs on PERCORTEN-V therapy may develop PU/PD, which may suggest excess glucocorticoids and/or excess PERCORTEN-V. Should this occur, close monitoring and dose adjustments are required. Initially, the glucocorticoid
dose should be decreased, followed by, if necessary, a decreased PERCORTEN-V dose at unchanged intervals.
http://www.percorten.novartis.us/pdf..._Monograph.pdf
Hopefully only a dosing adjustment is needed, has Jasper's vet mentioned that drinking and urination could be increased by the Percorten?
Keeping you both in my thoughts and prayers.
Love and hugs,
Lori
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Tina, I forgot to mention that excessive drinking and urination can be a side effect of the prednisone too!
Hugs from Leah and Maya:)
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Lori and Leah,
Yes, I knew that excessive drinking and urination can be a side effect of prednisone. In previous days, my vet mentioned that she thought that this may be what was happening with Jasper. But like Kim said, he was on a low dose then just as he is now (2.5 mg daily). I imagine it would still be possible. He seems to be sensitive to meds, so probably is to the prednisone too.
My vet did not mention that drinking and urination could be increased by the Percorten, but I had read that when I researched about it also. :) I will ask her about it. I have also read that they can be symptoms of Addisons as well as Cushings. Sheesh, lots of possible causes or contributing factors! :rolleyes:
My vet did mention that we will be checking Jasper's electrolytes in 2 weeks from the date of the Percorten injection, and again in 25 days to see how well it is working and how it is maintaining the levels in order to determine if a dosage or interval adjustment is needed. (I think that is what she said, I will clarify the next time I talk to her). She also said something about possibly reducing the prednisone to every other day at some point. So that might help.
Jasper has had the excessive drinking and urinating throughout this entire roller coaster ride, so I really don't know what to think about what is causing it now. It first started due to the high cortisol, but now he is bottomed out so maybe it is because of the Addison's now? Or most likely a combination of things?
Love and hugs to you both,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina,
My little Boston is on pred. She weighed 11.5 lbs last time she was weighed, gets 1.25 mg either every other day or daily as needed and she has strong cush signs since starting the pred. Everything except hair loss and skin discoloration is present - excess urination, excess drinking, strong hunger drive, and pot-belly. She pants heavily and easily, and sleeps a lot but that is due to another reason so I can't lay that fully at the feet of the pred.
The times she has been able to manage with every other day dosing presented milder and fewer signs. The times she needs daily dosing, the signs are strong. When I reach to pet her, she has to nibble my fingers just to be sure there isn't something to eat hidden in there. :p She stands at the water bowls and drinks every drop I put in there whether 1/2 cup or a full bowl, around 3 cups...she drinks until it is gone, then usually throws it back up if I don't control her. It seems like she pees constantly. I tried diapers on her a while back and she ended up with red skin around her waist so I stopped using them and just follow her around with paper towels, rags and Nature's Miracle. :D Her skin was in bad shape when I got her and it has improved tremendously so I wasn't willing to risk that discomfort to her for my ease.
I'm not saying the pred is the whole cause behind the signs Jasper is displaying but I did want to share our experience with pred and how it has caused Tash to present as a cush pup when she isn't.
Hugs,
Leslie and the gang
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Everyone,
I have been getting caught up on some threads and just want to touch base about Jasper. I have had a lot going on unfortunately, and haven't been on the site very much in the past week and a half. :rolleyes:
Leslie, thank you for sharing all of the information about your baby on prednisone. I am hopeful that when we look at tapering the dose that we will see some improvement in the drinking and peeing.
Jasper is still hanging in there and seems to be doing well overall I think. We had originally planned to recheck the electrolytes at the 14 day mark after the Percorten injection. My vet looked over all his labs, and decided that we will wait to recheck the electrolytes at the 25 day mark when the next Percorten injection is due, since his sodium and potassium were not terribly out of line on the last check. He will get the next Percorten on 10/29 so will have blood drawn then and based on those results we will see if any adjustment in the Percorten dose can be done for the next months dose. We will also look into considering decreasing the daily prednisone dose at that time. She said we may look at checking another baseline cortisol in a month or so.
He has been doing great with everything until a few days ago when he started to have decreased interest in eating. Started eating a few bites, and then walking away from the bowl. Most of the time he would eventually finish, but not always. I picked up some Cerenia from the vet last evening and gave him a dose last night because we think he seems to be nauseated. The vet does not think it is related to the addisons. This morning he would not eat at all. He seems hungry but acts like the food in his bowl is icky or something. I talked to my vet again and she suggested getting some pepsid to give him, 5 mg daily. She also said to see if I could get him to eat a little bit of the canned prescription food he was eating after being in the hospital. She said that sometimes when they are nauseated "they hold out for the good stuff". Lol. Well, the little stinker ate the canned food right down. I will give him some more a bit later and then try mixing some with his regular food a little later tonight.
He seems good other than the eating issue. No vomiting, and his poops look good. Energy is a little decreased, but not bad. So off I go to pick up some pepsid!
I have done quite a bit of reading about Addison's , and have not seen where they have a forum like this one. If anyone knows of one, please let me know. I did see a yahoo group, but have not joined it. Does anyone know anything about it? I am hopeful that if Jasper stays with permanent Addison's that I can continue to be involved in this forum. You all feel like my family, and I want to stay here even if he ends up not having Cushings anymore.
Love and hugs to all,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Oh gee Tina, it doesn't matter if Jasper does or does not have cushings as far as being a member of this forum. You've been a member of the family for quite awhile and we don't tend to let go of our families hands. We all hope that Jasper in fact does not go back to cushings, that he finds that happy medium once again. We have some here that have gone Addisons and are still there. It's just the nature of the beast so to speak.
Not sure what the not eating is about. The pred should be controlling the cortisol so it doesn't go to low. Maybe some of the others can give some thoughts towards that issue. At least he's not vomiting or diarrhea.
It's a good sign that he ate the canned food. If the other isn't agreeing with him tummy right now though, he probably wouldn't eat it. Molly gets like that. If her tummy is upset, or she doesn't feel so good, she won't eat her normal food. I end up having to mix in another type to get her going. Usually a bit of can on top of the dry will do the trick though. She won't necessarily eat it all once every time, but more graze at it.
Hope Jasper perks up soon.
hugs,
Sharlene
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Thanks for the update. IMPORTANT - please tell me you bought Pepcid AC and not regular Pepcid. Don't ask me what the difference is because I cannot remember but I DO remember being told NOT to give a dog Pepcid and that only Pepcid AC is tolerated.
Hopefully someone with a better memory can elaborate but I didn't want you to give Jasper something that could hurt him.
Hugs,
Kim
PS how bout that game? geez. ;)
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Kim,
Thanks for the info about the Pepcid. I got scared for a second, because I examined all the variations of Pepcid on the shelf and dont remember seeing a regular Pepcid, only Pepcid AC and Pepcid complete. My vet said to get Pepcid AC, she said I could get the generic form, so I did because it was lots cheaper. The only active ingredient is famotidine. She said to get the 10 mg dose and give Jasper half a tab, 5 mg daily. There is a maximum strength which is 20 mg per tablet, so you have to watch the dose. Is it the Pepcid complete that you are thinking of that could be harmful? It has some other active ingredients in it in addition to the famotidine. I hope it's ok, because I already gave it to him. :o
Yeah, we sure lucked out with that game. The turnovers and muffed punt returns, sheesh! :rolleyes:
Hugs,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina,
What you got is the right thing, Pepcid AC. The ingredient that you are looking for is the famotidine only.
I had to look it up on a vet info site, but that is what it said.
Hope it works for Jasper and he starts to feel better.
hugs,
Sharlene
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
:D:D:D:D:D:D:D
You did good Tina! Just had to check. Thanks Sharlene for checking it out for us.
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Kim, so glad you mentioned it!! I wouldn't have even known that if you hadn't.
It's all about team work! This forum is a family team. :)
hugs,
Sharlene
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Well, Jasper has had a rough past few days. I struggled to get him to eat over the weekend. At first he would eat some canned prescription diet late Saturday and part of Sunday, mixed with a bit of his regular food. He was getting the pepcid and Cerenia for nausea. Sun evening he barely ate with much coaxing, and Mon AM he wouldnt eat at all, even the canned food by itself. My vet had said that if I couldn't get him to eat over the weekend I could drop him at the office on Mon morning and she would take a look at him. So that is what I did.
He was there all day. His physical exam was ok. They checked his urine which showed 3+ protein, which she said she was concerned about since the urine is so dilute. I don't think he has had that before, and if he did, it wasn't that much. Based on that she rechecked the kidney bloodwork and it was all normal. (I don't have copies of the labs yet). She did an abdominal X-ray to see if there was anything going on in his belly GI-wise, and it didn't show anything abnormal. She sent the urine off for a culture to see if maybe he has a UTI which could account for the protein.
She is not sure exactly what is causing him to not want to eat. She switched him to purina EN prescription diet, he was eating that right down at the vets office. Also, she thinks that maybe the decreased dose of prednisone (2.5mg) is not enough to keep him feeling comfortable. He had been on the lower dose for about 3 1/2 weeks and doing ok, and we had hoped to try to decrease it further. He started to seem less interested in his food last week. Saturday he went to the groomer. I watched him real close and he seemed ok, but then the eating went downhill over the rest of the weekend. I am thinking that this may have been enough stress to really make him not feel well. We have increased the prednisone back up to 5 mg daily. She said that he might be a dog that needs a bit higher dose to feel well. She is hoping that this is what has caused the loss of appetite.
So he was eating the new food well, seems to like it, no problems. Yesterday I came home from work and he had had a large amount of diarrhea. :( I immediately panicked, but there was no blood thank God. My vet was not in the office but I talked to another one of the Drs there. He is now on home cooked hamburger and rice diet which he is eating and tolerating, and metronidazole. The last liquid poo was about 2:30 this morning, so he is showing improvement thankfully.
So I don't know if he got diarrhea because of the new food, if it is colitis that has flared up, or of it is because of the Addison's and low cortisol. My vet is out for a couple of days, so unless she calls to check in tomorrow, we will need to discuss the plan on Friday.
I really am trying to stay positive, but it just seems like it is one thing after another for my little baby. He is such a good boy and doesn't deserve all of this. It doesn't seem like my poor Jasper can get a break. It is so hard to see him feeling so poorly.
Hugs,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Dang hard to know the cause of the runs. I can share that canned pumpkin firms up the poop faster than anything I've ever seen. Get the plain pumpkin not the stuff with spices. Only give between a tsp and a TBS at a time (twice a day). What I have done is freeze the remaining pumpkin in little bags for future use if you don't feel like making pumpkin bread ;) Give Jasper a hug for me. Kim
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Poor little Jasper..:(
I hope today is a better day for him & you.
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Awwww Tina, sorry to hear that little Jasper hasn't been well. Leslie is right about the canned pumpkin for diarrhea- it works a treat, if you can get them to eat it. I bet you Jasper loves eating 'human food' When they stop eating like that, you try anything. Maya hardly eats any doggie food anymore!:)
I hope he feels better soon, I know how worrying it is for you. It does sound like it could be Addisons related. Those are the typical symptoms, diarrhea, lack of appetite. Lets hope Jasper benefits from this pred increase.
Thinking of you both.....
Hugs from me and Maya
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
oh my gosh. Poor Jasper really has been through the ringer. Well, both of you have.
Hope he is feeling better. Everyone says that Pumpkin is the thing to try for the "runs". I'd go with Kim's suggestion and try it. I wish I'd known about it back in March when molly got the runs so bad.
hugs,
Sharlene
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Thanks Everyone! Jasper is hanging in there, again. He continues on the hamburger and rice home cooked diet, and has been eating that well. He will have that through tonight and then tomorrow I am supposed to start mixing in a bit of the canned i/d prescription food to see if he will eat that. Then gradually increase the canned food to taper him off the home cooked. Then we will look at what food he will eat for maintenance. My vet said she will be handling him with kidd gloves since all of this has happened. We will be taking it very slow. The diarrhea has resolved with the diet and metronidazole. In fact he is pooping less than normal, I hope now he isn't going the other way! He has a history of getting backed up from time to time in the past. I hope that doesn't happen now from all the rice. I have noticed that his drinking has decreased significantly over the past 4 or 5 days also. I imagine that is related to the diet.
The urine culture came back negative, so now my vet has sent urine for a urine protein creatinine ratio test (?) which she said will quantitate the amt of protein in his urine, since an infection is not the cause. (I think that is how she said it). We don't have those results yet. I am kind of worried about that.
Tomorrow he has a previously scheduled appt to have blood drawn to check the electrolytes again, as it will be 25 days since the last Percorten injection. He will also get another injection. He also continues on the prednisone at 5 mg daily.
He seems to be feeling much better overall, and I am very grateful for that. It seems that this is all very complex and it is a very fine line to keep things balanced and to keep his little body feeling good and with some level of stability. It sure doesn't take much to rock the boat anymore.
I hope everyone's pups are doing well, and you all are enjoying the weekend. :)
Hugs to all,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Great update. Fingers crossed for good results on the testing and weaning. Keep us updated! Kim
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Sounds like your vet is doing a good job keeping an eye on Jasper and trying to figure out what is going on with him.
Hugs,
Sharlene
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Everyone,
Sorry for being absent, I had a pretty rough time with work last week.
Jasper had his appt last Monday and had electrolytes drawn. He also had another Percorten injection. The vet decided to decrease the dose by a little, 10%. The dose he gets is 1ml, so that decreased it by 1/10 ml. She decided on the decrease since he has continued to have increased drinking and urinating, and this can be a side effect of Percorten if the dose is too high.
We got the results of the electrolytes the next day, and both his sodium and potassium were wnl. So that is great news! The results of the urine protein creatinine ratio came back at 1.27. I don't have a copy of the lab report, but my vet said < 1 is normal or a good result, > 2 indicates that further evaluation needs to be done and that treatment is needed. An in between result warrants monitoring and is kind of a gray area. She said she was a bit concerned by this result and isn't sure if the protein is increased because of the Cushings (even though it is controlled now), or if there is something else going with his kidneys, and if treatment should be considered.
We have one IMS in town (actually in the whole state, I think), and she said that she wants to work up a case study type of report on Jasper and send it to him to review to see what he thinks and maybe get some recommendations. She wants his opinion specifically regarding the amt of protein in Jasper's urine, what might be causing it, and if he feels treatment is needed. She also wants his opinion as to why Jasper has continued with such increased drinking and urinating even though his cortisol is so low. She said that he is real good about giving consultations, but that sometimes he wants to see the dog himself. Of course I will do whatever they recommend. I appreciate so much that she is willing to take the time and effort to do this for Jasper, and that she wants to make sure that she hasn't missed anything, and also that her treatment plan is the best plan. He has been through a lot, and it has been very complex. I am sure it won't be easy or quick to get it all in a report.
Jasper is now transitioned completely to the canned prescription i/d food, and beginning Tuesday, I will start mixing in a little of his regular dry food to start transitioning him back to that. His appetite has been real good while getting the canned food, I am hoping that continues once I start mixing back in his regular food. He continues on prednisone 5 mg daily. My vet said we will try to start tapering that down once we get him back on his regular food. One change at a time so we can keep a very close eye on things.
He seems to be feeling good with how we are managing things now, but I know he can't stay on that high dose of prednisone, or the canned prescription diet. He has been through so much, I just get a little anxious to start changing anything. I have noticed for about the last 10 days or so, his water intake has been decreased. Still a bit higher than normal, but much better, and some days has actually been about normal! Not sure why that would be happening now. The vet is aware and she isn't sure either. It would be nice if it would continue, I have actually gotten some sleep for a few nights!! :D :cool:
So I will wait to hear what the IMS thinks about everything. I am so grateful that my baby boy is feeling better. And fingers are crossed that he is on the road to some level of stability now!
Hugs to all,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Tina, Thanks for the update. Yes, that IMS is out of Kansas State's vet hospital and if you have to go there they will work with your vet closely. I ended up going directly to K State (long story) but I was very very impressed with them. You're in good hands. Take care and keep up the good work. Kim
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi, good to hear from you Tina. Totally sympathize with the busy work situation. I'm glad that Jasper seems to be feeling good these days. It's always so stressful when they aren't.
I think it's usually beneficial to have an IMS consulting with your vet. I love it when a vet suggests the consultation themselves too. :)
hugs,
Sharlene and molly muffin
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina, I am not sure if this is relevant but my non CUsh pup Koko had a physical with these results- vet was mentioned could be Addisons or the start of kidney disease and that I should watch him and retest him.
Bun is marked 33 normal is 7-27
Creatinine is 1.7 normal is 0.4-1.8
Specific Gravity is 1.025
PH is 7
no protein in urine
I think consulting with an IMS is a great thing. I hope you and Jasper have a good week and work is not so hectic for you:):)
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina! Hope everything is going well with you and Jasper. Not working too hard I hope.
Hugs,
Sharlene and Molly Muffin
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Thank you Sharlene, Kim and Addy for checking in on us and for your comments. I made it through another somewhat wicked week at work. My immediate co-worker has been out due to a family illness, and then on funeral leave :( , so it has been a little rough on the work front. Things should be improving in the coming week, I hope! Thank goodness Jasper hasn't had any emergencies or critical issues during the past couple of weeks!!
I started transitioning Jasper back to his regular dry food on the morning of 11/6, slowly mixing in a little with each meal. Well darn it, by 11/8 am, he had a loose stool. Of course I immediately feared that the colitis was going to flare again. I put him back on all canned prescription diet immediately, and he did not have any more loose stools thankfully!! Now I am thinking that maybe he is not going to be able to tolerate going back to his Blue Buffalo food, even though he had not had any problems with it before (other than not wanting to eat it!). Talked to my vet, and she recommended that we transition him to the dry version of his prescription canned food and see if that will work to get him off the canned. It is Hills prescription diet i/d low fat GI restore dry food. I am not too thrilled about it, and I know how some of you here feel about Hills/Science Diet and I can't say I disagree, but I am going to try it. I talked to my vet about it and she understands my feelings but said that she really does like their prescription diets. So far he is willing to eat it (yesss!!), and tolerating it just fine. I started mixing it in yesterday morning. My vet said we don't need to keep him on it forever hopefully, but need to get him off the canned food for a time, and then can think about trying the BB again.
We also discussed the consult with the IMS and his feedback and recommendations. She asked him about two issues, the protein in Jasper's urine, and his continued increased drinking and urinating.
1. Protein in the urine: The IMS suspects that it is caused by a combination of Cushings and the steroids and is not an indicator of another problem. (Yay!!) He suggests to monitor it for now, and recheck the protein-creatinine ratio in a month or two. He said that frequently the urine protein will stay high in dogs with Cushings, even once the Cushings is controlled. He also said as long as the steroid dose is high, protein will continue to spill in the urine, so it may be related to the increased steroid dose.
2. Increased drinking and urinating: The IMS felt it could be related to the Percorten injections. He said some dogs are sensitive, that it is not common but is possible. He also said it could be the steroid since Jasper is on an increased dose. He feels that the 5 mg dose is above a physiological dose for Jasper, which could be causing the increase in symptoms. He suspects that is not a function of underlying disease but a function of one of his meds. (Another yay!!)
He said that he is not convinced that Jasper needs the Percorten injections since his electrolytes have not been really highly abnormal other than the time he was in the crisis and was so dehydrated. He wonders if Jasper has a glucocorticoid deficiency but not a mineralocorticoid deficiency.
The only way to determine this is to not give the Percorten injection when it is next due, but check the electrolytes at that time and then again in 10 days, and then in another 10 days. We would need to watch for Addison like symptoms to return.
He also said that we should try to decrease the prednisone and see if Jasper continues to feel well. (This was already in the plan). If he can't tolerate that, then the IMS said to consider another steroid such as dexamethasone. He suggests to see if we can decrease it to the 2.5 mg daily dose. (This was the dose he was on for about 3 1/2 weeks before he had the last episode of not wanting to eat and the colitis flare).
Conclusion: My vet and I were very relieved that he didn't identify a bunch of things that should have been done differently, or that were missed. :) ;) And also relieved with his opinions that he didn't think there were additional problems going on that were causing either issue.
The plan is still to get him transitioned to a dry kibble diet, and once that is stable, consider trying to decrease the prednisone dose if everything is going ok. We will discuss whether to give the next Percorten injection or not, depending on where we are at with tapering the prednisone. Right now, his next injection is due the day after Thanksgiving, so I don't know if I want to try to rock the boat then. Plus, we haven't been able to try to decrease the prednisone yet because we have had set backs with getting the diet stabilized. Of course, it won't be any more convenient in a month, closer to Christmas. We will be discussing it to see what we feel is best.
So that is where we are at. SO sorry this is so long, but it helps me to get everything documented in once place for my records also!! I don't know how many times I have gone back to my posts to see when something happened, or a timeline for something, so that I could report accurately to my vet.
Jasper seems to be feeling pretty good overall. I am keeping my fingers crossed. Thank you all SO MUCH, and hugs to anyone who takes the time to read all of this!! As always, I greatly appreciate any feedback, comments or suggestions! :)
Love and hugs to all,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Tina, I am impressed! It is so nice to have an IMS in our state now and they seem to be on top of things as is your vet! Overall great news and a solid plan. Keep us posted.
I know what you mean about using your thread as a timeline/reference - it is really easy to go back. You might want to periodically save the thread to your pc for safe keeping. (just as a backup)
Good job mom! Thanks for the update. Kim
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Thanks so much Kim! Yes, it is a blessing that we have an IMS in Nebraska now. I forgot to say in my last post that my vet sent Jasper's complete report of everything that has gone on from the beginning, with dates, etc, but she just focused her questions on the two issues I listed. So he is aware of everything. I am sure it took her quite a while to get that all together. I appreciate her so much and feel very lucky.
At the risk of sounding stupid, how do I save a copy of my thread to my pc? I have often thought that I would like to save it somewhere just in case.
Hugs, and thank you again for your ongoing support,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina-
I'm so glad to hear Jasper is in a good place and that you got lots of good news after your vet appointments. I'm glad you saw the IMS and that he and your vet are in contact and in agreement. That is always helpful! It sounds like the food transition is going well too! Hopefully someday you can take him off the Hills diet altogether, but at least for now the diarrhea is under control and Jasper is willing to eat the dry food.
As for coming back to the forum to check on what was going on/keeping a record/I do the same thing! It is a wonderful place to come to refresh my memory if needed!
I hope that work will calm down for you soon and that Jasper continues to do well!
Julie & Hannah
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
There might be an easier way but I go to "thread tools" upper right side and select "printable version" - you get the page of the thread. I copy and paste that into a word doc. 20 pages means you do it that many times but you have it.
If someone has an easier method I'm all ears! :D
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Tina, thank you for stopping by and checking on me and Zoe. I alway check on you and Jasper too. I am glad things are working out with the IMS and with the colitis. It is sogood to have that under control. When I had to transition Zoe from her prescription diet, I had to go very slowly, one teaspoon a meal sometimes.
Thank you for the tip about Zoe standing next time for her blood pressure. It is a life saver for sure:):):) She gets so stressed but I cant say I blame her with all the poking, etc and frequent visits.
(((((((Hugs))))))))))))))))
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Tina! omg! A Plan!! We have a plan. LOL Doesn't it feel good to at least have a plan in place and know what you are aiming for in the coming weeks, months ahead. Something has simple as making the diet change, deciding on the injections, it all gives one a sense of at least semi control of a situation which has waaayyy too many days of out of control stress. You have had plenty of those. You and Jasper both really deserve to have a controlled, relaxing holiday season. :)
Thanks for stopping by and saying hi to Molly's thread. People here are so great!
hugs,
Sharlene and Molly Muffin
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Yay Jasper & Tina!! sounds like things are moving in the right direction. I am like you. I like to document everything here. Anyway else in my house & there is a good chance it will get lost. :rolleyes:
Glad things are flowing smooth for you.
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Thanks for the kind words everyone. We are continuing the food transition and so far so good. Jasper is continuing to eat well, and his poops look good. I am going to decrease the canned food again tomorrow. My vet called last evening for a report and feels he is doing well enough to start tapering the prednisone again. :eek:
He started with the decreased dose this morning. It is now 2.5 mg daily, down from 5 mg which he has been on for the past 3 weeks after he stopped eating and broke with colitis. Even though he did well on this lower dose for over 3 weeks when we tapered him the last time, I am a bit worried about decreasing it. Logically I know it should be ok, but I just get scared to rock the boat because he has been feeling so much better.
My vet plans to check in again in a week, and if he is continuing to feel good, we will need to discuss whether or not he will get his next injection of Percorten, which is due 11/23.
I have noticed that his drinking and peeing have increased again over the past week or so. :( It had been better for about 10 days, but now is increasing again, and we are back to going out at least once during the night again. I can't really explain either the decrease or now the increase as no meds had been changed during those times.
So my goal is to not have a need to call the vet for anything for the next 7 days. That would be a record at this point! :D :cool: :rolleyes:
Hugs,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Happy weekend Everyone!
I have Jasper completely transitioned to the dry prescription low fat i/d diet as of last evening. He had his second full dry meal this morning and he is eating it all. A bit less enthusiasm than with the canned food, but he finishes. Hope that will continue. Poops have been good so he seems to be tolerating it well! :)
We started tapering the prednisone again and decreased the dose to 2.5 mg daily starting 11/13. I think he is doing well with that also, although seems to maybe feel not quite as perky as on the higher dose, but I will keep an eye on that.
Last week I noticed that his water intake was trending up again. It started a few days before we decreased the prednisone, but after looking at my journal this morning and comparing dates, it significantly increased beginning on 11/13, the day we decreased the prednisone. On 11/13 and 11/14 he was back up to drinking 7 cups (56 oz) per 24 hr period. He had been drinking around 35-40 oz/day for about the week prior, then kind of crept up to 48 oz for two days, then the 56 oz like I mentioned. Well, for 11/15 and yesterday 11/16 he drank a whopping 72 oz per day! I was off work yesterday and I was literally letting him out every 1.5-2 hrs. We are back to getting up at least twice or more during the night again to go out. Ugh! :eek: :eek:
Looking at the dates, it seems to correlate a lot with decreasing the prednisone, but this does not make sense to me. The IMS felt that his increased drinking and peeing was likely medication related and recommended decreasing the prednisone, which we had in the plan anyway. I would think the water intake should be trending downward with the decrease. I realize that Jasper has not followed the rules for anything else through this journey, so maybe this is another example of that. :confused:
He had a period from about 10/24 to 11/10 where the intake was consistently about 40 oz per day or less, and some days it was even normal. He had a colitis flare during that time, and was on the higher 5 mg prednisone dose during that time, so I don't know the explanation for the more normalized water intake. Now I really don't know what to think. Today he seems to be almost constantly at the water bowl.
Thank you all for any opinions or feedback.
Hugs,
Tina and Jasper
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Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina,
Yay on a successful transition back to dry food for Jasper.
I'll let others comment on possible reasons for the water intake changes and prednison. I'd just be guessing. My thought is that the prednisone maybe makes him feel better, but not as thirsty, whereas when the pred is lowered that changes somehow. Remember pred is addictive and they have to be weaned off of it, so how the body reacts to that lowering could manifest in different ways and Jasper has shown himself to be pretty sensitive to medications.
Anyway, hopefully someone else has experience and a better explanation. I'm just guessing.
hugs,
Sharlene