Have I finally found my friends? (Palmer has crossed over the Bridge)

Hi!
Palmer just had his latest stim test. His eating, drinking, tummy symptoms had returned the last time he was tested and his Pre #s were the highest we've had and his post #s were the second lowest we have had. If you look back at the 6/09 numbers they were very good. The bad numbers showed up 10/09. We had a stim test in Oct and his pre/post were 1.8 and 3.6. The only difference in what we were doing is that we shifted over to compounded drugs after 6/09. After 10/09 we went back to Vetoryl. Now all of his numbers are well within their ranges except for Alk. Phosphatase....that has always been high. Does anyone know if that is something to be concerned about?
The weather here has been bad all winter. Either too cold or too wet. We've had three "hundred year" floods. I got him a remote control car to play to give him some exercise.The funny thing is he is more interested in the little wire on the remote control! He acts as he would if a bug were flying around his head. It's soooo funny.

Other than that the tummy goes up and it goes back down. He seems to be feeling very well and will turn 13 next month. I just wanted to share the good news.

-Susan

Hi Susan!

It is good to hear from you, we have missed you and hearing about Palmer.

Re; the Alk. Phosphatase (ALP), is his ALT within normal range? If it is, then I wouldn't be too concerned with the ALP being elevated...out of curiosity just how high is Palmer's ALP? The ALT is more specific to the liver than the ALP.

Quote:

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We had a stim test in Oct and his pre/post were 1.8 and 3.6.

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If his pre was 1.8 and his post was 3.6...these to me look like pretty good numbers, tho his post could go higher, say to 5.4 according to Dechra. How are Palmer's symptoms now? If his symptoms are still present then most likely his intermediate/sex hormones are elevated, especially if his cortisol is being controlled.

I bet Palmer is having a blast with his new toy! My cat would love to get his paws on that car too!

Please keep us updated, and it was so nice hearing from you.

Love and hugs,
Lori

Susan, Lori brings up a very good point. If you are definitely seeing a "rebound" in some of Palmer's symptoms with the cortisol under control, it's very likely that elevated intermediate hormones may be the culprit/s.

Debbie

Hi Susan,

So good to hear from you! :cool::) And with good news to boot! :cool: It sounds as if our Palmer is handling his meds ok and feeling quite good. As long as he is acting good and the numbers stay good, then your goal has been met. ;)

It sounds as if the compounded drug didn't work well for Palmer. Interesting..... I wonder why? Someone else had trouble with compounded meds...it gave the pup diarrhea. Turned out the culprit was one of the mixers used by that pharmacy; a colored additive, if memory serves. Just goes to show that these babies are individuals and what one can handle, another cannot. ;) You are such a smart mom to go back to the brand name! :cool: I'm glad that did the trick for Palmer!

I would love to see him chasing the "bug" on wheels! That sounds hilarious! :p And what a great idea for exercise! I wish that would work with Crys, but she would have to "kill" the remote vehicle and eat it. :eek:

Keep in touch and let me know how Palmer is doing...and you! I hope you both continue to flourish.

Hugs,
Leslie and the girls - always

Hi gang!

Lori-Palmer's ALT is 89 which is within the range. The only other time we got an ALT test result was back at the beginning and it was 200 (9/08).

Debbie-I never have understood what "elevated intermediate hormones" refers to. I asked the vet if she knew what they were (way back) and she said "no." Can you help me understand that? :o:o:confused:

Leslie and the girls- Palmer's remote control car is way too big for him to get it into his mouth. It's about 12" long, I think. I had to make sure he would not be able to try to swallow it. It seems there is nothing between the tiny ones and ones like this, size wise....unless you want to pay big bucks. It's made by Tyco and is call Stunt Psycho. It goes forward, back and around in circles. It will flip over and then you can get it to right itself. As I recently had foot surgery and am having more knee surgery on Monday, I had to have something that would take care of itself. I won't be able to be chasing something around to put it right side up:D:D:D. When you turn it on, it has headlights that light up. :cool::cool::cool: It doesn't make much noise. You can turn it to the left and turn it to the right. It will even do wheelies! It's simple enough that I can operate it. Now that the weather seems to be getting nicer, we may take it outside and play with it on the lawn. I'll try to get a picture of Palmer and his new toy this weekend. It really is a hoot!!:cool::)
Thanks for responding....it's so nice hearing from you all. I will try to get back here more frequently.

-Susan

Hi Susan,

It wasn't clear from your earlier post whether or not Palmer is still suffering from an increase in Cushing's symptoms, or whether he's OK now that you've switched back to the brandname Vetoryl. Also, what were the actual results of the stim test that you just had done?

Those two pieces of information will help us know whether or not there may be an issue with Palmer's intermediate hormones (and I'm afraid I've got to run before explaining in more detail what they are -- but I know that somebody else will do so!)

Marianne

Hi Susan,

Quote:

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Trilostane always increases 17-hydroxyprogesterone (some cross-reactivity with pregnenolones in assays??), and frequently increases estradiol and androstenedione as well.

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This is from the UTK treatment option sheet.
http://www.vet.utk.edu/diagnostic/endocrinology/pdf/Treatment%20Info,%20Atypical%20Cushing's,%20revise d,%20Oct.,%202009.pdf

The 5 intermediate/sex hormones: (Estradiol, Androstenedione, 17-
Hydroxyprogesterone, Progesterone and Aldosterone) all are made from the adrenal glands, now the estradiol is made from the adrenal gland and other places.

Since Trilostane increases some of these hormone levels, a pup's clinical signs can come back even when the cortisol is being controlled.

Hope this helps.

Love and hugs,
Lori

Gosh-I thought for sure I had posted the stim test numbers. His pre was 3.6 and his post was 10.4, His symptoms have decreased - his tummy looks good, his thirst has calmed down and his eating is way down. He's been kind of "punk-ish" the past two days, but he seems to be fine.

With regard to the intermediate hormones, I still don't understand what it means if they are elevated. How does that affect them? In looking back, I see we have had those results only once and that was with the original UTK testing. I don't know why the testing that is being done is not including those readings.

He turns 13 on the 20th. I know he's looking forward to that. ;);)

Thanks for getting back to me!

-Susan

Hi Susan,

Only the lab of the University of Tennesse run by Dr Jack Oliver, can do the full adrenal panel which tests the 5 intermediate/sex hormones.

The intermediate/sex hormones if elevated can make their clinical signs come back even if their cortisol is controlled. By clinical signs, I mean a pups symptoms would emerge again.

If Palmer's symptoms haven't returned, then I wouldn't worry about this. If his symptoms do return and his cortisol is being controlled then I would concern myself with this.

Hope this explains it better. :)

Love and hugs,
Lori

Quote:

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Originally Posted by Palmer's Mom

Gosh-I thought for sure I had posted the stim test numbers. His pre was 3.6 and his post was 10.4, His symptoms have decreased - his tummy looks good, his thirst has calmed down and his eating is way down. He's been kind of "punk-ish" the past two days, but he seems to be fine.

-Susan

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Hi Susan,

That's great that Palmer's symptoms have improved and that he is generally doing well (hope he's no longer feeling "punkish" by the time your read this reply!). However, with a "post" result of 10.4, if you DO start seeing a rebound in his symptoms, I think you'll first want to increase his trilostane dose before worrying about the possible effect of any elevated intermediate hormones. His stim result was higher than the level that is recommended by Dechra (the manufacturers of Vetoryl). As you'll see on their Treatment and Monitoring Flowchart, the ideal "post" result is between 1.45 and 5.4 ug/dl. However, as long as symptoms are controlled, they're OK with a result as high as 9.1. But Palmer is now even higher than that. So if you do see a return in his symptoms, his cortisol level is the primary issue that needs to be addressed. Here's a link to that Flowchart:

http://www.dechra-us.com/File/vetory..._Flowchart.pdf

And all best wishes in advance for Palmer's Happy 13th Birthday on the 20th!!

Marianne

Thanks Lori. That's a big help and I'm glad you explained about those results only coming from UTK.

Marianne - thanks for the link and for your thoughts. Palmer is feeling better today-except for this sudden burst of hot weather.

Guys-keep an eye on the photo page. I now have pictures of Palmer with his new toy.....plus there is one from the snow you might get a kick out of.

-Susan

Hi! :D

I just wanted everyone/anyone to know Palmer has been doing well. He goes in next week for testing. Apart from the 90+ degree heat, he is doing very well. The belly has trimmed down.....he's not eating as much. His thirst seems to be moderate. The distended tummy is a good bit smaller. His energy level is pretty good for such an old dude! All in all he is managing the summer pretty well. We go in for a test next week...just the regular 4 or 5 month test. The walks are not as long....but then it has been in the 90s for quite a while. He is still very playful and seems to be "truckin' along" just fine for now.

I am happy to be able to post such a positive report! :):):)

-Susan

I am happy to hear Palmer is doing better!

I merged this thread with your other one so others can see how far you and Palmer have come. :)

Terry

Hi Susan!

It is always great to hear from you and Palmer. So very happy to read that Palmer is doing so well. The heat and humidity is just awful! :eek: Wishing you and Palmer the best of luck with your stim results. Please keep us updated.

Love and hugs,
Lori

Hi Susan!

Good to hear from you again and especially to hear that Palmer is still doing so well!

Keep in touch and let us know how the test turns out.

Hugs,
Leslie and the girls - alawys

Hi guys-

Palmer's test results were outstanding. I've not had time to input all the detail, but I will get around to it.

I'm here to let you know Palmer has been very sick. He has eaten maybe a total of 1/2 cup of food in the past week. His medicine is administered via his food, so he has not been getting his meds. He has had diarrhea since Wednesday. He was mostly not drinking water. He does not appear to be out of sorts otherwise.

We went to the vet yesterday and she gave us diarrhea medicine. She also gave Palmer fluids, saying he was dehydrated. Lots of fluids. He looked like he had football pads on! He has started drinking more water, but the diarrhea remains unchanged. She called this afternoon to see how it was going and I told her "no change." She has now given us appetite inducer, something to settle his stomach and a tube by which we will hopefully be able to give him his meds without getting bitten. :mad:

The next step, if we need one, would be fecal testing. That's close to $300. The next step after that, if that doesn't provide us with the answer, is a sonogram. That's over $500.

His tail is down. He likes being by me but not too close.

I knew you guys would understand how hard this hits. We are coming to a crossroad and, if he does not get better, and does not start eating, we're going to have some hard choices to make. We had to go through this process with our first dog and taking that action was the hardest thing I've ever had to do......and I've had some bumps in my life.

We're giving it a day or two and then we'll revisit how he's doing.....if he's eating and not having diarrhea and is keeping his fluid level up.

The ACTH stim test was just about perfect. This is quite a shock.

-Susan :(:(:(

Susan, $300 for fecal testing, that is OUTRAGEOUS! I just had fecals done on both of my boys, & the total for both of them was $110. All they do is screen the sample for the possible presence of parasites. IMO, I would be asking just exactly what kind of testing is being done on the sample, & why so unbelievably expensive.

I'm so sorry to hear that Palmer is not doing well. Hopefully, the medicine & fluids will help. Have you been given medicine called flagyl or metronidazole for him?

Debbie

I wonder if the part of the fecal testing cost is the giardia blood test. I was considering doing that on our new pup Cooky but everything I read says it's very expensive. Unfortunately, the usual fecal test does not pick up many cases of giardia, and that might well be a possibility for Palmer. I also found that there's a medicine (dewormer, basically) called panacur that is supposed to be effective in cases of giardia and that it may be cheaper to just give that drug than to run the test for giardia. At least, that's what I was reading. Sue

Oh Susan,

I am so sorry Palmer is feeling so ill and I do hope and pray that he feels better soon.

When was he last dose of Trilostane? His vet did tell you to stop giving him Cushing's meds, right?

Will he eat baby food or chicken broth without onions? Plain, unspiced canned pumpkin can be given to our pups for diarrhea.

Keeping you and Palmer in my thoughts and prayers.

FWIW, I just had both of my boys done...fecal tests and giardia tests, the giardia test is a seperate test. The total for both of my boys was $200.00. My vet charged me $80.00 each for the giardia test.

Love and hugs,
Lori

Hey Susan,

Oh, I don't like reading this post, honey. :( You sound so defeated. :( Don't let it get to you just yet, ok?

Since the ACTH was good, then we can assume he isn't overdosed...unless there was a major error on the bloodwork. So that would lead the thoughts to parasites or an inflammation/condition in the digestive system as the next thing to look at. Squirt has had several bouts of spirochetes but meds took care of them with no problem. She also had a round with giardia several years ago and that was much tougher to get rid of...but the testing wasn't near that expensive! I wouldn't have been able to afford it at that rate. geez.... I wonder if this is a special fecal test of some sort? I can't remember the drugs she was given for the giardia but it seems like there were 3 different ones at the same time, and she was one sick little girl.

Is there any way the vet could keep him on fluids and IV meds for a day or two? That would give his system a chance to settle down and not have to digest meds, food, etc. If not, you might ask if there is a liquid alternative for the drugs he needs now. And that does not include the Trilo, melatonin or lignans. I would withhold all of those for now...give only what he has to have to help his system right now. I wouldn't try feeding him right now, either. Let him have 24 hrs or so without anything solid and see if that helps at all. You might also add some Pedialyte to his drinking water. The plain, unflavored kind.

Don't give up hope. OK? We will help you and Palmer fight this. He is a tough little fellow, and so are you. So just keep your chin up, sweetie.

Hugs and prayers for you both,
Leslie and the girls - always

Susan,

They go through periods up and down.

Like the others I am thinking it is not the Cush treatment.

The Cush treatment can lead to other issues as a Cushpup is imunosupressed.

A dog eats. A dog which will not eat is sick.

I also do not get the exhaustive fecal tests.

I think you need heart/liver results.

Scott

Debbie-One of the four medications we've been told to give right now is the metronidazole. The vet specifically told me to give the Trilostane.
Re: fecal testing-it is a number of tests. 3 I think.

I'll bring up spirochetes and giardia blood test. Regarding the eating-He has not eaten anything for one week. NOTHING interests him.

Lori his last dose of Trilo was 1/2 hour ago.

Scott-he has a heart murmur, but it seems okay to the vet. The liver is a possibility-when they gave us the original ACTH results-the special place, not Palmer's vet...the doc spoke of a liver biopsy. The cost for that was out of the question and the vet seemed to be playing that down.

Thanks to all of you for such a quick response. I am indeed very upset. This is my little guy. Your support is wonderful. I'll give you an update tomorrow.
Susan

Susan,

Sorry to hear that Palmer isn't eating. Annie just went thru a similar situation - no diarrhea but stomach cramping and she would hardly eat. Here are the tests I had done:

complete blood panel
B12/Folate (can indicate bacteria in intestines)
Pancreatitus
Ultrasound (to get a good look at what is going on with organs)

After those tests and more that I have forgotten and 2 months of no progress I took my dog to Kansas State (closest specialists) and they did a bunch of tests and finally got the dx when they did an endoscope. She had a nasty bacteria in her stomach that had caused ulcers and bleeding. Sores going all up her esophagus. Who would have thoughts.

Just sharing in case that helps you at all... Kim

Susan,

Is he drinking without being coerced? And if so is his thirst normal?

I think this is one ounce/lb/day.

Scott

Thanks Kim. I am on my computer to put together a fax to send to the vet so she'll have it first thing in the AM. I will include your thoughts.

Scott-there is NO coercing Palmer to do anything. His water intake has slowed down from what it was earlier on. When he comes in from outside, he usually goes right for water. The quantity, however, does seem to be down a good bit. He had two major messes on the carpet this evening....he didn't even let me know he wanted to go out. I don't understand what could be coming out since nothing is going in. We tried rice, this evening, and I just tried some very small bits of steak. The steak he was eating....it was our last resort. Now-nothing. I just played with him a little bit-pushing my hand around his head and he playfully gnawing on my hand.....very gently. He has been shivering this evening.....but the house does get cooler for sleeping. He won't touch the treats.....we have tried everything. I'm guessing at this point he has gone beyond feeling the hunger.

I just don't know where to go with this. He had four needles stuck in him yesterday-three for fluids and heartworm test. He screamed. I've never heard him make that sound. It was almost like a sharp moan.

I think we're meeting with the vet tomorrow. I'll keep you all updated.

Thanks.

Susan

Susan I am so sorry to hear about Palmer - here's hoping he will find something tasty enough to start eating again and that the vets have some answers for you tomorrow.

We are here for you honey,

If it were me I would definitely stop the Trilostane. If Palmer is not eating he is not absorbing the Trilostane properly: CLINICAL PHARMACOLOGY:
Trilostane absorption is enhanced by administration with food. http://www.dechra-us.com/files/dechr...ts/Vetoryl.pdf

Missing a few doses of Trilostane, I don't think, will do any harm, in fact it might be what Palmer needs. Even though his ACTH numbers were perfect just maybe they were too low for Palmer. One can not go by numbers alone, one should take in account the way the pup feels too. JMO. Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

I'm with Lori on this one. I would not be giving trilo to a dog that wasn't eating.

Palmer is obviously feeling pretty awful and so I wouldn't want to make him feel any worse. Skipping a few doses wouldn't hurt and it may just help.

Hoping for some good news.

Jenny

Hi Susan,

I am so sorry that Palmer is having such a tough time right now. I would assume your vet has done bloodwork, yes? Can you please post the abnormal results for us, including the reference ranges? Has your vet told you what he thinks the problem is? Pancreatitis, renal failure, primary liver disease?

I absolutely agree with the others....there is no way I would be giving my dogs Trilostane if they were in Palmer's condition. No way, no how!!

Glynda

Susan, Just wanted you to know we are all thinking of you and wishing the best for Palmer. Big hugs, Kim

Good Morning.

Palmer had another round of diarrhea around 2AM....outside :D

After that we were able to give him about an ounce or so, if that, of sandwich turkey. He turned up his nose at bread.

This AM he got up and had a good amount of water. I just tried to get him to go for a walk and he is not interested.

Sent my fax off to the vet and have not heard back yet.........she'd just be getting in about now. I know she will call when she can.

He has become more needing of closeness.... of which I am happy to oblige :)

More news as it becomes available.

Thanks to all of you for being so supportive.

-Susan

Just curious as to what those 'outstanding' ACTH results were? Sounds like it's been 3 or so weeks since the test was done. Do you have the specific results or can you get them and post???? Because I know from experience with Zoe, that one time her numbers fell dramatically - to .7 and 1.6 when she'd always been difficult to get below 5. Don't know to this day why it happened. But it's possible so I wouldn't rule out an unexpected drop in the last couple weeks. Sue

PS - then again, if it is something like that, by stopping the trilo, you might see improvement. Electrolyte testing could shed some light.

Hi Gang-

Saw the vet late afternoon. She okays the stopping the Trilostane.
We are running three different "tests."
Fecal test which will include parasite testing and Giardia test.
Complete blood panel.
B12/Folate test

I am also going to make an appointment to see the internist for a consult and for abdominal ultrasound. If the aforementioned tests give us an answer, I can cancel the Ultrasound.

Palmer had his last bout of diarrhea at 2AM. His total intake today has included some water and two 1" length pieces of a Snausage.
He is more sedate today.

I asked the vet if at some point we would administer nutrition and she says if he doesn't get better, we can do that.

Palmer will go in early tomorrow AM to have his blood drawn and so the vet can get another "look" at him. The fecal results should be back tomorrow.

The vet is perplexed, so far, as to what is causing all this. We did have a lawn treatment one week ago, today. Palmer often chews on grass. I don't know if that occurred before we could get the stuff watered in. The vet said one week later is entirely possible to be continuing to have a reaction to that, if he did it.

Okay - here are the test results from 7/8/10.
(You will find a number of earlier results posted earlier.)
Pre ACTH 3.7 Range 2-6
Post ACTH 4.8 Range 60-018.
We had high results in the following;
Alk./phosphatase 567 Range 10-150
GGT 18 0 - 14
Bun 57 7 - 27
B/c ratio 35.6 no range shown
Anion gap 25 12 - 24
Neutrophil Seg 82 60 - 77%
Auto Platelet 799 164 - 510 Thous/ul
Absolute neutrophil Seg 13694 3000 - 11500/ul
WBC 16.7 5.7 - 16.3 Thous/ul
He was low in the following;
MCHC 31.8 32 - 36 g/ul
Lymphocytes 8 12 - 30%

If it comes down to needing a liver biopsy, we are not going to put Palmer through that. That was raised when we first tested w/UTK and at that time we agreed we would not put him through that.

So that's today's events. He is sluggish and not drinking much water-but drinking some. We have tried a gazillion different foods and he has interest, but then turns away. He's crashing on his bean bag bed now and we'll go cuddle up in our bed soon.

As always-thanks for the support and the suggestions.

Susan & Palmer

Susan, I don't know if you know what Palmer's normal water intake is per day but I would measure out water and start tracking it. While food is important - water is critical. Annie went as low as 1/4 cup one day.

You have probably tried all foods known to man but just to be safe... when their tummies are upset they always say to try the simplest easiest things to digest. Homemade chicken broth, white rice, chicken breast are my standbys. There were days when broth was all I could get her to take.

Heating food makes it more attractive. Try giving him things that are easy to digest to see if that helps. I assume you tried canned food - have you tried totally new food groups like venison, buffalo etc? You can find them at most pet stores. Usually combined with sweet potato. I also cooked sweet potatos. Annie did eat those. Boil eggs and give only the white part - it is a protein source.

Try sneaking some pedialyte into his water for extra nourishment. Babyfood (chicken, sweet potatos)

I didn't realise you had just done a blood panel. There are enough things elevated in the last one to perhaps point to something. Maybe Deb has some thoughts.

Was Palmer eating when that panel was done? Annies lymphocytes were off as well due to her bacteria infection.

Other than diarrhea - do you hear his stomach growling/gurgling? Can you feel it churning? I know this is tough because I just went thru it and you feel so helpless. I send my very very best wishes your way. Kim

Susan, the couple of things I see are the elevate WBC, & absolute neutrophil count. The elevations are not extreme, but they are an indication that there is probably an infection somewhere. That BUN is pretty high, but was Palmer's creatinine normal. Dehydration will elevate a BUN, but as long as the creatinine is normal, this may not be a kidney issue. I don't have time tonight to recheck the past couple of days posts, but were the result of the stim you posted at the beginning of the month before or after Palmer got sick? If they were before, I think it's imperative that you run a stim ASAP. Even though trilo should clear the system in about 12 hours, if Palmer's adrenal glands have suffered any damage, this may be the actual problem. What has the vet said about trying some prednisone to see if it might help?

Debbie

PS- Concerning the pred, it won't hurt Palmer. The several times that Harley has had a severe round of vomiting for unknown reasons, my vet has always wanted me to try the pred, first. When he showed no improvement with the pred, we started looking at something else besides Cush related problems. Actually, I just went back & checked those results, the BUN /creatinine ratio appears to elevated. The normal range that I found looking around is 4-27. Granted it's not elevated a lot, but it's enough that I think it might be worthwhile to ask the vet about the possibility of early renal failure. I don't think renal failure is the core problem, I think there is something else going on that is increasing the stress on the kidneys.

Well-I may have at least a little bit of good news. First-the fecal reports came back and were negative for parasites and Giardia.
Today's events are-Palmer was shaking this morning. :( That's not like him. I covered him up and cuddled him. He went to the vet and when he returned, we watched tv together on the bed. Palmer was not eating and not drinking. Mid afternoon he took a good bit of water. I tried everything I could think of, once again, and he turned his head away at all of it. Kim-thank you for mentioning the chicken. It's been discussed before and I tried it last week and had no luck. With him not drinking and not eating and this being day #9, I was very concerned. In addition, the vet's office is closed Saturday and Sunday. The vet saw Palmer this morning, and took the blood sample, and (I could not go) did not tell my husband anything new or different. I was figuring we'd need to get nutrition in him by other means before the end of tomorrow.

I was getting back to being really upset and had to go out for an hour. On my way back, thanks to the reminder about the chicken, I stopped and picked up a cooked chicken breast. (And it was $2 off because it was cooked @11:30 and the meat guy wanted it to go!)(This was 3pm.) (It had been kept very warm.) I came back home and let Palmer sniff the grocery bag. It looked like he had interest. I started slicing and chopping away and put down about 1/4+ cup. HE ATE IT!!!!!!!! :D:D:D:D He did not finish the bowl, but went back several minutes later and then did finish it off. I cut up some more, another 1/4 cup, and he ate that as well. The only "bad" thing about it is about 3/4 hour later he was heaving, but what came out was like a few spit balls. The chicken stayed down. I didn't want to give him any more than what I had because he hasn't eaten for so long and I didn't want the stomach reacting to too much food. We got him right outside and he just kind of sat around staring off into space. When he came back in he went and retrieved this huge squeaky, fluffy duck he has. It's as big as he is! That is his Linus blanket. Whenever he gets uneasy, he heads for the duck. He plays with it at other times. (As a matter of fact, he "uses" it to stimulate himself. He doesn't always achieve his goal, but he still keeps trying.);)

A little later I took him outside while I watered some plants. He went to the end of the driveway and I told him to stay out of the street. (We live on a cul de sac. I mostly didn't want him going over to a neighbor who doesn't like Palmer. ) So he sat at the end of the driveway.....just as if we had an invisible fence! We went around back to water a couple more plants and he saw a gal friend of his. He went over to greet her, as she was heading toward him and they visited. Buffy, the friend of his, is about five years younger. They have always gotten along and even played and romped, but his age is beginning to show. He doesn't romp much anymore. So we hung around as the dogs visited and I visited with the owner. We came back inside and watched tv together. So far (this is 11pm) everything is staying down. His water intake seems to have gone back to normal. He was looking, kind of, for more food, but I wanted to "reenter" eating at a slow pace.

He looks brighter. He's hangin' with me now. So hopefully we have turned a corner. He is scheduled for an ultra sound next Wednesday, but if he continues to improve, I am going to cancel that. I still look forward to the remaining test results and will post them when I get them. I should have at least one tomorrow, if not both. The vet says she'll call us Saturday if they come in that day. Our son is going to come visit for the weekend and that should be very positive for Palmer (and for my son.)

So-all in all, it turned out to be a positive day. :D:D Nothing has come out the back door since the diarrhea almost 48 hours ago. There can't be much left to come out........before the chicken. We will hope for a good night's rest and an even better day tomorrow.

I'll check back in tomorrow and let you know if this continues.

Susan

Wonderful news Susan!! Maybe you could try some mushy cooked rice, mixed with cooked chicken and I cook some sweet potato and green beans and add that too. I have never seen a dog turn away from my homemade dog food and its easy on their stomach.

I was thinking about you tonight when I went through Casey not wanting to eat today. Its very scary so it must have been extremely hard watching that for 8 days.

Love and hugs,

Glad to help! I would keep anything else you want to add to the mix separate vs adding them into the chicken because that way if he doesn't eat the new items you don't have to throw away the whole batch. Plus you can test one item at a time - like we do with drugs. Do it slowly so you can tell what is working and what is not.

I could not figure out annie's pattern until after the dx I realised that she could only eat foods that were soft and didn't hurt that nasty throat and her ulcers!

Annie had the shivering! Full body shivering. She had it for quite a while and it came and went. I am convinced that is pain. (or was in Annie's case)

Have you noticed any tummy growling or gurgling? Gotta be if you had diarrhea right?

Anyway.... glad to hear some great news. Keep it up Palmer!

So you stopped the trilostane a couple days ago and things began to improve, right? Like Debbie, I'm suspicious that maybe his cortisol did take an unexpected nosedive for whatever reason. Palmer's numbers on July 8 were good, but could have fallen in the two weeks after that. Did the vet suggest how long to withhold the trilo? Sue

Hi-
The trilostane is being discontinued for "a few days."

Today is not so good. The vet called and said his Kidney enzymes are elevated and she thinks he is dehydrated again. She wants him to receive fluids intravenously for 48 - 72 hours....and of course, we're coming up quickly to another weekend and those nasty "emergency" rates. Her office can do it, but there is not 24 hour monitoring there. They will be closed as of 5PM tonight. She would have someone come on in and check Palmer...maybe it would be her. The Emergency ER will have 24 hour monitoring over the weekend, but neither Palmer nor we have ever been there. Then the vet suggested we take him to Annapolis where he is scheduled for the ultrasound on Wednesday. If he went in today, we'd get the ultrasound done on Monday but by a different DR. We are trying to get an idea of the cost for any of these. So far I know the Ultra sound, consult and weekend emergency rates will be a minimum of $786. That doesn't include any fluids nor the boarding rate. The Annapolis place won't give me any idea-they say the vet will have to call. So we are now waiting for the vet to call us back so I can tell her that. Then we'll be waiting for the vet to call back with the #. Bob wonders if we can wait to take him until Monday. Then he'd be there already for the consult on Wednesday. I asked her what would happen if we just did not do this and she says she cannot answer that-since we don't really know what the problem is.

Today-he is back to not eating. He seems ok, but he has seemed ok pretty much all along. He never has looked seriously ill. So now the discussion revolves around how much are we willing to spend to continue on this path. If he is having renal failure or if they find a tumor with the ultrasound, we would not be pursuing further action. We are not going to subject Palmer to surgery. So we could go through a lot of expense (they're talking over $2000) just to find out we can't do anything.

That's where it sits. This just is not a pretty picture. I am also wondering if we should just get back to treating the Cushing's and not pursue this....but then we still have the issue of him not eating. I'm not willing to watch him starve himself to death.

I don't know....I just don't know. I can't promise real regular updates, but I will try my best to get in here at least once every 24 hours. Please pray for Palmer.

-S