Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

Marianne, you make an excellent point! I usually rely on dogfoodadvisor as my first point of reference, and I have noted that he will rate all the products in a certain line, if the line is small. For example: he has rated all the formulas for the honest kitchen, but chose only one formula for the in depth analysis. Some of the lines are so very large, it would be impossible to provide an analysis for every single one.

It would be so nice if the pet food industry had the same regulations as human food - that way we could rely a bit more on some transparency in the ingredient and nutritional analysis content.

Boy, ain't that the truth! ;)

great that molly is doing fine!
i hope that between those samples there is one which she really likes and keeps her stool firm.
i don't use commercial dog food, so i do not know much about the different brands. grain free sounds good, molly is a little wolf, not a cow ha, ha!

Sharlene, I was just looking back at Molly's UTK summary, and I think you may have made a conversion error in terms of her cortisol.

Quote:

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ACTH (2 draws - this is due to the agent used by the vet) June 2012
Cor1 - Cortisol (base) 172 (30 - 300) 6.23 ug
Cor 21 - Cortisol (ACTH) - 1 hour 924 33.49 ug
Cor 22 - Cortisol (ACTH) - 2 hour 1014 36.75 ug


ACTH april 2014
Pre 29.5nmol range 2.1 - 58.8 1.06ug
1hr 283.1nmol range 65.0 - 174.6 10.26ug
2hr 345.6nmol range 65.0 - 174.6 12.52ug

---

I did not notice this before, but you have noted the UTK units as being nmol/l. Are you sure this is correct? Usually their reporting units are in the form of ng/ml. If so, this would mean that Molly's April cortisol levels would convert to the following units of ug/dl: 2.95, 28.3, and 34.5. :(

I would suspect this is the case, because her numbers are elevated quite a bit above the stimulated reference range (which I do believe converts to 6.5 to 17.5 ug/dl) and this is also pretty much consistent with her previous ACTH. Just wanted to double-check this with you. :o

Would someone please explain what the SO diet is? Thanks.

Sharlene-you surely have had your hands full. I hope Molly continues to improve.
Hugs!
Susan

You're right Marianne! Again. LOL I typed in nmol but it is ng, so in reality, it hasn't change very much at all from 2 years ago.

Is that weird? Should it be increasing over the years with no treatment? I thought it was very strange when I thought it dropped, now I think it is strange that is is the same. And there was something about that her base remains normal but I can't remember why that was significant, since I thought we see that alot and then the adrenal glands dump a lot (the post factor)

I really don't know what to do. I know I'm not having surgery done. I don't know if we should be treating her or not. The IMS I still need to talk to but was in meetings all day today myself, so couldn't and have to ask my vet to call back tomorrow to talk about the crystals, etc. Just no time and I find it so confusing. No symptoms either still, so again, back to a dog with no symptoms, do you treat or not. Most say no, Dr. Peterson says no.
I think I'm at wanting two things done. An LDDS end of june and then based on that perhaps start on lignans and melatonin as it is farily benign.

Food wise, from Fromms, I have found a couple doable ones, whitefish has a low fat content and no grain, it was the lowest with no grain and then the weight management and Senior reduced activity both are low in fat. So, possibilities there and probably the shredded chicken can if the store has that, would be the lowest wet food.

okay, it's been a very long day and I'm exhausted and a bit emotional right now, with the news of Squirt tonight, so I think I'll head to bed and pop in tomorrow.

Oh Susan, SO is the Medi cal Urinary SO food for dogs prone to crystals. Molly has done pretty good on it, but a few times now she has gotten the gastro upsets and taking her off it always has helped to clear it up. (except for that last bad one, where only chicken rice and antibiotics helped)

hugs all
Sharlene and molly muffin

Marianne needs a prize Sharlene, she got post *2000* on your thread! Plus she is great at figuring out those numbers!

I agree about not looking at surgery for the time being, her nodule is small. In an asymptomatic dog I would just watch it too.. well that is what I am also doing. Flynn's left adrenal nodule has been there since before his right adrenalectomy, so that is 18 months now. Active surveillance is a very acceptable treatment option for this type of thing. x

Oh, I am proud and honored to be the 2000th poster!

But Sharlene, I apologize for dumping the cortisol figures on you right now when we're all in the midst of such a sad time. Partly, I'm inflicting my own way of coping onto you -- when I am sad or upset, I try to settle myself on a concrete task, like working on the puzzle of Molly's results. :o

Also, though, I knew you would be talking with the IMS and wanted you to have the correct information in hand. And what a puzzle Molly remains. I cannot disagree with a very conservative approach unless something changes. As we talked about earlier, the UPC may be the wild card in that respect. If it steadily increases and no other cause is obvious, then more aggressive intervention may be warranted at that time such as the maintenance dose of Lysodren. Just my feeble thoughts right now.

Many hugs to be shared among our family on this morning,
Marianne

Hi Sharlene:
Tipper eats the senior reduced calorie Fromm's if that helps any. I know we are all just not thinking right at this time. If you do go tomorrow talk to a vet please ask them what the likelihood is of an adrenal tumor rupturing? Vicki is also going to ask to get us some more info on what to do here. I read and read and the stats that I saw for mortality on this operation are way too high for my comfort. I believe our of the two scenarios operating is the riskier of the two. We are to get thunderstorms today so I will be ready with Tipper's meds. Blessings
Patti

It is okay, I'd rather that this be caught, than to proceed on bad info. So, thank you Marianne. I completely understand trying to focus on anything other than what is on all our minds this morning.

I haven't spoken with the IMS yet, but I did have a conversation with my vet.

Molly has has both struvite and oxalate crystals at one time or another, but has been doing well since 2007 when the bad batch of struvite crystals were caught and she was started on the SO food which stands for struvite/oxalate and helps to keep an even PH so as not have either. The bladder stones she had were small and have now passed The kidney stones are small and we'll have to keep an eye on them.

Due to her not having symptoms, we are going with right now following up on the UPC. She'll have a test in a couple weeks to recheck that and then another one following in about a month to recheck. They want to see 3 consistent high UPC's before saying this is a problem and not just a fluke of the day or something else going on.

In June she will likely have an LDDS test. If it is a functional adrenal tumor, it should show up on this next LDDS test.
I have just found a lecture paper, talking about how dogs with AT could have a normal 4 and 8 hour cortisol level. Interesting. I don't have time to read the entire thing right now. I will however, put the link here for the rest of you to check at your leisure: http://www.ivis.org/proceedings/wsav...usch2.pdf?LA=1

It is interesting in that she doesn't ever seem to have high levels in her body, only in the adrenal glands, her base has been within normal limits and that is likely why we don't see symptoms, it doesn't appear to be dumping until an ACTH is done. My vet said, molly remains one of the more constant mysteries to her, and both the IMS's that have seen her. To look at her, she looks fine, other than the knee and hip, which is actually both part of the same problem. (years of over compensating on the one side for the other side, has likely been the cause of the knee issue)

The tumor is small, and agreed that monitoring to see if it is growing is our best choice. My vet did not seem to think that a rupture was likely. She said, you can never say anything 100% but she didn't think it very likely. I'll also ask the IMS about this, but I know the IMS's thought when we spoke is that we would monitor too. I think if she Did thing a rupture likely then that wouldn't have been her recommendation. My vet said, this is very small, I don't think you have to worry about it.

Okay not much time at the moment.

hugs all and thanks

Sharlene and molly muffin

With Molly having kidney stones I don't know how accurate an UPC would be, wonder if Molly's IMS would know?

Quote:

---

It is interesting in that she doesn't ever seem to have high levels in her body, only in the adrenal glands, her base has been within normal limits and that is likely why we don't see symptoms, it doesn't appear to be dumping until an ACTH is done. My vet said, molly remains one of the more constant mysteries to her, and both the IMS's that have seen her. To look at her, she looks fine, other than the knee and hip, which is actually both part of the same problem. (years of over compensating on the one side for the other side, has likely been the cause of the knee issue)

---

Sharlene, I have only a moment to post right now, but I don't think Molly's baseline results would explain the lack of overt symptoms. Many symptomatic dogs have baselines that fall within normal range (and conversely, many normal dogs may have elevated baselines if they are stressed during the testing), and that is why baseline cortisols are useless in terms of Cushing's diagnostics. It is only the stimulated result that is meaningful in terms of differentiating dogs with hyperadenal activity.

Marianne

Well .... fooey! LOL My vet is actually the one who mentioned the low baseline, but I did point out that the posts were still high. (don't think she looked that over before calling me)

We're heading out for yet another dinner for hubs birthday. This is his third one this week, all with different groups of people and I need to check and see if he is up for a greek buffet luncheon tomorrow before we had downtown tomorrow night for the theater and "We Will Rock You" it's getting good reviews in Londan (UK) and I can't wait to see it.

Molly got the SO for breakfast and we had the not so great poop this afternoon. This morning after last night having some of the Fromms, she had perfect poop, it is definitely a food/gastro thing I think we can safely say.

got to run
hugs all
sharlene and molly muffin

That's great you figured it out, I have been feeding my boys Fromm for a few years, it is excellent food and family run. Happy Birthday to your hubby! Enjoy your celebrations :)

Have a nice dinner out Sharlene and Hubs, Happy Birthday to him. Is it the Japanese restaurant tonight?? Yum!

Glad you have the cause of the bad poops narrowed down, sounds like it is under control! Yay Molly!! xx

My brother says that we don't have birthdays, we have birthday weeks. :-)
Mine was yesterday. Happy birthday to hubs!

Well heck Happy Birthday Valerie! :) We do birthday weeks too, sometimes months even, as things drag out and different people can get together at different times.
I love to make hubs laugh when I am still calling him the birthday boy. :)
Yep, Japanese tonight, tomorrow Greek and then the theater.
I really hope to rest on Sunday, going to need it, but hubs has mentioned opening the pool!! ack! Course then there was the mention followed of carribean rum punch, so maybe we need to hurry and get it open. LOL
Molly loved having everyone around this evening after the dinner out. She didn't even bark at everyone coming in, just popped right over and said hello. Who is this dog, she normally barks at everything!!
Oh she had that front paw act up right before we left today. Hubs said he thinks that it fell asleep on her. I massaged it a bit, I put her down, he gave her a treat and she continued to hold the paw up, then took off on it, with a bit of limping and then was fine.

got to run, exhausted here!
hugs
Sharlene and molly muffin

Rum punch sounds delicious!!! Get that pool open :) Hope Molly's is doing well. I see she likes to be as difficult as Kaibo. Why don't they play by the rules already? Don't they know what they are doing to us? :eek: Just stopped by for a quick hello! Take care. Nikki and Kaibo

Sharlene:
Glad you had a good time out for your hubs birthday. He sure had a lot of celebrations which sounded nice. It is dreary here this morning and I don't want any more thunder. I am not feeling well this morning so I am taking it easy. I have Leslie and Squirt burned into my brain, and it keeps playing like on a loop. This has really shaken me. It puts you one step closer to you own babies mortality. I hope Molly is settled down with the poops?? Wonder what is up with that? Have a good weekend. Blessings
Patti

Hey Sharlene, I wanted to come back and add a better explanation about the baseline cortisol info. Here's a quote from Dr. Peterson that gives more detail:

Quote:

---

Basal cortisol concentrations, when used alone, are not reliable in the diagnosis of hyperadrenocorticism in dogs. Because of the episodic nature of cortisol secretion in dogs, basal cortisol concentrations fluctuate throughout the day, resulting in a high degree of overlap of values in normal dogs, dogs with nonadrenal illness, and dogs with hyperadreno-
corticism.1-4,17,18 The sensitivity of basal cortisol determinations in the diagnosis of hyperadrenocorticism is only about 0.5 (approximately 50% of dogs with the disease have high random cortical concentrations), whereas the specificity can be extremely low in dogs with severe nonadrenal illness. This severely limits the usefulness of basal serum cortisol concentrations in the diagnosis of hyperadrenocorticism. Plasma or serum cortisol values are only useful after dynamic stimulation with ACTH or suppression after dexamethasone.

---

http://www.researchgate.net/profile/...cf3ee6045e.pdf

I know you're looking at the baseline in terms of symptoms and not purely diagnostics, but I'm guessing the same explanation would be involved. Since Molly's stimulated reserve is abnormally elevated, it is likely that there are indeed times (like when she is excited or stressed) when the cortisol release throughout her body is excessive. You've just not been catching those times on these baseline draws. As to why she does not evidence overt symptoms from this, I remain clueless but grateful!

Marianne

Seems to be the food. The SO and maturity are both giving her the bad poops from what I can tell and when I use the Fromms food the poops have been some of the best ever. (the beef one gave an excellent poop I must say) However, and this is fine, as I'm using the sample up and will get some feedback from that trial run, but the fat content is too high for prolonged use, so I'll check out the maturity and less active senior food, as they have the least amount of fat content. (one of those you feed to Tipper)

I don't know if the kidney stones being small will throw off the UPC or not it's possible. Another question to follow up on.

It's true, we do birthday celebrations a lot around here. I think it is because neither of us have any extended family here, just our immediate, which is small, so our friends over the years have become our family, and each other, we do a lot for each other and spoil each other as much as we can and of course molly our baby.

Today will be a busy day as we'll be in and out, so I won't be on the forum that much.

hugs
Sharlene and molly muffin

And throwing the probiotic back on as poop went kaput this evening. Big sigh.

Orangish. Is that liver? I was thinking it is. I know her liver supplement is bright orange in color too. But when her poops go off they seem to be orange.

Hugs
Sharlene and Molly muffin

Hi Sharlene

If liver is off and it has to be way off to change poop colour, the colour of poop changes to pale greyish and the urine to orangey or dark. That is because the bile which gives poop its brown colour cannot get through the liver so spills back into the bloodstream and excreted through the kidneys hence the dark colour in the pee. So don't be worrying about liver here! Maybe is a bug, might be time for a poop specimen? x

Sharlene, Daisy's poops were orange and then yellow diarrhea when she contracted guardia. I would look into that since it requires antibiotics to get rid of. Hope she feels better soon!

Sharlene, it seems like most every time Jasper gets colitis, his poops are orangish at some point. This is usually an indicator that I need to start metronidazole. Hope Molly's tummy settles soon.

Hugs,
Tina and Jasper

hmmm, interesting. I'm glad it's not his liver. Guess I'll have to take a specimen in and get them to check it. It hasn't returned to diarrhea, but it has gone soft. Strange because she didn't get any SO food today just the Fromm's. Two times today now it has been formed, but very soft.

I'll see what the morning brings.

I'm sleeping in tomorrow I hope. I've already told molly she best be planning have a lie in too. (she seldom listens) At least she doesn't act like she feels bad, had a nice walk tonight when we got home.

Tomorrow we have stepdaughter and her boyfriend here. They plus hubs are cooking breakfast for me. (prob more like brunch as I have no plans to move too early in the day)

I am going to get little miss straightened out one way or another. :) I wonder if it isn't colitis, or a bit of IBD with her and how often she gets this. So now I wonder if it was the food or not. I thought I had it figured out, because after the first Fromm's that day she had the best poops she's probably had since she was young, perfect poops. Now I wonder though. Drat it.

Marianne, I am inclined to think that molly does have cushings (due to the consistently higher cortisol and now the adrenal tumor) but I am hoping an LDDS test in June will tell us if things have changed and she will now test positive on the LDDS or not. If that adrenal tumor is functioning, don't you think it would show up on the LDDS now?

Then we are still back to the same question. Do we treat or not with her not having symptoms still. I measure water intake, check her food intake and what she eats, how much. Even the Fromms which she loves, she didn't eat all at breakfast, but came back in and grazed later. I kept thinking I must be missing something but I can't figure out what it would be. :(

hugs all, enough of this for one night. :)

Sharlene and molly muffin

I guess its hard to tell if she is still eating a little of both. Maybe transition fully to one type of food and see how she goes... not too fast either. Maybe that is what happened after she had the Fromm's with her tummy getting used to new food it just had a little spazzy attack hence the lastest soft ones?

That could be too Trish. :)

I think I just ran out of energy. Not use to late nights 3 nights in a row any more.
LOL

hugs,
Sharlene and molly muffin

Sharlene:
Sorry to hear Molly is still not doing well with the poops. It does sound like colitis or IBD. I guess you will have to keep her on one food or the other to nail down the cause. I am sure you will get this under wraps soon. I hope Molly lets you sleep in and you have a wonderful breakfast. Happy Mothers Day Sharlene. Blessings
Patti

Poop report please?!?! Hope its settled down by now! You sound like a week to recover from all the lunches and dinners out would be good about now!! Sounds like you had a nice Mother's Day too... brekky in bed is always a winner :DWishing you a nice and easy work week :)

Still no report for us, Mike is back from his holiday and emailed today to say he did not have it either so he is going to email the IMS. This is the longest I have ever had to wait for a report, first time seeing this guy too! Maybe tomorrow. :rolleyes: x

Popping into see how the delightfull Molly and her poops are getting on :)

You will be tuckered out with 3 late nights I hope you got your lie in:D

I did get a bit of a lie in on Sunday. Loved it.

Molly is doing great again. She had a day of wobbly legs in the back and paw holding up in the front, but then seems to have recovered with gusto. This morning I had to catch her mid air as she jumped right almost over my arm in her enthusiasm to head downstairs to see what her daddy was up to. Then this afternoon after I got home from work, she finally after a long winter, got to spend some time running and running around the back yard checking out all the new scents. She had a grand time and when I asked her if she wanted a lift up the stairs to go inside, she did a running evasive maneuver and up the deck stairs she went. (they aren't steep luckily but they are many)

Poops have been back to normal in the mornings. Solid as I could possibly want. So, hopefully that will continue. She remains on the probiotic and low fat Fromms food at night till I know she is sorted. I mix in a bit of the SO if she isn't drinking enough, which has always been one of her issues.

Who'd think a dog with cushings you'd be having to try to get them to drink enough water?? It isn't that she doesn't just not have the outward symptoms but that she is actually the opposite in things like drinking water.

But I am not going down that road yet. Concentrating on the kidneys first, then we'll LDDS test later this summer and then see where we are at. It always seem to be wait and retest when it comes to molly muffin. Such a pampered little scamp she is.

:)
hugs
Sharlene and molly muffin

Sharlene:
Glad to hear Molly is better with the poops. You are great with attacking things and getting them done, so the plan of starting on the kidneys sounds good. When there are so many issues like Tipper has, you just have to start dissecting one by one or you will go nuts with the whole ball of wax. Sounds like Molly had fun with the new smells in the yard. Tipper was happy for the 15 on the porch the other day checking to see if any critters had been in her territory! Can't wait until Friday and these darn storms are out of here. Blessings
Patti

Sharlene:
This is going on day 4 of the storm situation and we have more coming any time now. Tipper is exhausted, this has really taken a lot out of her. It uses so much energy when she gets wound up tight. I just keep talking to her like normal, but she ain't having it! She is napping now and I made some stronger herbs like the vet said and we will see what they do. Glad you got Molly to forget about it, as this is definitely hard on a dog after four days. How are the poops still ok? That freaked me out reading that article about the dogs and the storms changing their cells!! Blessings
Patti

Poops remain good. She is getting her SO in the morning and the low fat Fromms in the evening for dinner and that seems to be working. I'll start to leave off the probiotic tonight and see how it is in the morning.

I'm just tired today and still have to get through tomorrow at work. arrgghhh Then a 3 day weekend... Whoo Hoooo!

Raining a bunch here, but no thunder. Hubs said he noted that when I react to the storm or anything, molly feeds off of my reactions. So, I'll try to chill more when thundering and hope that helps. It should, it did yesterday, but not any bad ones here like have been down in the states.

I need a nap, and molly is already napping. Think I'll join her in a minute

hugs
Sharlene and molly muffin

Sharlene:
It started up here again, so I gave Tipper the stronger brew. She is sleeping off and on now. I hate to do that to her, but have no choice. I also ordered the Bach remedy. I never got it before because of the alcohol, and it has a lot in it. I decided to do a search for the alcohol free version and low and behold they have one out. I just ordered it for her. I have to test it on her skin first because it is very flowery in the ingredients and she is so allergic to everything. I hope for the rest of the evening it is just rain. Does Molly sleep in her own bed or with you? She seems like she would be a cuddly sweetheart to curl up with. Hope you have a good nap. Blessings
Patti

Molly usually sleeps in her own bed on the floor, unless hubs is away then she takes 3/4 of a king size bed and gets huffy (makes huff and puff noises) till I pick her up and put her on the bed. :)

Molly looks cuddly but in reality, cuddles happen on her terms. She likes to get up right next to your leg on the couch, but doesn't want to be on a lap, unless it is for a treat and as soon as the treat is gone so is she.

In the bed, she doesn't want to be near anyone and will manage to take as much room as possible (not really sure how she does that) but if you touch her she'll move if she is in a "mood".

Hope the strong herbs help. I'm not sure of what we'll do when the thunderstorms get bad here. I usually am up all night with her then too as she shakes and pants. Best is if she will go under the bed till the storm passes, but she won't always do that.

Hope it's not bad tonight.

hugs
Sharlene and molly muffin

It is the Lhasa in Molly:):):):):) They always have to have their terms, not big on cuddles I think. Zoe was the same way and bossy too:rolleyes:

I am rooting for continued good poos.

Pleased to hear things are getting sorted in the poop department :)

I'm picking up some new food for Henry next week (I really like Fromm but want to give him some variety so I've ordered Dr Tims) and I'm hoping he's going to be OK with it. When we first got him the breeder was giving him some total junk so I switched him (gradually) from the day he came home, however he didn't do very well with treats so I've restricted his diet quite a bit, but now he's older I'm hoping to expand his palate ;)

HaHa - love the bit about Molly on the bed. I'm convinced that the smaller the dog, the more room they manage to take up on a bed!!! OH and I unexpectedly had to share a bed with Hamish at a hotel once - we had an inch each and spent the night trying to stay on, whilst he took up the rest of the bed and snored loudly.

Things sound good with Molly..poops all good now, yay!
Trixie does cuddling on her own terms too, very much the same as you describe with Molly.

I hope the storms stay away from your area so that Molly doesn't get stressed! I hate when they shake and pant, poor pups. I think you're right when they find a place to ride it out-like under the bed it's better for them. It's so humid here...storms due tomorrow. We'll see how Trixie handles it, she seems a little better lately when she hears the heavy rain but thunder is another story!

Barbara