Hi Barbara,
Just a quick question, I thought you were doing part Vetoryl and part compounded. Could you remind me what Trixie’s dose is currently? Thanks for your help. I am just contemplating Zoe’s dose.
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Hi Barbara,
Just a quick question, I thought you were doing part Vetoryl and part compounded. Could you remind me what Trixie’s dose is currently? Thanks for your help. I am just contemplating Zoe’s dose.
Hi Addy...yes...doing 28mg a day for Trixie divided into 14mg am/pm. I use 10mg Vetoryl and 4 mg trilo.
I'll post this on your thread..not sure you meant it to be here on Pattis.
Barbara
Hi Patti,
I don't know about headaches but I do think dogs definitely react to the change in air pressure. I know Trixie usually hides when she hears the wind blowing...even without rain! Maybe she equates strong wind noises with thunder? I don't know but maybe Tipper was reacting to the wind and the other weather noises you had last night. I also have seen Trixie sniffing the air when the wind blows...she's sometimes on the couch and puts her nose up straight and sniffs.
I have been really afraid to try the fish oil. Trixie's gastro system has been so good lately, (knock wood)...I'm so afraid to mess with it by adding something new. She has a sensitive system so I don't want to start up any diarrhea or vomiting episodes right now, that's why I havn't given it a try yet.
The day she went in to have her acth and blood test she was not fasted. Not only did she have treats on the morning walk at 8am and her breakfast at 10am then I gave her three dog treats at 2pm that they have on the desk at the vet right before she went in. I didn't realize it could screw things up so much.
So...she ate those 3 biscuits, (and they weren't small) and went in to have the blood drawn probably within 15-20 minutes of eating them. I don't believe they were "fatty" treats but I read that it can definitely change the results. The article said that eating before the test can raise Triglycerides up to 20% more than fasting levels. She should be fasted at least 12 hours before testing...since it was also an acth she had eaten (and eaten plenty).
I'm sure her triglycerides are not super low but maybe that really high number would not have been quite so bad had she not just eaten 3 treats plus the earlier meal.
I want to do another test and next time a fasted test to recheck her triglycerides and also her liver numbers. She's back on Denamarin again so after a month we will retest the blood to see both the Triglycerides and liver numbers.
Trixie seems so good but those liver numbers have me worrying.
Barbara
aww Patti, sorry I posted to Barbara on your thread in error:o
Barbara:
I usually get a blood panel on Tipper every time she goes for an ACTH as it is easier on her when they are doing the testing. She always eats before her test too so I have very little blood work while she is fasted. I am going to get one though in a month I want to see her Reticulocyte count. I know what you mean about messing with the gastro system. I know I had heard other members on here talk about their dogs licking air, I wonder if the smelling is associated with that?? Just seems odd she has never done this before, but then again with this disease there are so many weird things it is enough to make you crazy sometimes. I told Tipper yesterday that I have to get a secretary to keep all her appointments etc! How is the work coming over at your mom's house? Hope Trixie is liking the cold weather. Blessings
Patti
Hey Patti,
Trixie loves the cold weather! Of course ever since Cushings so do I!! That heat made everything so much worse for Trixie, and I know you feel the same goes for Tipper.
Things out at the house are moving along but not so fast...I am chipping away at all the stuff. I can't be there everyday, if I could it would go a lot faster. We did get 25 big bags of donations packed for the Big Brothers/Big Sisters organization. Gosh, my parents just had so many clothes and we never cleaned out my dad's stuff while my mother was alive.
Luckily they will pick up from the house and they keep 40% of the donations right in the local area (Long Island) and the rest they send to areas that don't get stuff as often. Many of the charities who request clothing donations take the clothes to be ground up and used for cheap furniture filling and carpet pads. I only gave very nice clothes in good condition and shoes..many brand new and barely worn. My parents both had a very fine wardrobe. Of course our family and some friends went thru and took things-then I neatly packed up all the good stuff for donating. We wanted it to go to people who need decent clothing, not ground up into rag filler.
Now onto furniture, rugs etc....we have a few local resale people coming in to possibly buy some stuff so we'll see how that goes.
It's all very hard for a sentimental person like me...I have to work fast when I'm there or else I start to think too much and then I get upset.
My mother was a saver, she was neat but boy she saved a lot of stuff!!...I even found a bill for the Vet from 1975!! The schnauzer I had growing up had bladder stones so was at the vet a lot...can you believe??-an office visit, x-rays, allergy tests, vaccination, and medications...grand total was $125. I'm sure my mother thought it was a lot of money back then but how I wish we had 1975 pricing now!!
I'm afraid Trixie has never had a fasted blood test except for the LDDS we did back in March. I am hoping things will look better on that fasted test when we do it...being optimistic here, hope I'm not fooling myself!
Barbara
Hi Everyone:
Today was blood pressure day, and Toby had to get Tipper riled up before we left so she was 140 today which is not high but high compared to what she has been. She gained weight from me taking the lentils away, and having to give more dog food in its' place. I have to get that taken care of. Leslie I emailed Cat the Nutritionist a few days ago and have heard nothing back yet, I am sure she is very busy so I am waiting. Barbara I am glad you are getting things moving at your mom's before the real bad weather sets in. You have accomplished a lot so far. My rescue cat Lucky suddenly took ill the day Monday. it probably is not his sludging as that starts over time. This was just right away on Monday he got sick and he never acts like this. I do not need another vet bill!!! I am waiting to see if this is just a fluke thing as sometimes cats do this or if it is something to go to the vet about. I checked him all nite and have not slept. Tipper got up at 500am and I am dead. She is still acting hungry and I do not know now if it is the lentils or her trilo dose is not high enough. I feel bad today all this stress is catching up with me. I have not even gotten my meds yet for my kidney stone, I am too busy with the babies. I will get on it today. Lucky is not eating so I have to see I may have to syringe food into him. If it comes up he may have a blockage. It is hard with 2 cats telling who went to the bathroom and who didn't. Tipper has laser therapy tomorrow and Monday the eye Dr. in Pittsburgh. I could use some help right about now. Blessings
Patti
Patti - Please take care of yourself and get your Meds that's an order lady. I know how this feels to be that busy with the furbabies and forgetting yourself as my body crashed last week cause I forgot my own meds so please take care of yourself. Poor Tipper acting all hungry Woody is doing the same at the moment, but I,m managing to ignore him so far. Good luck for tomorrow and Tippers laser appointment I do so hope you get the results you need from the eye doctor as well. Your plate is really full but please take time for yourself as you will be no use to the babies otherwise. :)
Tracy:
I know it is easy to get all wound up with the babies. I am going to take this afternoon and get my meds etc. taken care of. Now with the cat sick, I really am bombarded! Thank you for caring I appreciate it. Blessings
Patti
Patti...you must get your medications and take care of yourself too!! I am so sorry about Lucky! I do hope the kitty is okay and like you said..just a fluke.
I always found Trixie to have a bigger appetite in the cold weather...this was even before Cushings. Is there a substitute for lentils...something with protein and fiber that Tipper can have? How about oatmeal or some brown rice? I give Trixie brown rice when we have it, and oatmeal is good for dogs and a small serving may keep Tipper filled longer.
I'm not big on changing and adding things to the diet, but maybe something like lentils will help the appetite issue. Trixie is always hungry...before Cushings and now with it. She's always ready to eat.
Barbara
If you don't take care of yourself, you won't be around to care for your zoo. So, you must just do it. Do it for them! xxxxx
Patti PLEASE look after yourself too, I know how it is, I am very ill as you know and I put Teddy first, and often think, Hang on, I must take care of myself, to be here for him.
So please please do look after yourself too. Love Diana x
Diana:
I am trying to, this is really hard with the kitty sick now. I have 2 appointments with Tipper and myself tomorrow and if the cat is no better he may have to go to the vets. HE gets stressed out so much form there and I was trying to prevent that. You take care and rest yourself and I pray for good results in January. I am sorry your test was bad, I hate when that happens. Cuddle up with Teddy and give him some kisses from Tipper and I. Your hubby is a real keeper. God Bless you all.
Patti
hi patti, I second what the others are all saying. You Have to take care of yourself too, so you can take care of the babies. :)
I know you are juggling a million things and crisis's at the moment, but remember, you are too are one of those things on the list to take care of and I hope you move yourself to the top of that list. You can say Tipper comes first, or one of the others but it is NOT true. They are all dependent on you and just you, therefore, you are 1 and then come the rest. This is not about sacrificing for them or not being as "immediate" of a need, this is about being smart and you are Very smart. They need you to be able to care for them and I know you know that but you are just forgetting how important you really are. :) Stop it! :)
See we love you :)
hugs,
Sharlene and Molly Muffin
Hi Patti yes I have seen that on your post, I have also commented on your post about you looking after yourself too, I know how hard it is when you put your babies first, but you need to get your meds so you can care for them too. They would ask you to, I am sure if they could talk they would say " Mummy please get your meds" wouldn't they? They love you Patti.
I hope Tipper will be OK for her tests, My hubby is a dear, but I have had to kiss a few frogs first you know, and my life has been very hard, Hence all my illnesses now, it is an after effect of the stress and trauma I have had over my 50 years, but now I don't complain much.
God Bless you too Patti, and PLEASE look after you too.
X
Gosh Patti... you make me tired just thinking about all you do for your babies. It's easier said then done, but you know you have to look after yourself too. Like it was mentioned, without you... they won't make it, so you have to take some time to make sure you are well. Please!!! even for my sake, make sure you are looking after yourself.
HI Patti..
sorry things are going hectic for you. Hope you are squeezing in some naps. You deserve some!
Hello you
Just wondering how you all are since there isn't an update for today? Hope lucky is feeling better and that you managed to get your meds!
Big hugs and kisses to all the fur babies
Mel
Xxxxx
Hi Mel:
So great to hear from you. I have been wondering how you and Boyce are doing. Unfortunately Lucky is still sick and I have an appointment tomorrow for him. I surely don't need this as Tipper is bankrupting me now. Has works slowed down any? Hope you are taking time for yourself. Blessings
Patti
Hi Everyone:
Tipper slept well last nite, but some trachea noises. This dog is so darn smart it kills me. She has started putting her feet underneath me when she sleeps so her legs don't shake from the tremors. She also turns and puts them under the pillow to try and stop it. These dogs are amazing. She is a problem solver like her mom! Lucky is a little better this morning. I have kept a steady stream of food in him with a syringe and baby food. I always have it on hand for this reason. I cancelled his vet appt. because my vet is out of town until after Thanksgiving and he is the only one who can draw blood from Lucky, as Lucky gets spastic at the vets. I discussed with them that I will take Lucky to the other practice that has an Xray machine should he turn around and get worse. They thought this was best knowing how Lucky gets, that the stress form the visit can make him even sicker. During all of this I neglected to order chicken for Tipper so I have to run over there today and take care of it. if she runs out I will give her salmon instead. It is dreary here and sprinkling off and on all nite. We are to get lots of snow this weekend, so that will make my Tipper happy, and anything that makes her tail wag at this stage is wonderful. She was really nervous waiting in the waiting room at her laser therapy yesterday. She trembled so much she almost fell off my lap. She knows they do not hurt her, she has just had it with all this already. I hate to take her Monday to the eye DR. but that is so necessary she must go. She will get a break then until January and only go to laser and blood pressure screening. I will hold off on any ACTH or blood work to check the reticulocytes until Jabnuary she needs a mush deserved break from all this before she becomes neurotic. Blessings
Patti
I have not yet found anything from Dr. P about twice day dosing being the better alternative for adrenal tumors though we know that it may be hard to control their cortisol so that could lead to twice day dosing. Zoe has always struggled with her evening dose.
IQuote:
Use of standard doses of trilostane, on the other hand, is more effective in lowering cortisol values in dogs with adrenal tumors so this may be the way to go if the client refuses any additional workup (6,10). However, if adrenal carcinoma is present, this drug would do nothing to stop tumor invasion or metastasis. And again, if the dog has non-suppressible PDH with a pituitary macrotumor, this might lead to neurological signs within a few months.Quote:
Pros and cons of Lysodren vs Vetoryl
So which drug to use—mitotane or trilostane? If the dog has PDH, she should respond clinically to either drug (1,4-6), but if an expanding pituitary tumor is present, that might lead to neurological signs within a few months (3,7). If the dog has an adrenal tumor, the standard doses of mitotane would be unlikely to help, but this failure to control the cortisol levels would help "suggest" that an adrenal tumor is the underlying cause (1,8,9).
Quote:
have a patient with an adrenal tumor. If I give VetorylR prior to surgery, will the mass
get smaller?
No. VetorylR has not cytotoxic effects on adrenal tumors. It will not shrink the mass or prevent metastatic spread. However, VetorylR does effectively control the clinical signs of HAC in these patients, and is licensed for use in dogs with adrenal tumors. Surgery is the optimal approach in these cases, but Vetoryl should be considered if the mass is inoperable or if other factors make surgery a poor choice
Hi Patti.... isn't Tipper just the real smart one. I'll have to remember what she does in case when I get older I get tremors. It's actually quite cute to imagine.
It's dull and dreary here, and we are expecting snow this weekend as well, think it's coming here from your area.
Have a great weekend and glad to hear Lucky is feeling a bit better.
Have a great weekend.
Hugs from me and "mah boy"
Wow! That is so cool that Tipper is finding a way to handle the tremors. She is so smart!
I hope that Lucky gets better!
Hi Everyone:
It was literally a hair raising morning. I took Tipper out and put her behind the gate in the living room as I always do. The only problem when I went to walk away I heard hissing and screeching, here Lucky the cat that is sick decided for some reason to go into Tipper's space. He never does this as he knows Tipper does not like him. She was on him before I could blink, I quickly opened that gate and got her off him. He was so petrified at her he could not even think to jump the gate and get away. She had a mouthful of his hair and there were balls of it all over the floor. Poor Lucky and he is already sick on top of this. I checked Tipper's face and eyes then ran and got Lucky and checked him all over. She is still so powerful, you don't mess with Tipper. I know Lucky will never do that again ever. I am thankful neither one is hurt. Tipper slept well and walked already it is very cold but above 32 so she can go slowly. I am in the middle of filling out paper work for the nutritionist to help Tipper. It was so long and so detailed I thought I was going to have to name my kindergarten teacher. My God it took me 3 hours to complete, but I am thankful she is so thorough. I need to get this pound off Tipper and get her onto a healthy diet that benefits her body to help fight off this disease. I am wanting her to not be begging for food anymore as it breaks my heart to see her like this. I have asked the nutritionist to give me a recipe utilizing the chicken I already have for her as it was so costly. My vet is gone for about 10 days so I cannot have Lucky seen until he comes back for blood work, unless it is an emergency. Lucky seemed much better and eating on his own until the incident with Tipper. I keep checking on him periodically. These critters are going to give me heart attack yet. At 3 o'clock in the morning the ice maker was making a terrible noise. It was clogged up and could not drop the ice. I had to get up and empty the_____ thing and have been up ever since. I hope I sleep tonite as Tipper and I will be up really early to go to Pittsburgh Monday morning in case of bad weather. Blessings
Patti
Oh my goodness. Not good for Tipper or Lucky or you to have a mix up.
Molly simply cannot leave a cat alone, unless she is at the vets office, then none of them seem to bother her a bit, but in the house, she thinks they are her playmates and bugs them continuously. It scared me to death as I was always afraid a claw would catch an eye. As it was I use to have to go get Nova's claws unstuck from Molly's beard, they would both be putting up a ruckus that they were dying. Nova never did put a scratch on Molly, but the worry was always there. We never got another cat after Nova passed.
You certain did have an early morning and an eventful one, so I hope that you can all catch a few winks and get some rest today.
We had a very brief few minutes of snow coming down hard and then it stopped, never did stick and it's sunny and cold out. We might have a few more of those during the day, who knows.
hugs,
Sharlene and Molly Muffin
Hi Everyone:
We are having a white out and the ground is covered. Looks like a scene from a snow globe. We have about an inch so far, it is coming down hard and the wind is still 50mph. It is like a snowstorm out there that you sit inside in the warmth and enjoy. Blessings
Patti
A snowstorm, oh goodness, I hope you get to stay inside.
Oh these kitties and puppies, thank goodness everyone is ok.:):)
Patti- Marianne posted links to articles on SID verses BID on my thread.
Oh no! Animals fighting scares me! I'm glad that neither was injured.
We had flurries, not enough to stick to the ground.
Cos Cob is under gale warning and our lights have ticketed several times tonight. The pets are in Bristol with grandpa. He got flurries too.
More snow tomorrow. Not ready for this weather!
Hi Everyone:
Tipper had a good nite, but we are in the single digits outside so there will be no doggies walking this morning. Tipper is already showing me she is bored. The wind here has not let up since it started yesterday. I am taking a rest today as we have to get up at 5:00am to go to Pittsburgh to the eye Dr. I hope the roads are not bad, I hate traveling that early when there is ice and snow. It just does not have a chance to melt from the cars traveling on it too early in the morning. I brought Tipper's pillows she lays on in the house so they are toasty for her to lay on. She will have to eat her breakfast in the car, and I will have to give her the Vetoryl while traveling, that is always fun!! I try to pull off somewhere and do it, but if there isn't anywhere I will have to just do it while driving. I usually have it ready and can stuff it in the chicken while holding the wheel. Not the perfect way to go, but you do what you have to. I am praying my Steelers beat the Brown today as they have been playing like dummies all season, and Pittsburgher's are not used to seeing this from them. Blessings
Patti
I am so glad Tipper had a good night and please be careful driving tomorrow. We are to get a dusting of snow tomorrow too. I worry about Zoe walking on icy stuff.
I'm glad Tipper can still handle car rides, Zoe is impossible- about like Leslie's Squirt. She used to love to ride shot gun on my lap, not any more.
Enjoy the football game. I am trying to give our dining room a good fall cleaning before Thanksgiving. It is the one room I dont allow the dogs access to unless we are in there and I dont really clean it thoroughly, I have to cheat somewhere to find time for everything else:o:o:o:o
Enjoy your Sunday
Dr. Peterson discusses UC Davis' study on twice daily dosing and comments on SID, BID and TID dosing on his blog. I have provided an excerpt from that blog as well as the URL to his site below:Quote:
Originally Posted by addy
http://endocrinevet.blogspot.com/201...rilostane.htmlQuote:
SID, BID, or TID administration?
Whether to start with once- or twice-daily trilostane administration is controversial (1,2). Although most dogs are controlled clinically with once-daily dosing, trilostane may begin to lose its effectiveness 8-10 hours after administration, so twice daily dosing may be necessary in a subset of dogs (1,4).
In addition, it is very possible that the efficacy of twice-daily dosing might be more effective than once-daily dosing in controlling the complications of Cushing’s syndrome (e.g., proteinuria or hypertension). However, the answer that question remains unclear (15), and additional studies are needed to resolve that issue.
So what do I recommend? Until it is proven that SID or BID treatment is better, I prefer to start with a twice-daily regimen —if feasible and the owner agrees —because controlling cortisol concentrations throughout as much of the day as possible makes sense to me. In diabetic dogs with concurrent Cushing’s disease, twice-daily administration is essential in avoiding large fluctuations in serum cortisol concentrations during the day (1,2). With once-daily trilostane administration, adequate diabetic control will be next to impossible in many dogs with concurrent Cushing's syndrome.
What about TID administration? In this study, 9 (24%) of the 38 dogs with PDH were eventually switched to a regime of trilostane, administered every 8 hours. In my practice, I have not found it necessary to use TID dosing, and I do not find that dose schedule very practical or realistic for most owners. If I can't remember to "take a pill" every 8 hours (and I can't!), how can we really expect the owners to give their dog a medication three times a day for the rest of their dog's life?
Thank you Glynda but he does not really say that specifically it is better to do BID for adrenal tumor based Cushings does he? Maybe I am missing something in that article. I was looking for a specific reference to it, which I have not found.
I took that as a general statement on his thoughts but not specifically addressing how BID dosing may affect an adrenal tumor except we know it may be harder to control their cortisol so in that regard, BID would perhaps do a better job with more consistent control throughout the day. I think I posted his blog statement about adrenal tumors on my thread as to why he thought Trilostane would be preferred over mitotane.
Hi Addy,
We know that adrenal tumors are highly resistant to Lysodren which requires much larger doses but to my knowledge that doesn't apply to Trilostane. You are the second or third person who has mentioned larger doses of Trilostane for adrenal tumors and it's possible I've read that but I sure don't remember. The modes of action are completely different and I believe dogs with adrenal tumors are usually prescribed standard doses of Trilostane, just like those with PDH. I would think the same considerations for switching to BID dosing would be the same as those considerations given dogs with PDH. Adrenal tumors have random secretory patterns, independent of the pituitary gland, so they don't constantly dump cortisol like PDH dogs, so the need for BID dosing may actually be less in ADH dogs. It just depends.....
There is only one condition that I'm aware of that BID dosing is usually recommended from the getgo and that is cushdogs with diabetes. Dr. Cook doesn't just recommend it, she states that it is absolutely necessary in order to sustain consistent control of cortisol throughout the day.
Glynda
Hi Patti,
Oh boy...Tipper and Lucky...that must have really been frightening! I'm so glad neither one was hurt in any way. Poor Lucky, still not 100% feeling well and lost a bit of fur. Tipper means business doesn't she...I guess you're right, don't mess with Tipper!
Hoping you have an easy and safe ride tomorrow. From the forecast I just heard you should be just fine on your drive tomorrow...watch out on Tuesday and Wednesday though..looks like the snow moves East.
Glad Tipper has been having good nights...hope it keeps up!!
I see the Steelers did win the game!!
Barbara
Have a safe trip tomorrow. I hope the roads aren't going to be too awful
hugs,
Sharlene and Molly Muffin
Thinking about you and the trip today. Keep safe and let us know when you are back.
Hi Everyone:
We are back form the dreaded trip. It was really bad around the country roads here this morning as we had snow last nite. It was 12 degrees when we started out. the first hour of driving was in the dark. When we got about 45 minutes out of here there were clear roads. On the way back basically the same thing. So here is the eye report:
Mild iris atrophy, lens sclerosis, stable tear film, no retinal hemorrhages, calcium deposits the same on the right eye, decreased in the left eye.
From all medical reports it is very likely her spleen reaction to the storms caused this hemorrhaging. Advised by client that Reticulocytes will be tested in about a month. No visit needed until April. He said this dog has better vision than he does. So I am very pleased with all that. Now if I can just get over the next 2 hurdles in January I can calm down a bit. I carry Tipper every where I go and never put her on a floor anywhere because of germs and her legs in the back. An older lady had a big grey dog you could see it was old, she held the door for us. Her dog wanted to get close and smell Tipper the Ripper, so she smelled Tipper's foot and Tipper growled and tried to lunge at her and showed her teeth. The old lady said "boy for a little dog she is brave going at this big lug!" We were all laughing. She was so tired of riding in the car and so was I, it is a long trip back and forth. She walked a short walk at home as it is too cold out. I just wanted to get her legs moving after she lay in the car for 5 hours. We were both up a lot last nite. I kept worrying I would sleep in and be late. I don't know if Tipper sensed that or she is not controlled. I am so tired and just going to do what I have to today. I had to run up to the bank after we got home, I saw some unauthorized charges on my debit card, so I had to cancel it and get a new one. My old man neighbor came over and told me his daughter had 3 turkeys given to her, and she does not like turkey so he was going to give me one. I know he wants me to cook it and send some over, I am no dummy to this, but that's ok. It said we are in for really heavy snow and bad weather tomorrow thru the rest of the week. Blessings
Patti
The eye report sounds good, Patti and I am so glad you are back home safe and sound.
My 20 minute commute turned in to 45 minutes this morning and we hardly had any snow.:rolleyes:
Stay warm and safe and inside:):):)
Glad you had a safe trip there and back. Eye report sounds pretty good.
Now maybe you can relax for a bit. :) Well after you cook turkey for your neighbor that is. :)
He sounds pretty lonely and I bet he is very grateful for all you do for him. What a wonderful person you are Patti.
hugs,
Sharlene and Molly Muffin
WTG Tipper glad to hear all went well today at the appointment. Now maybe you can chill out a little bit Patti. I hope you got your meds and are looking after yourself. :)