11 year old Doxie with tumor on Adrenal - Bondo has crossed the rainbow bridge

I can totally believe that. Have you heard of vets who don't recommend any treatment for cushings though?
That is a new one for me.

Sharlene

Yes, Sharlene, there are times a vet will not suggest treatment if there is a current illness that would not allow it or that illness would become worse.

Also some vets will advise not to treat just becuase they dont know any better because the disease is hard to diagnosis and they are afraid of the drugs.

Love ya,
addy

Thanks Addy. I know you shouldn't treat cushings if there is another illness. I was wondering though about one who has just straight out recommends not treating at all for cushings. I think you supplied the answer to that though too. :)


Hugs,
Sharlene

A couple of years ago, I was looking for vets to treat Squirt while visiting a friend in case something happened. Out of something like 14 vets I called, only one treated Cushing's. The rest either simply didn't treat it or sent the pups to Memphis to an IMS. I was floored but have found this response not to be uncommon at all. The reasons were varied - owners wouldn't or couldn't do their part, there is no cure so no point in treating, they didn't know enough and didn't want to learn, it is too complicated for a GP vet. So, yes, vets will tell folks not to treat even in the face of obvious signs or when presented with a cush pup already on treatment.

Cushing's is difficult for not only us but for the vets as well. They aren't taught a great deal about this in school and what they are taught isn't positive...owners will fail to do their part or can't afford it so don't bother mentioning treatment, and that two year thing, ya know. :rolleyes:;)

Hugs,
Leslie and the gang

Good Morning to all
First of all, if any of our readers are anywhere near "Sandy" my thoughts and prayers have been with all of you these last few days. How very sad.

Well, yesterday was our appointment with Bondo's vet. He said he did not need to do any blood work now but to wait 7 days after we start the Trilo. Bondo weighs 22 lbs and he put him on the 30 mg. After doing some research and thinking he should only be on the 20 mg. ....the 30 mg did fit into his weight range.

I gave him his first pill this morning and I am the who ( I think) are having the symptoms..... I will watch him very carefully but, still, treating him like normal. The vet said I could take him off at any time and to call him if I need him. Like several post have sugguested that I get a prepscription for the presidone which I did...(*thank you all)

I agree with Leslie that most vets do not really "treat" cushings as so many of their clients do not want that expense of the Trilo for the rest of their dog's life and if the dog only has a few of the many symptoms they just let the dog be.

However, I do believe that there is a difference in ENLARGED glands and a TUMOR on the either gland. Am I right?????? Bondo just has enlarged glands, no tumors. If a tumor is present, the vet may have been more interested in starting the dog on some type of treatment.

Happy Halloween to all of you and stay safe.

Love and dog licks to each and every one of you.
T

Hi Trese,

True Cushing's always involved a tumor. Either on the pituitary gland or on the adrenal glands. Most cush pups, 85%, have the pituitary tumor which leads to the diagnosis of PDH - pituitary dependent hyperadrenocorticism. The remainder of cush pups, about 15%, are diagnosed with ADH - adrenal dependent hyperadrenocorticism. Both are true Cushing's, the tumor placement dictate whether it is PDH or ADH. But tumors are always involved. There is another form called Atypical (not considered true Cushing's) in which the cortisol is normal but one or more of the intermediate hormones are elevated. In this form, a tumor may or may not be present on the pituitary.

In general tho, Cushing's = a tumor. ;)

Hope that helps!
Hugs,
Leslie and the gang

Usually enlarged adrenal glands, and you have done all the tests and come back positive for cushings, the LDDS, ACTH, Urine, ultrasound, then it is probable that like Leslie says, there is a pituitary tumor. Many of these are very, very small.

How's it going with Bondo? First day nerves?

hugs,
Sharlene

Hello to all.
It is a very windy night this evening and we may get some needed rain. yeh. I have not posted for awhile as I was keeping a journal for my Bondo and wanted to post that......

Bondo started on his Trilo (30 mg.) on Oct.31st. I had to go into the Vet to pick up Trilo and he was going to do blood work but decided not to. Home I went with Trilo in hand.

Oct. 31st. 8:40 gave first pill. I give Bondo a small piece of chicken with the pill tucked inside....then I put his meal down
11:50.........resting
1:00............I think feeling good. Barked at postman.
2:46...........wants me to play with his Sqeaky with him
5:00 ...........ate dinner

November 1st.
7:45 .............gave pill the same way. This is what I feed Bondo...Chicken Breast meat I just bake in the oven with a little water. I make up alot of pieces and freeze them, small amount of brown rice, small amount of raw carrots and dry dog food ( Natural Choice) and I just started adding VITAL made by Fresh Pet. It is called Complete Meals.
Rest of day went well
9:15 PM Very groggy and moving slow. His stomach is making alot of noises.

November 2nd
Same routine. His water consumption is down a bit. He is, still, hungry alot. Sat in the sun with him today He seems just to start off into space at times.

November 3rd. Very good day. He is very perky.

November 4th Good day again. His sores are,still, there on his neck and body.

November 5th Good day

November 6th
9:30 picked up Bondo and he let out a little yelp. I think I just pinched his skin. Hope nothing else is wrong.

November 7th.
Good day.....had Vet appointment at 4:00 pm and the Vet was happy with the results. He wants me to come back again in a week. The results : White blood cells a little low, Platets were at 68. His cortisal was a 6 with the range being 1.1- 5.0 the vets tells me.

So that brings us up to today and I just checked on the "I call him the little money pit".....and he sleeping very nicely up in the recliner with his blanket tucked around him......He is such a good boy.

The VCA hospita sent me the ultra sound results and I will post them here in my next post.

The reason this post in so long, I just wanted to give new "cushings" dog owners info that not all dogs have adverse reactions to trilo and you must think postive and take one day at a time..... Night to all.

The acth stimulation test must be done within 4 to 6 hours after dosing. If you give Bondo his pill at 8:00 am, you need to have him to your vet by 12:00 and really no later than 1:00. A post stimulated number of 6 is good but given that the stim test was done way too late in the day, I think Bondo's cortisol levels are actually lower. That plus the fact that cortisol will usually continue to fall in the first two weeks and sometimes well into the first 30 days, I don't think Bondo has much leeway so please keep a very close eye on him for signs of low cortisol. It's very possible that 30mg will prove to be too much for him.

ACTH stim tests are not cheap and since Bondo is a smaller dog, you can save a lot of money by providing your vet with information on how to store the stimulating agent, cortrosyn. This stuff is liquid gold and even though instructions call for using the entire vial, your vet need only use 5ug/kg. There are 250ug in each vial so I'm sure you would get several stim tests out of one vial. Please either refer your vet to the url below or print out the article and give it to your vet. It will be well worth your while to help your vet help you.

http://endocrinevet.blogspot.com/201...rosyn-for.html

Also make sure your vet understands how to monitor treatment properly so that undue risk to Bondo are mitigated. You can help your vet by providing him the url below to Dechra's treatment and monitoring charts.

http://www.dechra-us.com/files//dech...ate_3_2_ps.pdf

If you have any questions about any of this, please don't hesitate to ask. It's all a lot to absorb.

Glynda

From what you are describing, I am wondering whether perhaps your vet just drew a resting cortisol level on Wednesday, rather than a full ACTH stim test? Were there two blood draws an hour apart, or only a single one? Since Bondo is only one week into treatment, I am thinking that maybe your vet is waiting until the two-week mark to perform a full stim. He may have chosen to draw a resting cortisol level just for some added confidence that Bondo is not dropping too low on this initial dose of trilostane. Some vets are starting to add baseline cortisols into the initial protocol as "interim" readings. And if the resting cortisol was 6, then he was definitely not too low at that time.

But if it WAS a full ACTH stim test, then Glynda is exactly correct in everything that she has advised you...

Marianne