Joined Today (Orlando has passed)

Orlando had his last ACTH on Wednesday, along with the geriatric blood panel. He will remain on the 50 mgs of trilostane once a day, which is fine with me. He does not seem to have any serious issues with it and I was glad to see that it has remained the correct dose. It was funny as the receptionist in the vet's office, who is probably in her 20s and not that experienced, made a point of telling me to fast him before the test. When I got in, I told her what I had done, which was to give him the trilostane within 4 hours of when I felt they would do the testing and to give him a light breakfast....as I have said he is never one to rush over to food in the first place, so it was not a huge amount. I told her that I did not want some high false reading which would put him back on a higher dose and then here we go again. She told me that apparently she should have been asking me the questions, with which I agreed completely. So thanks to all of you for keeping the info updated on all of this.
I believe that O is still somewhat arthritic. He is no where near as bas as he was with the high dose of the trilostane, not even reacting as if he is in pain, but still slow to walk and disinclined to go very far. The vet has ruled out the NSAIDs due to his high Alk Phos numbers which are now down to 430 which is a drop of almost 200 points since the last test. I am fine with that as I have always had issues with them from years ago with another dog. What do you recommend in terms of natural arthritis supplements, or even meds like Adequan? Currently he takes no supplements for this.

A good supplement is Glyco Flex. It comes in 3 strengths and my dogs love them like treats. Adequan is good. Also look into Dasuquin and Cosequin. Hydro therapy,cold laser therapy, and acupuncture can also do wonders.

Glad Orlando is doing well on the Trilo!

I use the glyco flex III for my dog. It does help her.

Good job on following proper protocol for the testing even when told wrong by the vets office. :)

After some thinking, I remembered that I had purchased some Phycox a while back for Orlando, but he did not like the taste and would not take it. This time around, I decided to break it into little pieces and give it like a pill, which was reasonably successful. Just in case anyone would be interested, the results were amazing. After two days he willingly went on his old walk, played tug of war after his bath, and remained much more up and alert....right up until his mommy figured out that the COX part of the name means that it is a COX2 inhibitor. I am going to look into the Glyco Flex, and in the mean time found another formula at a privately owned pet store which has most of the desireable ingredients without any NSAIDs. But I do have to say that the results were shocking for anyone whose dog can take NSAIDs.

Orlando has continued to do well on the 50 mg dose of trilostane. The cold weather has helped him to feel more energized and we are walking a little more, which he seems to enjoy. However, a new issues has arisen. The vet who has treated him as moved to another veterinary hospital a few miles away.While I am on very good terms with the remaining vets at the old place, I would like her to keep treating his Cushings. Orlando is very much afraid of other dogs, probably stemming from the fact that he was taken away from his mom at 3 weeks old and never had that learning time with her. He ironically loves to go to the old vet, loves everyone there and has not had any trouble being left there for the time that the Cushings testing takes place. I think that this is because as a little sick puppy he was taken there early on and bonded with them However, it is out of the question for him to go to a dog park, Petsmart, etc without complete panic setting in. I intend to take him to the new hospital for a trial run in the near future, probably about a month or so. If he completely panics, would it be a good idea to leave him for the stim test? Can the cortisol level be raised or can a false reading result if he becomes hysterical? I can try to insist that they let me stay with him, but I don't know what their policy might be about that. I do basically trust the vets at the old hospital, but would prefer that he see the same vet if possible....but I don't want to mess with the level of trilostane that he is taking if it is not completely necessary.

Panic can cause cortisol to raise, whether it would be enough to completely skewer the ACTH test or not I don't know.
I definitely would not have his first trip to the new vet hospital be for the ACTH though.
It might be getting the ACTH done by the regular vet hospital he is comfortable at would be the better option, while slowing introducing him to the new hospital. You can get the results and then decide what you want to do after you know the results and even call your regular vet or have the results faxed to your regular vet. I do think you need to do a gradual transition though if panic is an issue.

Thanks so much.....I do plan to bring him to the new place for a trial run before I would even schedule the test. That might answer some questions, but you have a good point about having the test done at the old hospital and then taking the results to the previous vet. I am trying to recall....are test results legally mine or could they give me a run around? I don't think that the parting of the old vet was on good terms, although I am not suggesting anything like malpractice.

Did you or do you have a plan for Orlando getting his ACTH test yet?

Sorry to be away for so long. Orlando and I made the trip to the new hospital last month and while he was uncomfortable to some degree, he did not react as much as I expected. The vet agreed that he could stay in the waiting room with me for the duration of the ACTH test, not be put in the back or in a cage, and I think that is probably a decent compromise. He continues to be stable and for that I am thankful.

Now I have another question. Do you advise not giving vaccinations to Cushings dogs? This was something that I was told by a coworker who had a Cushings dog at one time. I am not an anti-vaxxer, having had a puppy years ago who barely survived parvo, and an acquaintance whose dog died of distemper after she had run titres and believed he was safe.

Welcome back, and I'm so glad Orlando is doing well!

As far as vaccinations, as I'm sure you're aware, many people have strong opinions. What I can offer you is simply my own opinion. I don't believe vaccinations should be given to anybody, human nor dog, during a time period of acute illness. However, dogs with Cushing's cover a broad spectrum, from those who are newly diagnosed with highly elevated cortisol and concurrent infections or vulnerabilities, to dogs who have been stabilized with treatment and enjoy controlled cortisol and are otherwise doing well. In the former situation, I would want to withhold vaccination. In the latter case, I would opt to vaccinate based upon the advice of my vet and the individual risk factors that are pertinent for my dog (prior vaccination history, age, lifestyle, geographics, liklihood of exposure, etc.).

For vaccines that seem appropriate for my dog, I would definitely try to obtain the longest-acting version that is available and that is allowed where you live -- for instance, 3-year rabies and 3-year distemper/parvo combos. And finally, humans and animals with compromised immune systems may be advised not to be injected with any "live" virus vaccines. Since the elevated cortisol of Cushing's does suppress the immune system, this can be another issue or consideration to discuss with your vet.

As I say, this is only my personal opinion based on my own reading and conversations with my vets, and you may hear from others here who feel differently. But whatever you decide, I'm really glad that Orlando is doing well!

Marianne