Jasper (12 yr old Mini Schnauzer) is now at peace

Jasper has continued to drink (and pee) a ton throughout the weekend. He has been eating the dry low fat i/d food, but is not as enthused about it as the canned. For every meal both Saturday and Sunday he would walk away briefly from the bowl at least once, but then return on his own and finish everything. Now this morning he walked away a couple of times, has eaten about half and now will not finish. I am wondering if his appetite isn't so good because we have tapered the prednisone dose.

He has been getting the decreased dose of 2.5 mg daily since 11/13. Maybe since it has been 7 days, it is catching up and affecting his appetite? He seems a bit less perky since the decrease also. Maybe it is my imagination, but I don't think so. My vet and the IMS feel 5 mg daily is too high of a dose for him to continue on long term. I am wondering if maybe he won't be able to tolerate the lower dose? I will be talking to my vet today, she is supposed to be calling to check in, so of course I will see what she has to say.

Tina and Jasper

Hi Tina,

I hope the vet has some answers for you today. Tasha takes 1.25mg of pred daily and she weighs 13 lbs...and acts just like one would expect with a pup on daily pred - lots of drinking and peeing and always starving. Sounds familiar, huh? ;)

It's not uncommon to see a slight increase in water intake when a pup goes from wet to dry feed because of the higher moisture content in the wet feeds...nor is it uncommon to see a pup prefer wet to dry feed as it tastes so much better. :D Not that I've tried either one, nooooo, not me! :D

Hang in there and let us know what you learn. You're doing a great job, Mom!
Hugs,
Leslie and the gang

Tina,
I hope you find the answers from your vet. Please let us know what he/she has to say.

BTW: Leslie, you made me laugh when you were talking about "NOT" trying the wet/dry dog food. Hmmm, I have to wonder. :confused::confused::p:p
It reminds me of a few months back when I was trying anything to get Bo to drink water by even getting down on all fours near his water bowl and showing him what he needed to do. Not that I really drank any. LOL We do it all. :D:D

Tina, Happy Thanksgiving to you and Jasper. Crossing fingers for answers.
The thing with Jasper is that he seems to react to any and every little change in a big way. That makes it hard to tell what is going on with him. :( Interested to see what your vet has to say.

hugs,
Sharlene and Molly Muffin

Thanks Leslie, Belinda and Sharlene for the support. Jasper ate just a few bites of his dinner tonight and then walked away from the bowl. He almost acts like maybe the food doesn't smell good. I just left the food there and each time he went to get a drink, which is quite often, I could hear him eating a few bites. He managed to finish it over about an hour or so. This is totally unlike him. His whole life before Cushings he would always finish his whole meal, no problem.

I just got done talking to my vet a bit ago. We discussed all that is going on. She was disappointed and concerned to hear about the appetite issue, and the excessive drinking. She agreed that the increased drinking makes no sense since the prednisone has been decreased. This makes her think that maybe it is not a side effect from the prednisone, but really is a manifestation of the Addison's. She also pointed out that we are at the tail end of the Percorten also, so it doubly doesn't make sense. The IMS felt that his symptoms were due to side effects from the meds, but now she isn't too sure since the drinking is so excessive now. His intake has been 72 oz daily for the past 4 days, and he is on track for that today also.

She recommended that I see if Jasper will eat a small amt of the canned food tonight, and if so, start mixing in a small amt with the dry food for tomorrow. Well, he did eat it right down. So that is good, the last time he stopped eating he wouldn't even eat the canned food.

We discussed that maybe his cortisol is going back up on its own. We both don't really think so, but we are going to check a baseline cortisol after work tomorrow just to see where we are at with that. I will hold the prednisone tomorrow until after the test, and then we are going to increase it back to 5 mg daily to see if it will boost his appetite. And I think she is a little concerned about him maybe starting to head toward a crisis again. I did tell her that he seemed to really feel better when he was on the 5 mg dose. She is thinking he might not be able to tolerate the lower dose. We should have the cortisol result back on Wednesday, I will talk to my vet again then.

Sharlene, you hit the nail on the head - it is hard to figure out what is going on with him when he reacts so much to every little thing.

Ok, now for something funny. Well, it's funny now that it is all cleaned up. While I was talking to the vet about Jasper and taking notes on everything, my puppy proceeded to have diarrhea poo right in the middle if the living room. :eek: :eek: Where is the Calgon when you need it?!! My vet said I could give her a couple of half doses of Jasper's emergency metronidazole. We just had to laugh so I didn't cry, literally. I guess it was handy that I had my vet on the phone! :rolleyes:

Hugs,

Tina and Jasper

When it rains it pours -Calgon take me a way or Chocovino works quite well:D:D

Since he ate the wet willingly, could it be you may have to keep mixing wet in to the dry? They cultivate a taste for wet pretty fast;) The dry doesnt smell nearly as good:):) Oh the pups and food.

I hope things get figured out for Jasper, you have been trying so hard with him.

I hope you have a good turkey day!!!!!!!! AND I hope puppy feels better as well.

Hi Tina,

Something else to talk to the vet about today is the possibility of diabetes insipidus. This is a rare form of diabetes in which the body cannot process water normally and has nothing to do with blood sugars like diabetes mellitus, the common form. The testing for DI is risky so many vets simply start treatment to see if it helps. If it does, the diagnosis is confirmed and treatment continues. We have had several cases of DI here so it's certainly worth asking about. ;) Excessive drinking and urination are hallmarks of DI.

Let us know what you learn today and how this sweet boy is doing.
Hugs,
Leslie and the gang

Oh Tina. Poor Jasper. He's had a hard road lately. You are both due for some smooth sailing.
I certainly hope they can get this figured out so that you can find some sort of normalcy again.

hugs,

Sharlene and Molly Muffin

Thanks Everyone. Yes, things have been a bit discouraging, but I am trying to stay positive. Jasper is eating his dry food with about 1/4 can of the canned food mixed in. I am hoping that continues, tonight he hesitated a bit but did finish. I took him in after work and he had a resting cortisol drawn. I am anticipating that it will still be way low, but who knows. I gave him a dose of prednisone 5 mg after we got home per my vets direction, as the pred was held this morning. We did not see the vet tonight, the blood was drawn by a tech.

Leslie, thank you for your comments about diabetes insipidus. Kim had also mentioned this to me a while back as something to look into. I think you may have even mentioned it before also. I remember I started to research it, and then Jasper got sick with colitis, wouldn't eat, etc. If I asked my vet about it then, I don't remember what she said. I did some reading about it while I was at work today, and will definitely be mentioning it to her and asking about it when we talk tomorrow.

A couple of the resources that I read mentioned that the nephrogenic type of DI can be caused by adrenal disorders such as Cushings, due to the effects on the kidneys. I searched and searched but wasn't able to find much information about that specifically. It sounds like this type is the more difficult to treat. The other type is called central DI which is more successfully treated, and is treated by desmopressin drops. It sounds like this treatment is not effective for the nephrogenic type.

So, I will see what I can find out from my vet when we talk tomorrow. She mentioned that she would have the cortisol results by then, it must go out to a lab in town.

I am struggling to stay positive about things and not get really discouraged. I know that being sleep deprived is contributing to this. Getting up every couple of hours during the night to let Jasper out continues to take its toll. I am praying that somehow we can get this under some control. And at the same time I know we have much to be thankful for this Thanksgiving season. We are so incredibly grateful for all the dear friends we have made on this forum, I can't thank you all enough.

Love and hugs from me and Jasper

Tina, Hang in there. Couple of thoughts - first off Glynda posted an article written by a well known specialist and it talked about schnauzers and how prone they are to get certain diseases and both types of diabetes were mentioned. I think it's worth checking out.

Also was wondering if the change in food and change in prednisone at sort of the same time didn't make things harder to figure out. Give Jasper a big hug from us and have a great thanksgiving ok? Kim

Hi Kim! Yes, I have thought the same thing about the change over to the dry food and decreasing the pred at about the same time also. :rolleyes: I remember I even asked my vet about it because I thought the initial plan was to wait until he was all the way transitioned to the dry food before doing anything with the prednisone. She said to go ahead and decrease it. I think the reason for this is that she was hoping to try to have Jasper go without the Percorten injection this month as the IMS had suggested as a possibility to try. We are on kind of a timeline with that as it is due 11/23. She wanted him on the lower pred dose for a while before we tried that. Right now, the plan is that he will get the injection on Friday, because he is not stable with the prednisone and other things right now. Of course that will also depend on the cortisol result from yesterday. Ugh, it is so complicated! :o

How do I find Glynda's post, is it under the resources section?

Tina and Jasper

I have a few minutes to search the forum... if i don't post it, it's because i had to go to work. lol. We'll find it.

I found the article and the focus is on diabetes mellitus - skimmed it as I have to go... could have sworn it discussed DI but I don't have time to read the whole thing right now... if it is meaningless... forgive me! :o

http://endocrinevet.blogspot.com/201...ceridemia.html

Hi Tina,

When was the last time your vet did a full blood chemistry or even an in-house mini chemistry which includes kidney values, at least one (ALT) liver enzyme and glucose. Can you get a copy and post the results here? I would be most interested in the glucose.

Glynda

Thanks for the link to the article Kim, it was not meaningless at all. It related to diabetes mellitus, but I read it anyway because it pertained to mini schnauzers with high triglycerides, which Jasper has also. :rolleyes: It was interesting, I love reading Dr Peterson's articles.

I talked to my vet today and the resting cortisol drawn yesterday was still < 0.4 ug/dL, so it has not come up at all. :( I think the lab must not be able to measure a value lower than this because the result always says < 0.4.

Glynda, I verbally obtained the lab results you were asking about. My vet said the last blood chemistry was done on 10/22 and it was all normal except for an elevated Alk Phos which was 1869. This was higher than the last check, she said it had increased due to the prednisone. The ALT was 53, and glucose was 110, which said were both normal. I will get a copy of all of the labs I am missing when we go in Friday for the Percorten, and can post the complete report with reference ranges then.

I asked about diabetes insipidus, and we discussed that. She basically said that she had been considering that as a possibility more about a month ago, before Jasper had those 2 1/2 weeks where the drinking and peeing had significantly decreased and some days it was even normal. She said that you don't see that happen with DI, that usually it is progressive, so she feels it is less likely since he had a period where his drinking was better. She is really wondering if the increase in the drinking/peeing isn't a function of the Addison's, and we see it start to go up when he is getting ready to get into trouble with the Addison's.

She said she has not completely ruled out the possibility of DI, but said it is very rare. She said she has only seen one case in 15 years. She wants to give the higher dose of Prednisone a chance again and see how he does. He will also get the Percorten injection on Friday 11/23 as scheduled.

So that is where we are at with things now. He ate pretty good tonight with some canned food mixed in. Thank you all so much for all the kindness and support extended to me and Jasper.

Happy Thanksgiving to everyone and their pups. :)

Love and hugs,

Tina and Jasper

Thanks for the update. Your vet sounds on top of things as always. FYI the other reason I brought up DI is because we've seen it here a bit and the ones I can remember were all schnauzers. Kim

Happy Turkey Day and GO BIG RED! ;)

OMG, GO BIG RED is right, how did I not mention that?!! :D ;)

Thanks for the compliment toward my vet, that really means a lot coming from you. When I asked about DI, she paused and then said "I wasn't going to mention anything about that". She knows how I am about details and didn't want me to worry more than I already am. We both kind of laughed about it. She was very open about her thoughts once I asked. She even said that the diagnostic water deprivation test is very risky and she doesn't do it, just like Leslie mentioned. Sometimes I think I drive her nuts with all my questions, but she is always very patient. I appreciate her so much.

Hugs from me and Jasper

Jasper had his Percorten injection today. My vet decreased the dose by another 10%, so he received 0.8 ml. It has been 5 days since the prednisone was increased back up to 5 mg daily. He has been eating good with a bit of canned food still mixed in, and seems to feel much better again overall, I'm sure due to the higher pred. His drinking and peeing continue to be excessive, but are a little less over the last day or so. Hopefully it will continue to trend downward! My vet is going to call in a week to check in and get an update.

I got printouts of a bunch of labwork. I need to go through it and will post his last chemistry results that Glynda was asking about a bit later.

Hugs to all,

Tina and Jasper

Well, it might not be the best suggestion for clear thinking when reading lab results but the first time I brought molly's home to go over, I sat down at the table with the results a piece of paper and a great big glass of red wine.
It took a while to get through. The bottle moved to the table nearer to the glass, the papers were all over the place and I was a mess over all. Of course by the end of it, I had what I needed to know and didn't really care that the table was a complete paper zoo. (probably the wine thinking there)
LOL

Good luck!
Sharlene and Molly Muffin

Hiya Tina, I am so pleased to read that little Jasper starting to feel better. That pred is amazing stuff!:) I believe Addisons like Cushings takes a bit of playing around with until you get the right dosage. Some dogs need more-some less. Sounds like you're on the right track with Jasper, now.
Hugs to you and your little man
Leah

Thanks Leah, so good to hear from you. How are you doing? I think of you often and hope you are hanging in and healing. Yes, I am finding that lots of adjustments are needed to manage Addison's also. Jasper's last resting cortisol was still < 0.4 ug/dl which is practically 0. So it looks like he is going to likely stay permanently Addison's. I think my vet wants to wait another month to make the definitive diagnosis, she said something about the adrenals not recovering for a period of 4 months, and then they consider that it is permanent Addison's.

I feel that Jasper is going to need to stay on the 5mg daily dose of prednisone. It seems that every time we try to decrease it to 2.5 mg (which is the dose that my vet and the IMS say is what he should be on), he starts to not feel well and have problems. So I guess we will see. I worry about the effects of the higher dose on his liver. He continues to drink and pee a ton, otherwise seems to be feeling pretty good. Thanks so much for checking in on us Leah.

Hugs,

Tina and Jasper

Ok, I am finally getting back to post the lab results that Glynda asked about a while back. I got a verbal report for some of the values from my vet and posted those previously, but here is the complete report. This is a Mini (in house) CHEM blood panel, drawn on 10/22/12. This is the last time it was checked.

ALP 1869 U/L (20-150)
ALT 53 U/L (10-118)
BUN 5.0 mg/dL (7-25)
CRE 0.9 mg/dL (0.3-1.4)
GLU 110 mg/dL (60-110)
TP 7.9 g/dL (5.4-8.2)

It looks pretty good except for the ALP, which has been high, but has gone up quite a bit since the last time it was checked. My vet said it has increased due to the prednisone. Should I be worried about that? He has to be on the prednisone, but as I mentioned before, I am worried about the higher dose.

He had gone in on this day due to not eating. He broke with colitis the next day, went back on bland rice and hamburger diet, and a course of metronidazole. The pred was also increased back to 5 mg daily.

Tina and Jasper

HI Tina and cute Jasper!

I am not much help with the numbers or his condition, but wanted to pop in and say hello and wish Jasper a happy day :) and thanks for your support with my journey too, it is so appreciated
Trish and Flynn xx

I'm sure someone will be along to check the numbers for you.

Just wanted to say hi and hugs

Just wanted to send (((((HUGS)))) also.

I'll let the numbers people talk about that too. The only other thing I see is that the Glucose is at the high end of the normal range, but I'm not sure what that means...maybe something to keep an eye on?

So many of our babies here have the really high ALP values. It seems to go along with cushings and now with the prednisone might be a part of Addisons too. So, again something for those who have been through this part of the journey to comment on.

Okay, so I know nothing! ROFL But hey, Big super duper Hugs to you and belly rubs to Jasper and a tickle to Shelby too. :) It's friendly Wednesday!

hugs,
Sharlene

Hiya Tina! I'm doing quite well thanks, considering.... The pain is starting to ease and my heart is beginning to heal. Things get a little better as the days go by. The photos and canvas we ordered arrived yesterday. We totally overdid it by ordering too many:o, but I don't care, they are beautiful! I have her up on the wall in every room of the house, so I can see her precious little face every time I walk through the door.:)
Regarding Jasper's ALP, it's bound to be high due to the prednisone and unfortunately not much can be done about it. If it's any consolation, Maya's ALP was over 3000 for at least a year! The specialist said, "Yep, it's high, but no dog ever died because of a high ALP." The best thing you can do is carry on giving him milk thistle or some kind of liver support.The peeing and drinking are probably also side effects of pred, so you'll just have to keep those rags handy!:p
I know it's hard, but try not to worry about something you have no control over. You are doing a great job! You said yourself, he needs the prednisone, so your main concern right now is helping him feel better and if 5mgs does the trick....so be it!:) Maybe some time in the future he'll be able to come down a bit. Just make sure you give Jasper his pred on a full stomach. That way there is less chance of it irritating or causing ulcers in his digestive tract -which seems to be one of the main concerns about prednisone.
I'm glad he's feeling better!:)
Love n hugs, Leah

Tina-

I just read through your whole thread. Holy heck!!!!!! You and Jasper have been through a lot. I am so sorry your little buddy has had so many highs and lows. Geez! I sure hope he stabilizes soon. How in the world have you been emotionally? I would be a total wreck. You are a good Momma. Give that baby a big belly rub from me.

Hugs,

Ro

Hi Everyone,

Finally getting some time to get a little caught up on the site. Thank you Leah and Ro for the posts of support.

Leah, glad to hear you received the photos and canvas of sweet Maya. I bet the canvas is just beautiful. You can never have too many photos as far as I'm concerned. :) I think of you every day and hope that things continue to get better and you continue to heal. Hugs....

Ro, yes, my Little Man has been through quite a bit, and there have been many times where I have just been a wreck. The worst I think was when he was hospitalized for the second time in a week due to an addisonian crisis and also had HGE. He was so sick and it just seemed like a downward spiral was happening. I was terrified and had a pretty big meltdown then. There have been a few setbacks since then. I somehow force myself to be strong for him. He is very sensitive and knows right away if I am upset, so I have to hide a lot from him because I don't want him to sense that and worry. I always hide my crying because I don't want him to get upset. It is not easy. The belly rub was given and enjoyed, Jasper thanks you! :D

Last Friday 11/30 my vet checked in. Since Jasper was overall hanging in there and doing about the same, she wanted to give it another week on the higher prednisone dose to see if the drinking and peeing would decrease at all. He has been feeling comfortable on that dose, but the drinking and peeing have continued to be excessive and she wondered if it might still be a manifestation of the Addison's.

She called for an update on Friday 12/7. Jasper continues to seem to feel good, appetite is good, etc. but the excessive drinking and peeing continue. It has not decreased at all. My vet is not sure, but thinks it may be side effects from the prednisone and is recommending that we switch the prednisone to dexamethasone. (this was part of the plan after she consulted with the IMS if the symptoms didn't improve). She said some dogs that can be sensitive to prednisone and have sides effects sometimes do better on dexamethasone. She said the dex is more potent than the prednisone, so the dose will be quite small. Jasper's pred dose of 5 mg translates to about 0.5 mg of dexamethasone so that will be the dose that we start with daily. It is longer acting than prednisone so she is hoping that we will be able to decrease the dose after a few days, as long as Jasper continues to feel well. And of course hoping the drinking and peeing decrease. :rolleyes:

So I will start the dex tomorrow. The plan was to start it yesterday, but Jasper had an appt with the groomer and I didn't want to start a different med the same day. He got sick and stopped eating a few days after he was groomed the last time, but was on the lower pred dose then. Now he is on the higher dose and I gave him an extra dose last evening and his regular dose this morning, so I hope this is enough to counteract the stress from the grooming. Oy, it is so much to think about! :eek:

So that is the plan now. If anyone has any information, feedback, or experience with dexamethasone, I would greatly appreciate it. I have done some reading, but I am still a little nervous to do any kind of change. From what my vet has said and what I have read, it shouldn't be a big deal. But then again, we know that my little guy doesn't follow the rules, so I am a bit leery.

Hugs to all,

Tina and Jasper

Today is Jasper's second day on dexamethasone rather than prednisone. It may be my imagination, but he seems a little less perky than he was. His appetite is still good and he ate well tonight. That seems to be the first thing to go when he starts not feeling well, so I guess I will just keep an eye on things.

My vet prescribed the dexamethasone at 0.5 mg daily for 4 days, then decrease to 0.25 mg daily for 6 days, then decrease to 0.25 mg every other day for long term. I was originally supposed to start the dex on Saturday but delayed it because he was getting groomed on that day. Now this will put us starting the decreased dose on Friday, just before then weekend. I am a little nervous about that, I think I will call my vet tomorrow to see if she wants me to stick to the taper schedule since I started it later than we had originally planned.

I understand that dexamethasone is longer acting than prednisone, but does it start working just as quickly after each dose? I have searched on the internet but can't seem to find any information about this. So far there hasn't been a change in his water intake, but it has only been a couple of days. I am praying this med change helps with this.

Tina and Jasper

Hi Tina
Hope Jasper does well on the Dex, hopefully you will see an improvement in his symptoms. Not much help on the speed of it working, but praying alongside you that it does work better than the Prednisome!
Trish xx

How is Jasper doing today with the Dex Tina?? Hope all going well and just checking in on you :)

Trish and Flynn

Just stopping in to say hi and check on Jasper. I am no help with the meds, but I can send a big belly rub to jasper:D.

Hey there, hope all is going well with you and Jasper and Shelby!

hugs,
Sharlene and Molly Muffin

Hi Everyone,

Thanks for checking in on Jasper. He seems to be doing ok on the Dex. I decreased the dose to 1/2 tab (0.25 mg) daily starting Saturday 12/15, and so far so good. The vet said to give this dose for 6 days, then decrease to 1/2 tab every other day. I am not sure I want to do that going into the weekend or the holiday, so I may delay that decrease. I am kind of scared to go to every other day, but the vet said her goal is to get the dose down to 1/4 tab every other day for long term as long as he can tolerate it. I guess the dose he is on now is still higher than the physiological dose needed for Addison's, so that could be why we haven't seen any consistent decrease in his drinking and peeing. (That's why I'm up now, to let him out!).

We are still hopeful that we will see a decrease in these symptoms as we get the Dex dose lower, but my vet did mention that Jasper may be showing signs of very early kidney disease, before it shows up in the blood or urine tests. She is on the fence with that thought right now, but did put it out there since he continues with the excessive drinking and peeing. I am seriously trying to not think about that possibility now.

He has an appt for tonight (12/19) for his Percorten injection and to have electrolytes drawn. We are expecting a winter storm to begin here later today, and they are saying that they are expecting near blizzard conditions by the evening rush, so I am a bit worried I may need to reschedule him. I hope it will be ok if I do, the injection is given every 26 days, so not sure if it can be a little late or not. Hopefully we will be able to make it. :rolleyes:

Hugs,

Tina and Jasper

I am going to hope for the best & pray that Jasper's little kidneys stay clean. ;) I don't want you to have to worry about anything else. :(

Sounds like winter is heading your way... burrr!!
Keep warm & I hope you & Jasper have a Merry Christmas. :)

Well, we will cross the kidney problem when we have to right?
Hunker down for the storm, hope you can stay warm and cozy INSIDE:D

I looped Zoe's leash through her mini harness and it works quite well for now. I'll look on line as you suggested since I at least have some breathing room and can use this contraption I rigged up in the meantime:D:D:D

Cush moms have to be creative:):):):):)

I hope the weather holds out long enough for Jasper to get his shot. Drive safely.

Hugs,

Ro and Chey

Hi Tina
Hope Jasper's decreased Dex dose is still going ok :) I know what you mean about not wanting to alter things too much over the holidays. Seems to be much less help available then, at least I have my vet's cellphone numbers (think they feel guilty with the whole swab debacle) so I can contact them if I need to!
Stay warm you guys, hope the appointment goes well on Monday!
Trish and Flynn xx

Hoping things are okay with you and Jasper