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Bailey woke up not feeling so well today. It probably has something to do with the pine cone she was eating.:mad:
Then she had a bout of diarrhea and vomited a bit. That was 5-6 hours ago and she seems fine now.
^That was yesterday........I don't know why I didn't get to finish it.:confused:
Heard back from Dr. Petersen on his thought of Dr. Oliver's suggestion for Zoe to add maintenance dose of Lysodren for 3 months. Any thought on his suggestion?
.Quote:
In dogs with Cushing's disease, you must use a daily loading protocol in order to adequately destroy enough of the hyperplasic adrenal cortex. It's quite unlikely that starting with a weekly maintenance dosage of mitotane would do much at all to lower the high serum cortisol concentrations in your dog.
But you don't necessarily have to use the standard loading dose for mitotane of 50 mg/kg per day. You could try a lower daily dosage of 20-25 mg/kg (with food) to evaluate the effect
I have read her numerous times low dose load for small dogs don't work. I am going to have to do something soon. Zoe is getting stronger symptoms. Spring is here. Ims said she'll go to Trilostane if she can't handle the Lysodren. Remember Lysodren is the drug she has experience with.
Thanks,
Addy
Good Morning Addy,
Do we have to go to work today??!!
I know at the last we upped Maddie's dose to see if that would bring down her numbers. I had read it wouldn't do anything to bring them down just a little because a loading is what really does the trick:o, but it did bring them down. Of course I do not know if having the cancer played into this because I really thought when I took her back for the ACTH test it was going to show they went up or stayed the same.
I think it just depends on the dog in each case. What will happen is you will be paying for more tests to see if a maintenance dose works first off or you will have to do a loading. I think if you do a loading with the lower dose--not a bad idea too. Oh I have been a real help here...
I hope you have a wonderful day!!! ((HUG)) Now it will for sure be a wonderful day--hehehe!!!
I definitely agree with Dr. Petersen that a daily loading protocol needs to be done with a dog having elevated cortisol.
As far as his suggestion to start at a lower loading dose I think one has to take into consideration that this lower loading dose protocol will most likely take a dog longer to load.
So I believe the question is: Will doing a lower loading dose over a longer period of time or would the usual loading procedure of closer to 50mg/kg/day over a shorter period of time cause Zoe's colitis to flare up. I would talk this over with your IMS and see what her thoughts are on this.
Love and hugs,
Lori
She's never loaded a dog with colitis.:( She's thrown around different ideas, she may load 3 days on, 3 days off, load at a lower dose, do maintenace at a higher dose. She said once I give her the go ahead she will decide what she will do.:eek::eek::eek:
I would feel better knowing the plan a head of time but maybe it is better I don't have time to think about it.:rolleyes::rolleyes::rolleyes:
All I know is
1- Zoe has shown a low tolerance to some drugs in the past
2- She may tolerate something new for a few days but the longer she has it the more chance of her flaring
3- I have to rule out starting with triolstane- no vet with experience which freaks hubby out.
4- The melatonin and lignans seems to be controlling her estradiol- she is not as crabby and reactive to strangers and stopped looking for cold places to lie down and loves snuggling in her new beds.
Man, I feel like a broken record, I am tired of playing this 45 :D
or in the modern word DVD;)
Yes, Marie, unfortunetly we have to work today:mad::mad::mad: And as you can see I am working very hard!!!!!:p:p
Addy, my friend, I really wish I had some words of wisdom for you. Since I've never used Lysodren, I really can't give you any advice.
I know this is a very difficult decision for you. I know you'll do what's best for Zoe.
Hi ya. Addy!
I have no experience with Lysodren. I do wonder about a vet who tells you...once you give me the go ahead, I'll tell you what I'm going to do. WHAT IS THAT ALL ABOUT???
Our former vet had no experience with Cushings.....that didn't particularly bother me because the "other" vet never agreed with me that something had to be wrong with Palmer. This was NOT just loose stomach muscles. I knew she was consulting with various docs and was doing a LOT of reading on her own. This was a group effort--that was clear.
We came down to Lysodren or Trilo. I struggled with that a while. I chose to go with the Trilo because she said it would be "easier" on Palmer. We never went to Lysodren....the Trilo worked fine.
So what does all that do for you?......You know Zoe better than anyone else. I would be needing a definitive plan, first. It can be one that is subject to revision, but where are we headed and how do we judge success? This does get to be an enormously expensive treatment. All the tests and then more tests. Try this then more tests. What really makes it rough, I think, when you're trying to make this decision is that you have no idea how much further the future will go....nor how it will look.
Do your research. Get comfortable with a vet. Put it down on paper if that will help. Soon something will "speak" to you and you will make your decision. You make the best decision you can make based on the information you have. That's all you can expect and ask for. Try something....whatever you think is best and know that you are not stuck with that. If it seems not to be working, you can revisit the situation. After only 3 or 4 months on Trilo I was not happy with the results. It started our great then started going down again. I pressed the vet to go to Lysodren. She wanted me to give it some time. I felt like there was a ticking bomb about to go off and I didn't want to wait to "give it some time." She finally pushed back and told me what I wanted to do was not what she felt was the best treatment plan. If we wanted to do Lyso, we needed to go elsewhere. However, if we went to get a second opinion and that opinion agreed with us, she would continue treatment. That was fair......after all I HAD chosen her for out vet. We never reached the place of getting a second opinion....the Trilo, once adjusted, started to make the needed changes.
I know how you love Zoe. I trust you will make the best decision for you and your circumstances and Zoe's welfare. Don't worry about feeling like you're a ping pong ball going back and forth from time to time. It happens to all of us, I think.
Finally.....as I did not appreciate how I needed to do this, enjoy each and every moment you can have with Zoe. That may mean snuggling up for a nap. It may mean going for a walk. Just know that we are all dealing with older dogs and ours are sick. Don't live your life in fear, but do appreciate every moment you can.
I'm here for you, gal.
Love,
Susan :)
Dear Addy
I know you are going through a difficult time with what is right for Zoe. You have a right to question everything. If it feel off balance to you then it is.
Have you email Dr. Allen from Dechra, Vetoryl about Zoe's ailments(colitis),sensitive to medication, and if she would be able to use it. Even our vet in Reno said she preferred Trilostane because you can go off it easily.
The question is if Zoe does have high cortisol reading despite the high sex hormones can she try Trilostane. Even if the doctors don't have experience with Trilostane you have a hugh resource of users on this site to guide you.
If her cortisol levels are low then no on the Trilostane because it will lower her cortisol more.
All I know is Apollo did well on the TRilostane and I will email Dr. Allen about his high sex hormone readings but I think I will try to stay with the Trilostane.
hear is a link to specialists in wisconsin
http://www.acvim.org/websites/acvim/index.php?p=228
I am hear for you friend.
Hugs Sonja and Apollo
Thank you all for caring.. Zoe's cortisol is pretty high, last UTK panel in January 2011, it was 40, Dr. Oliver said some of that could be from her being so ill the previous 2 months prior to testing but most of it would not be from an illness other than Cushings. June 2010 her cortisol was 32. She was in the middle of flare then as well. She is always sick when we test her:(
I don't want to give up the melatonin and lignans. I feel they are helping her. Her UTK panel showed it helped. She was barely on the right dosage for 3 months and it already had helped. That tells me I am on the right track. Even her blood work improved. It was normal for crying out loud. If she did not have colitis, I would load her without thinking about it twice.
After talking with Dr. Peterson, whom is like the other Cushings guru next to Dr. Feldman, I am leaning toward loading her as he suggested.
I would just feel better if I could understand why Dr. Oliver truly believes a maintenance dose without loading is an option for Zoe even with her sky high cortisol. That is my sticking point. I have tried for 3 months to reseach that and come up empty except for Dr. Oliver believing it. If someone knows how he believes it could work, please let me know.
Love you all,
Addy
Hi Addy,
I too agree with Dr. Peterson and to tell you the truth, it bugs me that Dr. Oliver is suggesting maintenance doses of Lysodren to members whose dogs have typical cushing's. Zoe has more than a moderate elevation of cortisol and a maintenance dose of Lysodren isn't going to do diddly. If your vet's lack of experience with Trilostane is the only reason you've eliminated it as a choice, just remember that you aren't alone. We have a pretty good amount of collective experience here and you have lots of friends who can guide you and your vet. I've told you this a number of times already but if I had a dog with colitis and mild symptoms but felt compelled to treat, I'd definitely choose Trilostane over Lysodren.