Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

ugh, you're right, I was reading them both as g/1000 kcal while the fromms is g/100 kcal

I couldn't get it anyhow. Picked up the blue buffalo as it was lower than the Fromms weight management I have been using to keep up with solid poops. The Protein in the Blue Buffalo is 18%, but doesn't give any analysis table that I can find online.

I might have just blow 20. bucks, but if so lesson learned and this should help at least till I can get the renal mp. (although see in my notes that the vet had recommended renal lp, but not sure I want Super low protein as you mentioned, it's keeping up with what is lost but still providing enough to keep her healthy. Such a balancing act this is!

thanks for the help Marianne!
hugs
Sharlene and molly muffin

Yeah, I definitely don't think you want to go as low as the Royal Canin LP. I think maybe Tina had to negotiate that one with her vet, too. :o

Just looked at the Blue Buffalo and yes, maybe it will pan out as at least mildly restricted protein which may be all the restriction Molly really needs tight now. The ingredients surely look better than the Rx foods!

Not that I am anywhere up to par on this as Marianne and Tina but Zoe had a high protein diet and just replacing some of her turkey rewards with potato and decreasing her raw diet while increasing her Honest Kitchen Zeal helped the protein in her urine come down.

So just cutting back some of the protein a tad may be enough to do the trick, looking at Molly's total protein intake including any snacks. I don't think you need to go really low on the protein when looking at food.

Does Honest Kitchen Zeal not work? Marianne- I think you used it for a bit with Peg. It helped Zoe's IBD so maybe it would not bother Molly's poos.

Okay, off to cough some more:rolleyes::rolleyes::rolleyes::o I think I am getting more exercise from these coughing fits than from walking:D:D:D:D:D

I remember you saying that Zoe was on Honest Kitchen, but I haven't found it anywhere up here in Canada.

Yea I don't want to go too low, and she is on medication, so I want to move to less protein, not too high in fat, and see if that helps her.

This blue buffalo might help her and it is what we are going to try for the next little while, supplemented with a low protein can food, that I use to get her to eat at all and for pills. Her main treats right now are the liver and the joint treat. She gets some very small cranberry treats, or other fruit based. She will not eat blueberries. She just attacks them. I'm going to work on that. Same with green beans, she just turns up her nose and ignores them. grrrr

Oh Addy, do take care of yourself. It seems you have had this for way too long!

hugs
Sharlene and molly muffin

Ha! So just in case I went and checked Amazon.ca again, and sure enough, now they have Honest Kitchen food! It still has to be ordered in from the US it looks like. Very expensive. I'm going to look around some more. Which one did you feed Zoe? Looks like there are several forumlas. Do we know the protein and fat, phosphorus amounts?

hugs
Sharlene and molly muffin

hmm, it doesn't give much in the way of percentage per... it seems higher than the moderate protein diets, but you said it and the potatoes brought down zoes upc?

hugs,
Sharlene and molly muffin

No, I ended up not using the Honest Kitchen Zeal because it was just too expensive for a big girl like Peg :o. It did otherwise work for her in terms of being lowfat. But it is specifically marketed as a high protein food, and the specs seem to back that up. I don't know whether there is a different Honest Kitchen blend that would be more suitable for Molly, but on the face of it, I'm afraid Zeal is much higher in protein than your vet would want.

I know it looks expensive but I have compared it to other quality canned foods and it really is not much more money when I compare the cost. I order a 10 pound box. It lasts about 6-8 weeks. Koko eats about 2/3 of a cup dry measure before I add water per day, divided between two meals. In the 10 pound box there is about 40 dry cups. He actually could eat 1/2 cup and be fine, he is a bit too heavy by a few pounds. 11-30 pounds can be fed 1/2 to 1 cup per day if average activity. It is human grade food, made in a human processing plant. My niece is a patent attorney and researched food for her dog which is how I first found Honest Kitchen.

I fed Zoe the Zeal which is the most expensive but that is fish and potato so has lower fat. I supplemented her raw turkey diet with the Zeal so she ate even less of it than Koko does but back then I increased the Zeal and cut back the raw as much as I could without it affecting her IBD. It was the only commercial food she ever could eat. After I increased the amount of Zeal Zoe ate and decreased her turkey treats, her UPC came down and stayed down. I had a long conversation with Zoe's GP about low protein diets. He felt the new thinking had changed on that and you did not want to go to a totally low protein diet. I also changed Zoe's probiotic and for the life of me cannot remember the name. I'll go back on her thread.

You can email Honest Kitchen or call them and they are very helpful and will tell you whatever you need to know and may even send free samples. They did for me. It may be that for Molly, it is not a good fit. But since it helped Zoe, I thought I would mention it.


P.S.
http://veterinarymedicine.dvm360.com...kidney-disease
Azodyl-not sure if it helps or is a placebo

I had a dog in the beginning stages of renal failure. I searched everywhere for a decent food. I finally settled on this one, because I found it to be the only semi decent food with low phosphorus. I also used an natural kidney supplement.
http://www.hillspet.com/sd-canine-na...-bites-dry.pdf

Do you remember which kidney supplement you used? Did this food help keep the UPC down?

Thanks for the info.
I'm researching like crazy.

Hugs
Sharlene and Molly muffin

Sharlene, Honest Kitchen is sold at The Healthy Dog Store in Tottenham.
http://thehealthydogstore.ca/ not too far from here. Perhaps they could ship you some? If that fails let me know, I can possibly pick it up and mail it to you.

Thanks Judi. I will let you know if I go that route. At the moment I am going to go with a moderate protein and see if that makes a difference.
Baby steps.

Hugs
Sharlene and Molly muffin

Hi Sharlene,

I had a live chat with one of the representatives from the Honest Kitchen today. She was very helpful. She will be sending me some samples for Rosie to try. Rosie is a picky little thing with allergies. It has been difficult to find something she likes that she will actually eat. I want to try Honest Kitchen (Zeal Formula- fish base)at least as a topper. I pay three dollars a can for the wet food I stir in now.Their dehydrated formula isn't that much more expensive. Liz (their representative) asked where I found out about their food. When I mentioned this forum, she knew a whole lot about Cushings.

Their main offices are in San Diego, California with manufacturing plants in San Diego and Kentucky. Who would've thought that they process this food about a half an hour's drive from me. There is also a retail distributor(A mom-and-pop pet store)about five minutes from me that carries it.I thought that I would have to order it online, but it is available locally.

FYI....If you decide you want Molly to try it, they have retailers in Canada and will ship samples out to you free. I did a little digging for you while I had her online.:D

That sounds great Kathy, and thank you. I did have a discussion with my IMS and she wants a lower protein content than what she has now, so I won't be going with Honest Kitchen. Not low, but moderate like Marianne talked about.
Of course it was after I had bought the blue buffalo and my IMS said she won't recommend Blue any longer after the problems due to the problems previously with vit d toxicity, she thinks it's maybe not as good as it use to be.
There is a Rayne food along with the Royal MP that she is thinking of now for molly.

I'm heading out of town again, but when I get back, I'm working a spreadsheet of info that I can post and we can look at.

hugs all, have a good weekend
Sharlene and molly muffin

Sharlene, Daisy tried BB and ended up in the ER. It was bad and despite the veterinary reports, Blue Buffalo refused to compensate us at all.

I have had no trouble at all with Blue Buffalo Basics Salmon and Potato formula. It was one of the few limited ingredient feeds that Buddy was able to eat due to his allergies. Rosie is now eating it too with other things stirred in, of course. I changed her over to it after her turkey/puppy formula made her itch like crazy. She is doing well on it, but doesn't really like it much. That's why I am going to try honest kitchen as a topper/stir in. Rosie is an allergy baby too.

So, tomorrow is Molly's appt with the IMS. We'll be checking blood pressure, doing an ACTH test and making a decision on food.

I'll need to drop the Fromms weight management that I currently use for protein, so I need to introduce something else to account for that.

We need a dry food, and I'm currently thinking of going with the Royal Canine MP dry and then perhaps MP canned to top dress to get the pills down molly (omega 3 is huge and those eye pills aren't anything to sneeze at either). And we'll see how she does on these options.
I'm hoping her blood pressure has been holding steady.

She has been an energy magnet in the evenings this week. Running around and very playful. Every since Sunday when we came home from Calgary. I love to see her like that. Molly as everyone knows has tons of personality and other than when she is feeling bad or off in some way, she rules the house wit her antics and just in general molly behavior. That hasn't changed and I'm really happy about that.

So, cortisol, protein kidneys and eyes. Those are our issues. I know with the help of the gang here that we will get this figured out, one way or another. :)

I couldn't do it without you and really do want to say thank you. When I am freaking, you are there, when I'm confused, you are there, when I just need to let off steam, you are there and when I'm happy and things are going fine, we're all there together enjoying the good times while surviving the bad.
This is family. Thanks all

Sharlene and molly muffin

Awww... what a sweet post. Big hug for you Sharlene. You are always there for me and Dixie and I just wish I knew more ways to help you with Molly. I'm so glad to hear she is feeling good and frisky! I know it does your heart good. :) Will this be trip #3 to the IMS this month? Geez. Bless your heart and pocketbook.

I'm hoping you get good reports tomorrow on Molly's bp, eyes, kidneys and cortisol. The food thing -- I don't envy you. I read a lot on Food Adviser but I end up just as confused as I was before I got there, so I just can't help you much. But I do wonder if plant-based protein would be different than meat protein with regard to kidney function? if so, there are lots of plant based protein powders at body building websites that could possibly supplement a low protein diet. But dogs eat meat, so I just don't know if that would work. See? Now I bet I have you confused too? LOL.

I'll be saying a prayer for you and your girlie tomorrow. Let us know as soon as you can how things go.

Good luck to you girls today!!!!!

With you all the way, Sharlene!

Thinking of you and Molly, Sharlene.

I'll check back later.

PAWS UP

You and sweet Molly are in my thoughts and prayers, wishing you both the best of luck today.

Love and hugs, Lori

Right back at you, your here for all us too.

Paws up Molly

I'm here too Sharlene, thinking about you guys. All the best today. Paws up Molly!

Hugs from me, Jasper and Shelby xo

I'm here waiting with the others too!

Still not singing, "We Are Family" Sharlene. ;)I am quite partial to "Soft Puppy, Warm Puppy" though. That's a possibility. :D

Quote:

---

Originally Posted by molly muffin

I couldn't do it without you and really do want to say thank you. When I am freaking, you are there, when I'm confused, you are there, when I just need to let off steam, you are there and when I'm happy and things are going fine, we're all there together enjoying the good times while surviving the bad.
This is family. Thanks to all.

---

Well, they did an ACTH test today, so I had to leave her for two hours because as you know, here in Canada they draw at 1 hour after the injection and again at 2 hours after the injection.
They also did a UPC today (I think, it was on the agenda anyhow) and of course the Blood Pressure.

So, BP - not good. She was at 180 - 190 - 210. The medication is obviously not controlling the BP as we had hoped and as it seemed to be 2 weeks ago. I'm guessing that the UPC might be high too, causing the BP to go up. We'll know more once the labs are back.

I didn't get to speak to the IMS today after all, as instead she'll call me when the labs are back in. I had left mollys leash in the car, and gone up to the desk and said I wanted to pay before they brought molly out, but they didn't have the invoice yet. They were going to add that to the system as soon as the last blood draw was done. Anyway, the lab tech brings her out, tells me the BP readings, and said the IMS will call me when the labs are back, and they are hoping those come back tomorrow afternoon. I walked out without even paying, my mind was in turmoil, thinking crap, that means she has retinal bleeds again too and of course a million other things like what the heck, is the kidneys worse than we thought or what. (we were thinking we'd caught this very early)

Anyway, I drove home, then called them to give them my visa and apologize profusely for leaving without paying. They were fine of course, I mean I'm there pretty regularly. LOL They'll email the invoice and also mail me a copy with the visa slip. So, nice but man the bill was way more than I expected. This has been a rough month financially with Molly that is for sure. We'll have to go back again to I bet with the BP up there like it is. I really have to call my vet and get her to call the other vet and see if they will do BP readings for us. Then acclimate molly to that vet setting. I need to order the MP food, but am waiting till the results come back from todays draw. Hopefully they were able to get it. I didn't know it was on the agenda and let molly pee before I took her into the vets office.

I think today, I'm just very rattled with things and not my normal cool collected self at all. I feel like swearing and kicking something.

Thanks for hanging in with me gang
Sharlene and molly muffin

Well dang, I am so sorry about the blood pressure because I know that is a great worry to you. But maybe just the stress of being at the vet drove it higher than it is normally (my blood pressure always goes up at the doctor's office :o).

I sure hope you get the rest of the results tomorrow so you don't have to wonder and fret over the weekend. I will keep checking back, and am so glad to hear that Molly is otherwise her spunky diva self!

Marianne

Sharlene, when did they take the blood pressure? Before or after the acth test?

With Zoe, the IMS would take it on the day of her acth test and it would be higher, the ophthalmologist knew how to calm Zoe down and the first reading would be high because they would force Zoe to lay on her side so then he would tell the techs to wait, he would stroke her head and then have techs measure with different legs and it would be lower. I remember someone on the forum said their dog freaked out as well when made to lay down on her side so her vet took Bp while pup was standing.

I think as well, Zoe always sensed my anxiety anticipating the acth test- she feed off me while at the eye doctor I was usually calmer because he had a good bedside manner.


just throwing stuff out there:o:o:o:o:o

Excellent point. I think the first was done before and the next two had to have been taken after the injection. The last one is pretty much discounted as molly was worked up. The first should have been better than it was though. Same guy took it the same way as the 150 last time. Molly knows him and seems to be fine with him. She is not fine when she has to stay there though like she did this time.

So I will mention this along with Zoe's history of BP testing to the IMS when she calls.

They seemed to think the results would be in tomorrow. So, cross fingers that they are right.

Molly having had the ACTH today, is a bundle of energy tonight. Even with the melatonin which I gave her because of the thunder and lightening. Good thing is the weather doesn't seem to be bothering her at all, but she is hungry for anything not in her dish (give me a treat, NOW) and is jumping and running all over the place. Lord help me if this is what constant cushings is like, I think I'd have a melt down at some point. LOL

I'm glad she seems to be doing okay though. Just have to survive the next couple days till this test wears off. She did this last time too. Man it was a long 2 days.

hugs
Sharlene and molly muffin

What a frustrating day for you. Dang that blood pressure! I was really hoping that her medicine was giving her good control. I'm with you on having the regular GP do this. I couldn't imagine paying the IMS for the BP checks as often as you may have to have them to monitor things.

I'm so sorry Sharlene. I know this is so frustrating for you and you're worried sick about Molly. I'll be waiting with you to see what her blood work shows and hear what the IMS recommends. In the meantime, my best friend says Ice Cream is good for everything. Maybe you and Molly should just have a nice bowl of ice cream. Hugs and Love!

Sharlene I'm so sorry about the BP readings but I hope you will get better results on other tests they did on Molly today.
Ginger gets very worked up at the vets especially when they take her away from me so I asked if they can take her BP in the examining rm with me sitting on the chair and holding her in my lap talking to her the whole time and the tech gets down on the floor and gets the readings from one of her rear legs. I don't know if this really helps calming her down but that's how we do it every time and I wouldn't do it any other way. Maybe you can try this way next time and see if that helps Molly stays calmer. I can also see Ginger gets more worked up as time passes so maybe it's better to get the BP out of the way early if possible. Many hugs to you and Molly. Song.

I bet that BP was effected by having to stay there and would be lower if it had been done like usual. ;) And just wait til Molly jumps on your tummy while you're napping and starts barking her head off, "TREAT! TREAT! TREAT! NOOOOOWWW!" :D On a more serious note, it was Squirt's eyes that got to me when her cortisol went up; I will never forget that haunted, forlorn look.

Hang in there, sweetie. You're the best mom and I know Molly is in the best of hands.
Hugs,
Leslie and the gang

Tap tap tap, waiting for the phone to ring with our news.... so impatient!!! Go Molly!!!!!!!!

Well not my phone :D haha that came out wrong!! Waiting for the update though Sharlene, hope your nails are not bitten down!

So, first BP 170 we agree the next two which were 200 and 210 could have been due to the acth injection. However, will monitor and redo again next week, as we want to make sure she isn't spiking her BP.

ALT 163, down a tad
ALKP 1439, up around 100 points
UPC 2.1 so the same

ACTH
pre 74nmol
post 1hr 858nmol
post 2 hr over 1000nmol

This is taken from my notes, actually results will be emailed.

plan is to increase med for protein to 2.5 mg twice a day instead of once

start trilostane at 1mg/1kg ratio (based on U Davis protocol) using compounded 8mg. retest in 10 - 14 days. We'll be using a compound pharmacy in Guelph that they use all the time and have had good results with. (you know we went over that pretty thoroughly)

no change in food at this time, as we want to see what all this does and then if we need to change food, we'll look at a transition.

Let me know if any questions that we want to have answered! Or if you notice anything. I think she said everything else on the labs was good and in range. I'll verify of course.

Thanks everyone for hanging with me.

hugs
Sharlene and molly muffin

Nothing like a good plan, sounds like you have one right there. no better place to be starting meds than here with the support of all these smart ladies!! Pleased the BP to be rechecked too, don't want anything complicating that. Are they doing a few and averaging them to take into account normal variation? Hope you find someone closer to do that!! Bet Miss Molly will take this totally in her dainty little stride and hopefully we get some much better numbers soon!

I agree -- it sounds like a good plan. I don't understand the numbers (nmol) other than the BP but I'm assuming the cortisol was high enough this time that all agreed that she should be on meds. I betcha a nickel that the trilo will help that bp come down also. Molly will do good on it and feel better.

I hope she has settled down some today and isn't still being a wild child from her ACTH yesterday. haha.

Hang in there Sharlene. You're getting there slowly but surely.

It's been a long road Suzie. We have been on this journey for over 4 years now. If not for the protein and bp we likely still wouldn't be doing dinner as she has never had the normal Cushing symptoms. Still doesn't even with the ACTH testing. She has food in her bowl still. Never finished yesterday either. Doesn't drink that much water. We have to encourage her even sometimes to drink. No accidents. Urine isn't dilute. In any other dog I'd say no way and they still don't know what the deal is with her cortisol levels. But we have to get it down so here we go. Another leg of the journey.

She is napping now after running around this evening. She doesn't want her food. Only her treats.

Got to run.
Hugs
Sharlene and Molly muffin