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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Okay Sharlene, you have two options for getting through the next 24 hours. Either you can take the batteries out of the little muffin or you can program her on a loop like a little electric train. That way she will run out her batteries on her own. LOL :D:D
I know, it's not really funny, but lightening the mood is always good.;) Our pups are bouncing off the walls after the Acth. Takes a while for it to wear off. Big hugs in the meantime.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Sharlene, I know its been a long journey for you and a very confusing one. I've read quite a bit of Molly's story but at 261 pages my eyes just won't hold out to read it all. I have been following consistently since I joined the forum tho. The atypical cushings appears to be just sooo "atypical" that every single pup is showing different symptoms and there is not much consistency between cases. I'm not lucky that Dixie has Cushing's, but I am lucky she is a very typical case and has been so easy to manage so far. (Keeping my fingers crossed it stays that way. )
Molly is very, very lucky to have you and the Hubby to take care of her with your kindness and generosity and always going the extra mile to make sure she is getting the best of care. I have faith that this will all get sorted out soon and you and Molly can enjoy some peace.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Hey Sharlene, sounds like your plan is all in place! :)
Since Molly is already picky about eating, I understand why you might want to wait on the dietary change if for no other reason than just not altering too many variables right as you're starting out on the trilostane. It'll be interesting to see if there is any effect at all on her appetite. Who knows, maybe she'll be one of our very few contrary pups who gain a better appetite when the cortisol is lowered. I don't think you had joined the forum yet when one of our long-term members, Sue, was here treating her Zoe. But darned if Zoe didn't always stop eating when her cortisol started heading north!! It was the craziest thing, but Sue knew Zoe so well that she could always tell it was time for a cortisol check when she'd leave food in her bowl.
One other question occurs to me, and that is about fish oil. Tina had mentioned it earlier. I know it has been prescribed for Jasper, and most of the stuff I've been reading recommends it, as well, for treatment of protein loss. Here's a quote from that IDEXX roundtable discussion on proteinuria:
Quote:
...we have antiproteinuric therapies that seem beneficial. These are interventions that can lower the magnitude of renal proteinuria. The most common are dietary protein restriction, dietary fish oil supplementation, and interventions that interfere with the renin-angiotensin- aldosterone system. In veterinary medicine, that latter group includes angiotensin- converting enzyme (ACE) inhibitors, such as benazepril or enalapril. In terms of reno-protection, the interventions that are supported by studies are ACE inhibitors and dietary fish oil supplementation. In dogs, for example, there is evidence that ACE inhibitors decrease proteinuria and renal lesion magnitude concurrently.10 In addition, a multicenter trial that Dr. Grauer led indicated that ACE inhibitors are antiproteinuric and potentially beneficial in spontaneous glomerular disease.11
Fish oil supplementation is also antiproteinuric and renoprotective in dogs,12 but there is no evidence yet of fish oil’s benefits in chronic kidney disease. Ongoing clinical trials in which Dr. Sanderson is involved are evaluating the potential benefits of long-term fish oil supplementation in dogs with spontaneous chronic kidney disease. There is reason for excitement.
https://www.idexx.com/pdf/en_us/smal...ound-table.pdf
So fish oil may be something else you want to discuss with your IMS if it has not already been mentioned.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
They put her on omega supplement 3 weeks ago. I think that would have fish oil I. It. But I will check. It was first thing we added along with the vision supplement. The omegas can cause diarrhea too they said. Joy joy. We have had diarrhea all week off and on. Poor muffin. I will never be able to use poops as a determination for the trilostane or eating either. So that has always given me pause to think but we have to do something.
Oh gosh Susie that would be a long read indeed to try to go through all of this thread. Lol. I was trying to say how frustrating it has been for such a long time not knowing what to do for her. We have had a lot of really good times though and only a few real problems so far. Thank god. Text book cases are definitely easier I think to diagnose. It is always a roller coaster ride though that's for sure.
Molly isn't typical atypical either since she has the high cortisol too and normally you don't with atypical. She also has the high sex hormones though that is a sign of atypical but with low aldosterone which is often seen in adrenal tumors. Argh. See I over think this stuff too much sometimes I think. Lol. Drives one batty. Will need a straight jacket at some point I think. Rofl
Kathy you never fail to crack me up. Lol. I was considering the programming a loop and letting her go option. I think we are past the worse of it though and she is getting back to normal activity level.
Hugs
Sharlene and Molly muffin
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Sharlene--I do want to go back and more of Molly's journey but the quote below really caught my eye. My Maggie (who was the reason for my joining this forum several years ago) was finally diagnosed by UTenn folks with atypical Cushing's with an overlay of "regular" Cushing's after testing showed the exact same pattern you describe below.
Quote:
Originally Posted by
molly muffin
Molly isn't typical atypical either since she has the high cortisol too and normally you don't with atypical. She also has the high sex hormones though that is a sign of atypical but with low aldosterone
We treated Maggie with melatonin implants and lignan extracts. A maintenance dosage of Lysodren was also recommended but, at that point, Maggie was too ill to tolerate it.
I wish you all the best with Molly's care along this roller coaster!
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Just checked and the very first thing in the Omega supplement is fish oil, so we're covered Marianne! Thank you for thinking of that.
Judy, it's so hard when they have a couple different things going on. My IMS opted not to go with the lysodren maintenance dose, as it is so tricky with molly not having the normal symptoms and with her low appetite and diarrhea, she (my IMS) said she wouldn't trust we'd be able to tell if the lysodren over did it and thinks we can manage the trilostane better. Hope she is right.
I hope Abbie is going to be an easier case to handle than Maggie. I'm following your journey too. :) A lot of twists and turns on this journey and darn if they don't throw a fork in the road in too every now and then just to keep us on our toes! :) :)
I do love the forum though. I just don't know how on earth I'd managed all of this without the people here. That straight jacket would have already been buckled up!!!!
My IMS said something yesterday that I thought was very nice, as we were chatting about results and working out a plan. She said, "it is so good to be able to talk to you as it is more of an exchange, than me just explaining, not that I mind explaining, but you already know all of this, so we can throw ideas back and forth and you understand what I am talking about, medications, dosages, risks, tests, protocols, etc." That was sweet. She had started to tell me about trilostane testing protocols, give in the morning, with food, test 4 - 6 hours later, test in 10 - 14 days and I swear I didn't say anything, was just letting her talk and then she stopped and said, I know you already know all of this. And I'm like, yea, I do, as I tell people the same thing all the time, but it's nice to know we are on the same page with it all too, as not all vets are. She started laughing and asked if she passed and I said, yep, you did, we'll be a good team. LOLOLOLOL
Hugs,
Sharlene and molly muffin
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
I had remembered you saying that they added the Omega's to Molly during the last visit so I never mentioned it to you, but the Omega's are great for eye health so you are getting a two for one in giving her those. The retina docs recommend them highly for their eye patients and it sounds like great for kidney health. I'm glad your energizer muffin has wound down. Have a restful weekend! :)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
It is interesting, the eye supplement, was engineered by vets, based a great deal upon studies of humans with retinal bleed and loss of focal point eyesight, add this in with the studies on dogs, and we are hoping that it will at least help give her some eye support.
Yep, she seems back to normal today, so the ACTH testing has worn off I think. Whew. :) It's cold and windy/damp here today so she isn't all that interested in going outside either. I'll probably have to convince her it is a good idea to go for her late afternoon and evening walks, as she isn't a fan of being wet and damp. (well really who is) When she ignores the rational, we really need to go outside so you can pee discussion, I just pick her up and out we go. A lot easier with a small dog, as impossible to pick up a big dog and do that. LOL
hugs
Sharlene and molly muffin
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
So glad that Molly is back to her normal Molly self.:p
I can just see that time to pee discussion. Lol :D Yes, it is so much easier to pick them up when they're small.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Glad to hear Molly is doing better.
Sending love and hugs
Sonja,Apollo and little Ariel
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Glad Molly is better Sharlene.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Just a quick update. Molly's BP was rechecked today, it was 150. Yay.
I picked up the trilostane, she'll start this weekend and her recheck ATCH is Nov 6 at 1pm, based her getting her med at 8 - 8:30am.
hugs,
Sharlene and molly muffin
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
YAY! thats great news on the BP. Go Molly!
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Just catching up on Miss Molly. It sounds like you've had a worrying time but it's good to see that her BP is better.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Yay! Brownie points for Molly for listening to mama.:)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
So glad the BP is down :):):):):):)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Thanks. I'm pretty happy about that too.
I actually am wondering if it wasn't all Falsly elevated, in that I'm not sure that first bp check last time was before the ACTH test now after speaking with the vet tech.
hugs
Sharlene and molly muffin
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
So glad the muffin'S BP is down, regardless of the cause. We'll take it!;)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
I'm with Kathy - glad to see this whatever the reason and hope this trend continues!
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Good Mornin' Sharlene! ;)
Just read elsewhere that Molly started her trilo on Sunday and all is good. YAY!!! :) :)
All fingers and paws crossed that things continue to go well and that the medication will be a help to her.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Thanks Marianne. Yes Sunday we started 8mg daily given in the morning.
We based it on the UDavis 1mg/1kg ratio. I think with Molly we just watch and make sure she continues the same and go from there. See what the test shows at 2 weeks.
Hugs all
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Hi Sharlene - I've been silent on your thread, but following along. Sure hope the girl continues doing well on the trilo. :)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Yep, our fingers and paws are crossed for good results on trilo.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Hope everything goes as planned, Sharlene. I'm sure it will be fine.:)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
I know it will be a relief for you to see that cortisol dropping in 2 weeks. Surely it will help her overall health. I'm glad shes tolerating the medicine. Have you changed her food yet and if so, how is she liking it?
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
No we didn't change her food at this point. The SO food has about the same protein/phosphorus as the moderate protein, so we opted to do one thing at a time and I felt the trilostane was the most important to get introduced.
Molly is her normal self and feeling pretty good overall if this afternoon is anything to go by. It's been rainy here this afternoon and rather than go to the door for her walkies, she was running all over the house, avoiding the door when I said, lets go walkies. Finally she ran for the door, leaping over a pair of shoes in her way and skidded to the door. Tail wagging when she got there. So if it has lowered the cortisol at all, she still feels okay and that is what I want. I'm not looking to go to low, with the way her back legs and back are, I think she'd be in pain if we did or at least feel those hurts more than she use to. I don't want that.
Thanks everyone for checking in on us.
hugs
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Love the description of Molly -- she sounds very spunky! :D
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
I totally agree with only changing one thing at a time - that way you know if something is helping or causing problems.
With Hamish one of the vets was very eager to give him joint pills but I refused a couple of times when she had prescribed other pills because I was worried about interactions - when I got copies of his files you would think I was the worst puppy parent in history for refusing the joint pills :eek: (I did get them, just at a time when he wasn't taking anything else).
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Yay Molly! We like spunky Sharlene!
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Hey Iris! Great to see you.
Hope that all is well with you and the gang.
Molly continues on, doing the same ole antics. She is a character. LOL
I on the other hand, am having a massive headache from that pupil dilation test they do on your eyes. I feel all cross eyed and wonky!
Do update your thread and let us know how you are doing!
hugs
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Oh you poor thing Sharlene. I hope you feel better soon.
I think I've managed to avoid that so far but remember OH having it, and I had to drive him home - he said it wasn't pleasant (and I don't think he meant my driving :p ).
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
STOP!!!!! You need to rest your eyes, so go do it!!!! We will survive until your return tomorrow. Well, most of us anyway! :D;)
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Eeek, it's hard to stop isn't it. LOL I should rest my eyes, but everything interesting happens when you aren't looking ya know!!!
Okay I'll stop. I took molly out for her last walk. Have a bit of an issue with the loose poops, but only at night, and this started before the trilostane, think it's the omega 3, as it was mentioned that it could and often does cause loose poops in dogs and she gets her's with the evening meal. She has so many other things in the morning, like eye, trilostane, and BP meds, that I wanted to space it out a bit.
Anyway, really will go close my eyes for a bit.
LOL MC, definitely not your driving. :) hahaha
hugs
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Sharlene -- hope you are feeling better today! Because I have such a long-lasting effect from the dilation drops, my optometrist now only uses a third of the dose and he is still able to get a good view of everything. I also found inexpensive "cataract" glasses (the kind that fit over regular glasses and are almost black) so I am able to at least drive home after the exam.
Maybe you could try adding Forti-flora to Molly's dinner. It has worked very well with Abbie's liquid evening poops. I know I can't take omega-3 without having "issues" so expect you are right about the cause of Molly's problems.
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Do they look like this?? :eek: :eek:
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Re: Molly, 11 yr, shih tzu - lhasa aspo, cushing diagnosis
Yes Trish they look Exactly like that!
Good idea about the florifora, I have some on hand, will add. This morning I gave her the omega 3 in the AM and the eye vitamin in the evening. See if that makes a difference.
Headache is all gone, luckily that stuff does eventually wear off. Until then you are all kinds of wonky though.
Ready for trick or treaters here! Molly is on guard and the spider bowl is filled.
http://www.k9cushings.com/forum/albu...pictureid=7186
hugs and shivers and giggles