Hi Vicki and Scoop
How's it going with you guys, hope you have some news for us soon as very worried for you, you sounded so upset. Let us know if we can help in any way sweet.
Trish xxxxxxxxxxxxxxxxxxxxx
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Hi Vicki and Scoop
How's it going with you guys, hope you have some news for us soon as very worried for you, you sounded so upset. Let us know if we can help in any way sweet.
Trish xxxxxxxxxxxxxxxxxxxxx
We're all here with you. Just so you know. Take care sweetie.
Hey everyone, Thanks for all the concerns and love. I'm sorry I haven't come back on sooner. I didn't mean to make you worry. I'm so stressed lately and I've been tired. The other night I tried to post and I dozed off and couldn't stay awake. Scoop has me worried. Saturday after he ate his supper I took him out to do his business, like usual. When we came in he started shaking so, so much. I never saw him shake like that before. When he would exhale it was so loud and you could hear how shakey he was. I covered him with a blanket and rubbed him and kissed him and talked to him for about 10-15 minutes. He finally started to calm down then another 15 minutes till he settled. Then Monday(I think it was) after he ate Raleigh was near him and he put his front legs on Raleigh's back like he wanted to hump him. He wouldn't leave Raleigh alone. So I took him out. I thought maybe when we came back in he would settle down. Nope, he sensed Raleigh was there and went on his back again. So we made Raleigh get out of the way and Scoop just started wondering around. He wouldn't settle down. Usually after supper he goes out and then comes in and lays aside of my husband on the recliner and sleeps. So this was very strange. He was walking all over and with him not being able to see I had to make sure he didn't walk into anything. The one time he stopped and my husband said it looks like he is going to poop. I said no, he's doing that "gagging" thing he does. Did that a few times. I sat with him and tried to settle him but he just wanted down off the sofa. I little more wondering around then went towards the recliner and stopped. He wanted to go on the recliner. Settled some but wouldn't sleep. My husband said Scoop kept leaving stinkies. I noticed later, too, that he was. Took him into my daughter's room. Still wouldn't sleep. I put him on my bed and I was laying there with him and he finally went to sleep. The other week the vet wanted to know his water intake for 3 days. It was 14-16 oz. Which was good.I kept measuring it. A couple days later he had 25 oz., then down to 18 oz. Yesterday it was 20 oz. During the night after the 25 oz. he had an accident in the kitchen. Last night after he ate his supper he had an accident in the kitchen before I could get him out. In the mornings he usually is sleepy but this morning he seems extra sleepy. He started giving me a hard time with his not wanting to eat his dog food. When I mix baby food(meat) or some of Raleigh's food he eats it. Guess he's had enough of the W/D crap. He eats so much of it I'm not surprised he doesn't want it. It worries me, what if he doesn't want to eat anymore. I am just so upset, worried and scared I don't know what to think or do.
Again, I am sorry for the worries. One small bright spot. Scoop saw his Opthamologist yesterday. She said he has no active ulcer. What I still see is scar tissue. It has gotten smaller but don't know if it will go away. Too bad that horrible tumor won't go away.
Anyone who's dog is on Vetoryl. Do they seem to sleep a lot? What makes Scoop sleep so much? Wish I knew.
I was just reading a link to 360dvm June 2010, where Dr. Feldman says his first choice for PDH is Mitotane. Does anyone know why? He says Trilostane is second given twice a day. I knows there's a report saying Trilo can cause the tumor to grow faster. Has there been any findings that Mitotane does that too? Scoop's vet never gave the option.
Hi Vicki,
We are so glad to hear from you.:) from what I have read there is thought that Lysosdren (Mitotane) may also cause a pituitary tumor to grow but I'm sure one of the Administrators will come by and confirm that. Sometimes a vet will select the drug based on his experience with it or what other health issues may be going on with the pup. The drugs work differently, lysodren actual erodes the adrenal glands.Trilostane is an enyzme blocker and does not erode the adrenal glands and could make them larger.
With my pup's IBD issues we went with Trilostane because it is not as hard on the gastro system as Lysodren and I can start it and stop it whenever I need to. If you stop Lysodren, you would probably need to reload.
I think every endocrinologist has a different opinion and it is hard sometimes to keep it all straight.
((((((((((((((((hugs)))))))))))))
Hi Vicki,
Dr. Feldman prefers Mitotane (Lysodren) because he's prescribed it for 40 years and knows it like the back of his hand. He thinks it's great that there are two choices for cushing's but he'll probably always be partial to Mitotane. I think another reason why he is not a trilostane convert is because based on his own experience at UC Davis, trilostane is not as side effect free as it was tauted to be. My cushdogs were treated with both Lysodren and Trilostane and were well controlled with absolutely no side effects.
It is documented in veterinary text books that Mitotane can facilitate growth of a macrotumor so yes, both drugs can have this effect. If I knew for a fact that my dog had an expanding macrotumor, I'd definitely have to reconsider treatment with either drug. For me, resolving overt symptoms like excessive drinking and peeing take a back seat to slowing the rate of tumor growth and maintaining my dog's quality of life for as long as possible.
Glynda
Addy, Glynda-Thanks
Do they think treatment can cause the tumor to grow that much faster? I read the link about the Trilostane but didn't quite understand it all. I'd thought about what would happen if I didn't give him Vetoryl. I wonder if he would feel better. Like I said he sleeps a lot. If he didn't get Vetoryl I wonder if his Calcinosis Cutis would get bad again and would he get some kind of infection again? Also would Scoop's diabetes be less under control without Vetoryl? He also had quite a bit of muscle loss in the beginning. Would he lose more? Can Vetoryl be stopped and restarted again right at the same dosage if need be? Maybe I should talk to my husband about it and see if he could handle the excessive peeing. Then talk to the vet. Funny thing though, I asked the vet a few weeks ago about it causing the tumor to grow faster and she said, no. I sent her an email Tuesday and today and haven't heard from her. One thing I asked her about was Chinese herbs. Jessica said Doc was on them. Has anyone else used them?
Vicki, since Scoop seems to be feeling so poorly and acting strangely right now, I surely understand why you are trying to weigh all options. But what makes things especially hard is that you are trying to weigh an unknown (does Scoop have an enlarging tumor?) vs. a known (he is diabetic with erratic blood sugars and he has suffered from some very serious complications of Cushing's such as calcinosis cutis and vulnerability to infection).
The majority of dogs being treated for Cushing's do not develop tumors large enough to cause neurological problems. On the other side of the coin, because of the shape of their skulls, breeds like pugs may be more vulnerable. But the only way you can find out the size of Scoop's pituitary tumor for certain is to perform expensive imaging of his head. So short of that, you can only guess.
If Scoop's only issues associated with Cushing's were outward symptoms that are manageable for you, then I'd be more likely to say, "Sure, go ahead and stop the trilostane for a while and see what happens." But you are in the midst of struggling to gain control of his diabetes, and his history of calcinosis cutis is scary to me. Sadly, we have seen dogs on the forum here who lost all quality of life due to the effects of calcinosis cutis. Those skin lesions can expand and grow in severity very quickly. So in Scoop's case, I think a decision to stop his trilostane would need to be carefully considered.
My opinion is colored by my experience with my own Cushpup. We started trilostane treatment with him and initially he did well. But he started exhibiting neurological problems that we assume were caused by an enlarging tumor (don't know for sure because we never had the imaging done). We did consider stopping his trilostane, and even briefly did. But when we did so, not only did he still act abnormally from a neurological standpoint, but he also resumed his non-stop panting and did nothing but lie down like a lump on our cool hardwood foyer. So we started back with the trilostane and did not discontinue it again.
Quality of life means different things for different dogs. My boy was a Lab and came down with Cushing's at age eight. Prior to that, he loved to chase balls, jump in our car for a drive anywhere, swim in the lake, go up-and-down stairs a zillion times each day to be near us wherever we went, nap on the couch alongside me each evening. His Cushing's caused muscle wasting such that he could no longer climb stairs or jump in the car or jump on the couch, he panted 24/7, he no longer ran after a ball, he couldn't swim, in fact he could barely walk about the block. All that in addition to excessive drinking/peeing/appetite. So I may be repeating things that I may have written to you earlier in your thread :o, but even had I known that trilostane may have caused his tumor to grow more quickly, I would still have continued treatment, regardless. But that is me, and him, and the specifics of our situation.
Coming back to Scoop, one thing that still puzzles me enormously is why your vet has never tried shifting him to twice daily trilostane dosing. If you do opt to continue with the trilo, I'd want to revisit that question with her. I finally found one of the quotes I've been looking for in that regard. This was written by Dr. Mark Peterson:
http://endocrinevet.blogspot.com/201...rilostane.htmlQuote:
In diabetic dogs with concurrent Cushing’s disease, twice-daily administration is essential in avoiding large fluctuations in serum cortisol concentrations during the day. With once-daily trilostane administration, adequate diabetic control will be next to impossible in many dogs with concurrent Cushing's syndrome.
Marianne
Hi Marianne-Thanks, it helps to hear your experience. I really appreciate you telling me about your Cushpup. When he was on the trilo, did he have any energy at all? I don't feel Scoop did well since he started on the Vetoryl. When he started taking it he was tired and mopey and it seemed the higher the dose the more tired he became. I wish I knew why he's like that. I just wonder in my head if stopping it would change that. Then as his vision got worse he also stopped being interested in his toys. I wish I could see my old Scoop back again. He loved walking around our back yard, sniffing, and peeing everywhere. He just loved that and when you called him to come, he would look at you as if to say, I'm not ready yet, and he would just keep doing what he was doing. We would call him Mr. Independent. Or he would sit on the couch and just look out the window. Oh how I wish he could enjoy simple things like that again. If we knew for sure the tumor wouldn't press on his optic nerve, we would consider cataract surgery on his one eye. As far as I know right now Scoop is infection free and his calcinosis cutis has really improved and if he wasn't on Vetoryl I guess that could all change. I did mention to the vet about twice daily dosing because of his diabetes and I even mentioned the article by Dr. Peterson. She just kind of brushed it off and said something about Vetoryl doesn't come in 20mg. I guess because Scoop's dose is 40mg, a 10 and a 30. I thought well isn't that when you would check into compounding or is compounding as expensive as Vetoryl?Also the IMS Scoop saw in Nov, along with the neurologist, told me she believes if you split the dose you also increase it. I know Dr. Peterson doesn't do that. Scoop hasn't seen the IMS since then but his vet emails her and gets her opinion. I would hate to split his dose then have to increase it. Since I'm worried about it allowing the tumor to grow faster would more make it grow even faster? If you don't increase it could the cortisol go up? He is having a fructosomine test done Mon so we'll see what that shows then maybe talk about splitting dose.
In mid Nov Scoop had the MRI done that showed his ear infection that lead to the surgery and it showed his pituitary tumor. It wasn't on the radiologist report but I asked the neurologist if he could give me the measurements of it. He told me to the best of his ability with the equipment they had he said it was approx. 8mmx3mm. To me that's pretty large for a dog with a head like Scoop's.
The radiologist report said:There are no masses or other structural abnormalities seen in the brain, but the pituitary gland is enlarged and protrudes dorsally from the sella turcica into the hypothalamic region. Mild ventricular enlargement and enlarged sulci are most likely due to age-related brain atrophy.
Then down further on the report he says:The appearance of the pituitary gland is most compatible with a pituitary macroadenoma. The mass is not causing any significant mass effect or compression of adjacent tissues at this time, but if it continues to grow then it may affect the optic nerve, hypothalamus, or thalamus. So this is why I contantly worry about the tumor.
Thanks again Marianne
I heard back from the vet. I had emailed her the other day. I mentioned lately Scoop's urine has been foamy when he pees. She will do a urine test. She said it could be too much protein in his urine. Anyone have any experience with that?
I think that Tina's Jasper is going through kidney issues right now that has to do with protein in the urine and can be a sign of kidney disease.
Her thread is here:
http://www.k9cushings.com/forum/show...3850#post93850
I wish I knew what would help Scoop the most. I think the twice daily dosing is a good option via compounding pharmacy.
All you can do is try to get him to play with you with the toys and see if that helps him feel better about his interaction abilities with the family. Dogs are often quite similiar to people in that they can get depressed and have to relearn how to deal with things without sight. I think though that they can be much quicker to adapt too though. They have a wonderful sense of smell that you could maybe work with too.
Hang in there.
Hugs,
Sharlene and Molly Muffin
Vicki, I apologize for forgetting that you had that imaging done earlier and therefore you already know that Scoop's tumor is a big one. I am so sorry for making you repeat all that information again! But thanks so much for reminding me.
My heart goes out to you, because I realize you are in a very tough position. Some of the changes you are seeing in Scoop's behavior may well be the result of the tumor and not the medication. But it's hard to know without altering Scoop's trilostane dose, and by doing that, I believe you'd also have to alter his insulin requirement, too. He is a very complicated little boy with a lot of interdependent issues. :o
I may be wrong, but out of all the things that are currently going on (including now the possibility of kidney issues also), I am guessing his diabetes still probably remains the most critical issue day-to-day. If he has sudden extremes in his blood sugars, that problem will "trump" everything else. And controlling his Cushing's seems to be an important part of controlling his diabetes. So even though the trilostane treatment may end up hastening the tumor growth in the long run, the trilostane may be essential for keeping his other physical issues as stable as possible in the short run. It is truly a dilemma. I am so sorry that you are facing this struggle. I know how hard it is to watch your baby slipping away from the happy, healthy life he once led.
Sending many hugs your way,
Marianne
Well, I guess I would be worried too if I read that on my pup's report.Quote:
Then down further on the report he says:The appearance of the pituitary gland is most compatible with a pituitary macroadenoma. The mass is not causing any significant mass effect or compression of adjacent tissues at this time, but if it continues to grow then it may affect the optic nerve, hypothalamus, or thalamus. So this is why I contantly worry about the tumor.
I am sorry, Vicki that you and Scoop are in such a hard place. Sometimes we can't get our dogs back. I wished that for my Zoe but I'm a realist and I know now that will never happen. So then, if we cant get them back, how do we judge their quality of life now with their handicaps and health issues? Is it better Scoop sleeps more but is not plaqued with the issues of uncontrolled Calcinosis Cutis? We dont know how long it would take for it to get out of control again. That seems to always be the problem. We deal with some many "what if":(:( So many unknowns.
I wonder if you had a consultaton with the IMS if that would help?
((((((((((((((((hugs)))))))))))))))))))))
Vicki,
I am so sorry Scoop is having problems. We just recently switched Boriss to the twice a day dosing. It seems to really help him so far. He seems to have less weird behavior. I really wish I had never learned about macros. It is always in the back of my mind & a fear I am sure we all live with. I don't want to anticipate it ever.. but, my mind goes there sometimes & I get really scared.
We are all here for you & Scoop. You can talk to us when you are sad & have fears about the what ifs.
Hugs..
Amy
Sharlene, Marianne, Addy, Amy-thanks
It's getting late. I'll be back to talk maybe tomorrow night.
But Amy I wanted to ask you, what kind of less weird behavior does Boris seem to have since switchig to twice daily dosing? What are his doses? Thanks
The main weirdness was he would not hangout with us very much. Which normally he stays right beside me no matter what. He just seems more content now.
Oh & to answer your question about dosage. Boriss weighs about 28lbs & takes a 30mg pill in the morning & a 10mg pill at night.
Amy-Thanks. So Boriss' dose isn't evenly split. Did the vet suggest that? Not too long ago Scoop's vet thought he was on 30-10 split. After his last ACTH she thought his numbers were a little too low and said maybe we would drop the 10mg in the evening. I said he's not on 10mg at night. Maybe I should see if she would want to try that. Then when I mentioned the Dr. Peterson report she said something about them not making a 20mg
Hi everyone, Sometimes it is hard for me to come on here and write about my Scoop. It makes me sadder than I already am. Scoop had the fructosamine test done and the vet didn't change his insulin. He had the urine test and it showed protein in the urine. The vet said to repeat the urine test again in 2 weeks and if still shows protein then repeat it again in another 2 weeks. Geez. After that I don't know what happens. The vet switched Scoop from Hills W/D to Hills G/D to see if he would eat that better than the W/D. I love Scoop so much. I don't know why he has to have so many dang problems.
Here are the results of Scoop's JR wellness blood test that was done a few weeks ago and I just haven't taken the time to post before this.
Test, Result, Range
cholesterol, 562, 112-328 mg/dl
glucose, 273, 60-125 mg/dl
TCO2(bicarbonate), 27, 17-24 mEq/L
chloride, 99, 105-115 mEq/L
sodium, 138, 141-156 mEq/L
B/C ratio, 30, no range given says High
NA/K ratio, 26, 27-40
HGB, 18.2, 12-18 g/dl
reticulocyte, 120, 10-110 K/uL
alk. phosphatase, 2029, 10-150 U/L
alt (sgpt), 447, 5-107 U/L
ggt, 68, 0-14 U/L
neutrophil seg, 86.5, 60-77%
lymphocytes, 5.1, 12-30%
eosinophil, 0.4, 2-10%
auto platelet, 639, 164-510 K/uL
absolute neutrophil seg, 11678, 3000-11500 /uL
absolute lymphocyte, 689, 1000-4800 /uL
absolute eosinophil, 54, 100-1250 /uL
Vicki:
Sorry you are so sad about your baby having all these troubles. I know how you feel, as I have had Tipper the whole time I have been sick with Lupus, and cannot think of living without her beside me. I sometimes succomb to desperate measures to keep her on track.I never spend any money on myself, as I know she could have an emergency and I may need it.Any spare money goes towards her supplements or health care. I have ignored my own health to look after hers. It requires a lot of my time, as this is a full time job being vigilant with a Cushings dog. I am not complaining though, as I will do anything to keep her with me. She has been so loyal to me when I am sick, and she really needs me now. We all live with this Macro tumor scare in the depths of our minds. Tipper has exhibited symptoms in the past that have scared me to death, and I just try to keep it out of my mind. You never really know what tomorrow will bring with this disease so I spend my day enjoying my Tipper to the fullest. I have never had a dog I was so attached to, and I pray to God many times a day to give her a long life, as I cannot do without her. I hope your baby gets past these problems soon, as I know the despair you are feeling. God bless you both.
Hi Vicki
Gosh, it seems one thing after another for Scoop. So hard to process sometimes - keep an eye on Tina's thread about Jasper, they are sorting out his kidney problems at the moment and their are links there re dietary advice, it might help you and Scoop. Although you do have another couple of tests to go first, so maybe it is not too bad like my boy Flynn who has protein too. He is having more tests this week too.
Hugs for you xxxxxxxxxxxxxxxxxxxxxxxxx
Tipper's mom-Thanks for all your kind words. You have been doing a fantastic job with Tipper. She is so lucky to have you to take care of her. It is so hard to not think about all their problems constantly because we love them so much and want to help them all we can. Big hugs to you and Tipper.
Trish-Thanks for the heads up. It's hard to keep up with everyone on here. I will check out Jasper's thread.
Big hugs right back to you and Flynn.
Hey Vicki, just checking in on you and Scoop. How's he doing over all? Trish is right, keep an eye on Jasper and Tina's thread as they sort out the dietary and maybe some of that will give you some ideas for Scoop too.
hugs,
Sharlene and Molly Muffin
Hi Sharlene-Thanks for asking about Scoop. He's about the same. Right now he is trembling so much and drooling. Last night he had one of his "horny" episodes again. For now he is eating his new food. We'll see how long that lasts.
About 15-20 minutes ago I said to Scoop it was lunch time, no reaction, said it louder a couple of times. No reaction. Asked him if he wanted to go eat his chicken. He just looked at me. Helped him into the kitchen. He ate but with not much enthusium. He usually gets excited about chicken. After he was done he went looking for his water. He had a hard time keeping his balance. Now he's laying here next to me again, getting an ear and belly rub and he is trembling again. Don't like what I see.
Hi Vickie,
I'm so sorry Bug is struggling so. I can only imagine how difficult that is to watch. We are all with you, honey, sending prayers and healing white light.
Hugs,
Leslie and the gang
Oh fudge Vicki. :( Has Scoop not been interested in food before. Did you check his BG? Maybe it is off.
What about vomiting? How is his poops yesterday and today?
Sharlene
Sharlene-Scoop ate his chicken when I gave it to him. It was weird. It was like he just wasn't hearing me but I was right next to him. Recently he's been giving me a hard time about not wanting his dog food and carrots but he will eat Raleigh's food, anything more meaty. The vet changed his food. So far he ate that. It's only been a few days. Yesterday he has such bad gas, worse than usual, then the next time he pooped it was pretty soft. Today it seems better. I don't remember exactly what day it was last week he had one of his weird episodes after supper and he vomited 3 times. One wasn't much at all but the other 2 were. Everything just seems so off lately. I'm so scared for him.
I was never able to do home BG testing on Scoop so if they are off, I don't know. I did check just a while ago with a keto-diastix and it was high according to that, like it usually is.
Just went out for another poop, 3rd today. It was very, very soft. Maybe it's the new food. Just thought it was weird since the soft one yesterday he had 2 that were ok and now one soft.
Well it could be a new food. That can always be tricky. Or could be something else such as pancreas too. Any signs of pain in the abdomen? Scoops hearing might be getting a bit more off too. Have you looked to see if there is any redness there? rule our an ear infection?
It's scary how many things can be wrong with these little babies and it's hard for them to tell us what is what.
hugs,
Sharlene and Molly Muffin
No signs of pain. His ear doesn't look bad. He had another soft poop yesterday. Couldn't tell this morning's. It was dark. Will check it out later when I clean it up. Scoop has been drinking so much water about the last week or so. This morning got up at 2:45am, got a drink, 3:30am got a drink, 4:30am got a drink, after he ate at 6:15am got a drink, 7:45am got a drink. Diabetes, cushings, kidney problem?
Anybody see anything of concern with Scoop's bloodwork?
Hi Vickie,
The thing that jumps out at me are the liver values. Has the vet mentioned anything about that organ?
Some of the electrolytes are a bit low.Quote:
alk. phosphatase, 2029, 10-150 U/L
alt (sgpt), 447, 5-107 U/L
ggt, 68, 0-14 U/L
The blood glucose is too high. Was a urine test done to check for diabetes?Quote:
NA/K ratio, 26, 27-40
chloride, 99, 105-115 mEq/L
sodium, 138, 141-156 mEq/L
Was the BUN or creatinine listed as high? This ratio indicates something was off with one of those values -Quote:
glucose, 273, 60-125 mg/dl
So based on my VERY limited understanding, I would want to know about Bug's liver, kidneys, and diabetes status asap.Quote:
B/C ratio, 30, no range given says High
Hang in there sweetie, you are doing a fine job.
Hugs,
Leslie and the gang
Leslie-Thanks, I appreciate your help. Scoop is diabetic, not well controlled.
The vet mentioned the one liver value was close to the same as his previous test and the other went down a little. Not sure about the other one.
Nothing was said about the electrolytes. I'll have to look up his last test results and see what the vet says. I know they should be checked when an ACTH is done. Could slight low counts have anything to do with cushings?
From what I can see it doesn't say if it's the BUN or creatinine that's high. Just says what I wrote. Would it be listed right there with B/C Ratio or somewhere else? When Scoop had his fructosmine test and his urine test to check for protein the vet said he was concentrating nicely. She gave me a couple of numbers but I didn't write down what they were for. She goes too fast for me sometimes. She's always in a hurry. I haven't gotten copies of those tests yet. I looked up reticulocyte. Scoop's is a little high. That could have something to do with his kidneys, too. He will have another urine test done next week to check the protein again.
Big hugs.
Can anyone tell me how to archive private messages? Thanks.
Hi,
I am not aware of any on line archiving but you can download them to your computer.
Goto your messages
Tick the messages you want to download (click in the little box beside each message to the far right OR click the top little box and it will apply a check mark to all the messages on that page).
Goto the bottom and you will see "selected messages" and there is drop down menu
Choose the format for this download
Another way would be to create a new folder called archive and Move the checked messages to this new folder. (will have to recheck to see if members are able to do this - but try it anyway). Look at the left hand menu bar going down the side and click on EDIT FOLDERS. Follow the instructions from then on.
Terry
Hi Vicki,
If you recently changed to a new food and Scoop is having soft stool, did you transition from another food over a weeks time? Hopefully his system will get used to the new food or you can cut back to the point durring transition that he did not have soft stool, stay on that mixture for a few day, whatever it was, say maybe it was 50% new food and 50% old food and then do the next step more slowly. Sometimes they just need a little longer transition.
Hang in there, sweetie, you are doing good!