Alivia was recently diagnosed with Cushing's - Alivia has passed

There was a mix up with the mitotane order. It was actually ready in one day. I thought it was going to my vet's but he called it into a pharmacy I had never heard of - probably 15 miles away. They left a message for me to "call to schedule a delivery", but never said a name or who it was for or anything. Thinking it was a wrong number I never called them back. Anyway, they are supposed to deliver it to me in the next hour or so. But, I am right back to square one and pretty sure I am not going to use it at all. I don't think I can load a dog who has a fluctuating appetite to start with. She hasn't had anything to eat all day and just walked away after eating half her food (something I know she likes, too).

I am just as confused as I was the day she was diagnosed (19 days ago). I am now re-thinking Trilostane and a bottle of wine. The wine would be for me, of course. :rolleyes:

Glynda, refresh my memory, do your dogs have adrenal tumors?

Pour me a glass while you are at it, is there room on the couch?;)


Arrggggggg!!!!!! It is always so darn confusing. Did Dr. Oliver suggest a maintenance dose to you knowing Ali's adrenal tumor and history? Just curious. Maybe I am remembering wrong but if he did then how would that work?

Okay, maybe pour us each TWO glasses:rolleyes::rolleyes:

Love ya,
Addy

Lysodren was delivered 10 minutes ago. Alivia just finished the rest of her food, after an hour and half break. I don't think I can do it.

Addy, thanks for reminding me of what Dr. Oliver said (in red):

Attached are the results of the adrenal panel testing done at your facility. My dog, Alivia, is a 13 year old, 18 pound, female, spayed Jack Russell Terrier. She had IMHA when she was 7 years old. She has recovered from that but has some residuals and still takes Amlodipine for high blood pressure and compounded aspirin to help prevent any clotting issues. Ali has been exhibiting typical Cushing’s symptoms off and on for about 2 years (fur not growing, panting, thirst, hunger, laying in cool spaces, skin infection), I did mention these things to her internist, dermatologist and regular vet but she was not tested for Cushing until recently. I am really confused as to the best treatment option for her. I have ruled out surgery because of her age and health; I am terrified she would not survive it and I don’t want to put her through the trauma. Her regular vet has recommended Trilostane because he believes it will be easier on her, with less chance of negative side effects.>>>We usually don’t recommend trilostane where sex hormones are increased. Trilostane increases androstenedione and estradiol levels in particular, and these dogs often come back with clinical signs of Cushing’s after they have been on treatment for awhile. Then you have to switch to another drug; usually Lysodren.

I am pretty scared of Lysodren because the drug seems so harsh and because Alivia’s appetite varies - she can be ravenous, have a normal appetite and occasionally has no appetite for a day. I am not sure how I would ever get a proper loading dose and wouldn’t want to cause her more harm than good.
>>>You can use melatonin, lignan and “maintenance” Lysodren (without the loading dose). This treatment is often used for these cases with good results.

[COLOR="Navy"]Current medications and supplements: Amlodipine, compounded aspirin, The Missing Link Canine Food Supplement, Flax Hulls (SDG) Lignans, Melatonin 3 mg BID (the Flax Hulls and melatonin are recent additions as I didn’t think it could hurt, but I can stop them if you recommend that).[/COLOR]>>>They can be continued.

>>>Your choices seem to be surgery (expensive and fairly critical surgery); careful follow-up needed in the immediate post-surgery time period. Otherwise, the melatonin, lignan and maintenance Lysodren could be tried. If the tumor is a carcinoma, it can develop rapidly and cause problems for you.

I have 200 mg capsules of Lysodren, just delivered....should I or shouldn't I. :eek: I am pouring the wine now!!!! Addy, I'll pour you one, too, but if you don't show up soon I'll have to drink it for you!

Girl, I am here but I don't know what to tell you.:D

I wish I could get into my email at work but I can't. I am trying to remember if I told Dr. Peterson that Zoe had Pituitary or I just said Cushings. I am so sorry I can't get at my emails for you.:(:(

I'll go look to see if I sent a copy to my other email account.

Glynda, Marianne, Lori, Leslie, please help us out here!!!!!!

I know I have read not to give mitotane to a dog that does not have a good appetite. Not sure how far to take that comment.:confused:

I'll be back.

Found it!!!!! I did tell Dr. Peterson Zoe had Pituitary Cushings. I guess the thing that bothers me is right back at Dr. Oliver thinking a maintenance dose could work so if that could work could a low dose load work?


You don't have to give it tonight unless you need to start on a Friday for the ACTH test to come out on the right day? Is it a timing thing with your vet?

My other question would be to Glynda- did your pups have other health issues when you loaded?

Who here has loaded a dog with concurrent health issues?

Hang in there and save me some of that wine:cool:

Love ya,
Addy

I think the appetite fluctuation, and health issues, was the reason Dr. Oliver recommended a maintenance dose instead of a full loading dose. Dr. Oliver is aware Ali has an adrenal tumor. Glynda posted here earlier today and she thought the low dose loading would not help with an adrenal tumor.

A maintennance dose would be much LESS than the low dose loading of 200 mg per day, right?

I wanted to start her on a Friday, so that I could be home with her for the first three days of dosing. But, I think Ali is making the decision for me that tonight is not the night to start. She seems to be constipated - she tried to go for at least 5 minutes when I came home from work and was not successful. That's not a normal thing for her - lignans, maybe? Her appetite was off - she paused for 1 1/2 hours before finishing her dinner. She is not panting like she has been and she hasn't drank any water since I've been home (2 1/2 hours). She seems very tired. If I had been "loading" her I would probably be calling the vet for Prednisone right now. I would LOVE to think she is going into a remission phase, something she has seemed to do in the past.

Hey Mary Beth,

I don't want to leave you but I have to run out with hubby. I am hoping others will come along to comment while I am gone.

I'll check in with you later. If you are in doubt, don't give the drug. Delaying treatment for a week won't mean anything. I have read over and over that treating Cushings is not an emergency.

Love ya,
Addy

Hi Mary Beth ,

I can definitely relate to how you feel right now. When Corky was first diagnosed with cushings, he was going to be treated with Lysodren, which I actually still have. Because he was on antibiotics for two UTI's, his treatment had to be delayed. His clinical signs then went into remission for seven months. His IMS is the one that put him on Trilostane, as she felt it would be easier on Corky because of everything else he had going on. I was actually relieved.

There are successes with both Lyso and Trilo. I hope you get to a point where you are comfortable with whichever treatment you decide on.

I know we do worry and wonder if we're doing the right thing.

I'll join you and Addy for a glass of wine. :D