Trixie - Schnauzer being treated with Vetoryl - Trixie has crossed The Bridge

Hi Barbara!

I think those ACTH numbers are great, and I'm so glad Trixie is doing so well. :)

FWIW, I do want to mention that my IMS told me that the liver values may never normalize in some Cushpups, regardless of the level of cortisol control with treatment. I have seen similar quotes to that effect, and will try to rustle one up for you to consider along with your vet. I realize further liver diagnostics are a tough call in that you don't want to overlook a primary liver issue. But I also hate for you to proceed unnecessarily if significant enzyme reduction is not a realistic expectation. I'll try to get back here with some citations.

Marianne

Those are pretty good numbers but what is better is how Trixie is feeling. I wrestle with changing from brand name to generic to- I would save $150 a month on Zoe;s Veotryl nad $80 on her Azodyl.

But it is hard to swicth when things are working so I totally relate to how you you feel:)

Hopefully it is as Marianne says and some dogs liver values just dont come down. If Trixie is feeling good, maybe that is the case.

Have a great weekend! Say hi to the Plaza for me:D;)

Barbara:
I am so happy to see that Trixie has good number and that she is continuing to feel well. You finally got to that sweet spot with her, where all is good. Do you give Trixie supplements for her liver? Blessings
Patti

Haven't had a chance yet to look for the info, other than to see that Dechra notes in their treatment brochure that ALKP and ALT levels may never return to normal range for Cushpups, but they *are* expected to decrease with treatment.

Can you remind us as to what Trixie's general liver enzyme history has been?

Thanks,
Marianne

Hi Barbara,

Did your vet do a full blood chemistry and if so, were there any other abnormalities? I'd be most interested in bilirubin. Has Trixie ever had a bile acid test?

Glynda

Well the ACTH looks real nice, but I'd be disappointed that the liver enzymes didn't come down. I do think that liver support supplements seem to need to be given ongoing once they start to have issues with cushings or liver numbers being elevated.
hugs,
Sharlene and molly muffin

Thanks everyone--
Marianne- here are the liver numbers from all the tests, I am missing the very first senior panel check up from Jan. 2013 that started the whole thing. It was then that the vet prescribed denamarin and clavamox for the first time and the liver values came down...it was shortly after that when Cushing's symptoms began.

April May Aug Nov (norm)
alk 1295 2123 1894 1830 (5-131)
alt 426 220 173 215 (12-118)
ggtp 39 34 13 19 (1-12)

Glynda-
the Bilirubin on all these tests has been the same 0.1 (norm:0.1-0.3)
She has not had a bile acid test. The only other abnormals on the test are the same two, and they have been on there every time--cholesterol and triglycerides. The vet seemed not to be too concerned, I always ask about it..he chalks it up to being a schnauzer, here is what those numbers look like.
April May Aug Nov (Norm)
Choles: 330 372 342 369 (92-324)
Triglyc: 1066 578 839 877 (29-291)

Also...none of Trixie's blood work was done on a fast except the very first April test which was done when she had the ldds. The vet always did her blood work when we did the stim tests...probably not optimum I guess but it's how we did it and saved me paying for another office visit.

I don't know what I would notice, if anything, if her liver function was compromised. She has been doing so well and her gastro system has been better than ever. I think Cushings really messed up her digestion. When I think of all the times we had issues with gastro stuff...and the "plumbing noises" that we used to hear from her in the evenings...now that is a rarity and actually I haven't heard it for many months. KNOCK WOOD!! Every time I write something like that I always seem to jinx it! So I am knocking on this coffee table I'm leaning over!! :D KNOCK KNOCK! ;)
I did ask the vet about fish oil and he was kind of on the fence about it, didn't want to add anything else now so I didn't push it. He said he did feel good that her clinical signs are great and that she seems to be feeling fine, acting frisky and energetic. Lately she is always looking to play. This morning she after she ate and had her meds she went into my daughter's room and grabbed a beanie baby from off a chair and skipped by me while I was having my coffee...being a little mischief maker and tempting me to chase her and take it back...lots of this kind of behavior from her lately...at age 9! :)

Addy--I am still trying to decide what to do about going all generic or not...don't want my choice to screw things up! Will decide over the weekend I guess. When I am next by the Plaza I will say hello from you!!

Patti and Marianne....yes back on denamarin. It was I who stopped giving it to her a month or two ago...I just felt like it was pills all the time and since she was seemingly doing so well I fully expected she might not need it anymore but that was dumb I guess...we started it again last night.
Trixie had a great walk this morning, it was pretty chilly and we both loved it. I can take the cold as long as it's not too windy, must be my Scandinavian side. I'm grateful the Cushings numbers are good and I'm hoping the liver numbers will improve. Would love to see any articles you come across Marianne, and I am going to do a little searching on this issue myself.
I didn't feel the vet was being too alarmist about it...we'll see what happens now back on the denamarin, maybe the antibiotic makes a difference for her liver too?? If she stays like she is now and seems to be doing well we will wait until after the holidays and recheck her blood work...if something changes we will do it sooner. For now I am so thankful that she's doing great!! :D :D :D
Gotta think I've got some help from above..my parents were big fans of Trixie, I think they're looking out for her!!
Thanks everyone for all the input!

Barbara

wow...just realized when I typed this that the alk did come down a bit from August! It's the other two that went back up...but the alk went from 1894 to 1830...still high but at least it's down a bit! I reversed them on my first post regarding the newest results. I feel a little better about that now!! :) :)

Hi Barbara,

GREAT NUMBERS!!!:D:D:D

Please don't get wrapped up in the liver numbers so much that you're not enjoying the moment. Now is the time to savor every precious moment you have with Trixie since she's feeling so well. Xxxxx

Barbara:
I know telling you not to worry won't work, cause it does not work for me either. I have to say I did not realize how high her liver numbers were. Dr. Bruyette told me once that Tipper's blood work was odd in so much as a Cush dogs normally is really out of whack on the ALT and ALK Phos. Tipper's are low in comparison to the others I have seen on here. I think partly because as soon as I got this formal diagnosis, which I really gave the vet, I put her on all her supplements for support. Some people don't believe in them and say they are a waste of money, but I have found out through using them myself this is far from true. I think all the supplements helped Tipper in that way. I think it would be a good idea to get Trixie back on them for her liver. It has helped many dogs on here. Look at all the herbs Leslie knows about and uses. So they definitely help. Blessings
Patti