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Oh I forgot to mention that they did a SDMA test on her. Which is a kidney test, the newer one and can determine kidney deterioration now when it is at 20 - 40% even, it use to be that kidney failure didn't show up till 60% of kidney had failed, so this is good to have a test that can show it sooner. Anyway, Molly's test came back in the normal range, which is another huge relief for us.
:)
So glad that SDMA results were good! I will definitely add this to my list of tests for Abbie at the end of the month.
Yay !!!!!!!!
Well that is great news for our little miss.
What a journey indeed, Sharlene and you are doing an extraordinary job!
Good news is so nice to hear! I'm happy for you and Molly!
Ya:p for Molly and you
Sonja,Apollo,Karma and Ariel
I got molly's results back from the last ACTH, and even though we went up 2mg, and it's been 3 weeks since the last test there has been virtually no real change in her numbers.
Since my works is absolutely crazy and I can't get off to go do tests till at least January, we are going to stick with this dosage until I am able to start back in with adjusting dose. This was discussed with her current internist. We dont' want to make any changes during a time when I can't be doing tests regularly. So, we'll resume early next year.
Her adrenal glands sure are stubborn!
06 Nov, 2015 - 21mg trilostane
ACTH
pre 53 = 1.9ug
post 273 = 9.8ug
14 Oct, 2015 on 19mg trilostane
ACTH
pre 60nmol = 2.1ug
post 270nmol = 9.7ug
So, ACTH:
09/23/2015 on 15mg trilostane
Pre 52 = 1.88 ug
Post 406 = 14.7ug
07/16/2015
Pre 34 nmol = 1.23 ug
Post 221nmol = 8.01ug
05/21/2015
Pre 29 = 1.05 ug
post 243 = 8.8 ug
05/07/2015
Pre 44
Post 103
Try pilling Rosie!:eek::eek::eek: Now that's STUBBORN!!! Wiry little minx!!!:o
Yes Sharlene, I totally agree. I wouldn't want to be increasing any dosages when I wouldn't be available to monitor closely and test either. ;) No point in taking any chances. Even though you haven't seen the numbers you'd like to see, Molly remain stable. ;)
Quote:
Originally Posted by molly muffin
Sorry work is do crazy for you, that makes it hard. How is Molly feeling? How is her hair, coat, any other Cushing symptoms of concern?
It sure can get frustrating so Big hugs (())
Oh phooey, sorry about Molly's numbers, them darn adrenals!! :mad:
Love and hugs, Lori
Sure wish Molly had a better response to the latest increase! I know it is frustrating that you have to wait for the next increase but it definitely sounds like the best choice.
Her coat still looks thin to me. She still isn't an easy eater or drinker although maybe drinks a bit more than she use to. Again that could be my imagination. Actually. I think everything is the same as normal. She does have a thing about begging at night now but it isn't food related. It's treat motivated cause she always has food left in her bowl.
Yea I'm not enjoying the work thing at all right now. I have to start usually around 6:30 am. Stop at 7, get ready for work, walk and feed Molly. Drive to the office about 20 minutes to be there for 8:30 and work all day. Plus cover anything evening or weekends that comes up. It's exhausting and I think mostly I just sleep when not working. This goes till January so rough schedule.
I have a gala dinner thing tomorrow. Ought and that is going to be tricky as I will need to work from home and take a long lunch maybe get ready and then finish working and leave right afterwards.
Plus somehow planning a baby shower too. Lol. My life is crazy.
I did manage to get one day off in mid December. Don't even want to know how I have to manage that day! Something like do some work at 5 am before heading to the airport on the Friday and then fly home on Sunday to be there for Monday.
Okay now I'm just whining and this is about Molly. Rofl. I'm puzzled about the cortisol level. Wondering about the compounder if that is the issue. Looked into pricing name be
Rand vetroyl and it is way expensive here. My IMS had told me that cost wise they seldom use vetroyl because it isn't affordable and many people won't treat when faced with the cost they go straight to trilostane.
Whine away anytime. We are multipurpose listeners! I managed to get five weeks off, but had to end up having emergency surgery to do it. I don't think you want to go that route!:eek:
Molly is in the best hands ever. You'll figure it out!;)
You can complain about work as we all can sympathize and appreciate the complaints as we feel the same way:)
I think if Molly is feeling normal, you made the right decision.
Everything seemed to push up Zoe's numbers, the eyes, then the ruptured growth on her back, finally the tumor. We never really know what else might be in play.
You need a girly drink:D
Make that several!!Quote:
Originally Posted by addy
My fear was that the adrenal tumor had grown but they said it hasn't. Couldn't find anything else tumor wise that might be causing it to go up.
I'm going to do,a comparison read between last two ultrasounds and blood work to see if I see anything. When I get the chance. She is just bizarre sometimes.
Yea she acts the same to me. Hope I'm not too close and not noticing something that I should. Pretty sure I have become a chronic worrier. Lol.
Hugs you guys. You are the best. Not sure I wouldn't be I. The insane asylum without you all.
Nope Kathy. Not going the surgery route to get time off doesn't sound fun to me. I hope you are on the road to recovery!! Besides work would probably hand me a laptop and say get to it right now. Lol.
Hugs
Sharlene, have you ever returned to your original compounder at the vet school/hospital, or have you stayed with the second pharmacy? You know I always get a bit suspicious when there are unpredictable results with compounded meds, and I know you are wondering about this yourself, too.
I hate it that Vetoryl is so darn expensive everywhere, and especially there in Canada. I keep trying to research more about the possibility of a generic finally coming out since I think Vetoryl's exclusive rights must surely be set to expire soon. You are finally now in reach of a brandname dosage of 20 mg., but two 10 mg. capsules daily would probably be pretty darn expensive for you. Still, the expense of all these ACTH retests mount up, as well. In January, maybe it would be worth it to bite the bullet for at least two weeks of the Vetoryl just to see whether or not that has any effect on Molly's results. Just a thought...
Stink!! Miss Molly never seems to give what we expect... I agree with Marianne... try the brand name... or else and I know I keep harping back to this. Adrenal tumours are notoriously hard to control cortisol... even though that nodule has not shown much growth she has had high cortisol as long as it has been there... how do they know its not that causing the problem? I know its different with Flynn's being a pheo, but his was only 1cm too and secreted enough catecholamines to stuff up his BP, eyes, kidneys.... so from what I can tell it does not have to be big to be secreting, its a hard call eh x
yea there is a big difference here in Canada between cost of the vetroyl and trilostane.
We'll see what her next test shows of how she has done over a period of time on this dose. I did test her at 3 weeks and it might have come down a bit.
I don't know, Trish, it could be that adrenal nodule, which is why I did the ultrasound to see if any change in it. They didn't think it was secreting because secreting adrenal tumors usually show growth (or so I was told) so they didn't think that was it.
Remember she never tested positive on an LDDS test either, even when her cortisol levels was very high, so I'm not entirely sure of if it is the nodule (which wasn't there during her first ultrasounds even though her cortisol was up) So we where thinking either, something else in her body made the cortisol go up, or pituitary tumor that was in an area that didn't necessarily respond to the LDDS test. (that tricky 5% who don't test positive on an LDDS).
She seems to be doing okay. Her worst problems are her back luxating patella and her eyesight that just gets worse (cataracts have increased in size over the past year). That makes her skittish and jumpy at shadows. She can still run around the house like a bat outta hell when it's time for eye drops though. (she hates any kind of drops, eye or ear)
my [glaucoma] eyedrops do sting a bit, so maybe molly's too?
or she is just a stubborn old lady who doesn't want eyedrops................
at least she still can be a feisty girl!
She is just stubborn, and they probably sting a bit. She doesn't like ear drops either, even more so than the eye drops and she has a lot of feisty left in her it seems. LOL
Hiya Sharlene... I was just reading about Molly's back leg giving out once in awhile and the same thing happened to Keesh long before the so called cushings problems. They did an xray on his spine and found out the myelin was being interrupted in the spinal column which caused his same problem. One day he saw a squirrel and took off, both his back legs gave out and he was looking like a frog, but he kept on going dragging with his back legs and pulling with his front ones, needless to say he didn't get the squirrel. It didn't hurt him a bit, which it doesn't and he was up and prancing around within seconds. Scared the bejeebers out of me though when I saw it. Could this possibly be the same with Molly? It did start in one leg, that was the only time I saw both affected, and it would rotate the weakness from one leg to the other. I didn't pursue it further as there was no cure and the only recommendation was to take him to a neurologist. If I remember correctly it was about 3-4 yrs before alll this cushings stuff came up. Hope you are doing well, I'm sure your are busy getting ready for the holidays. It's just me and this tazmanian devil of a cat here, so I'm not putting up any decorations. Business is terrible, so selling it off and will be moving again soon. I missed my calling, should have been a professional mover, but I thought the last one was going to kill me, I'm sure this one will.
I am pretty sure that it is the luxating patella that causes molly to sometimes go sideways and lose her balance. It's only the one side that has the highest grade on the patella.
She seems to be fine otherwise and still in great spirits. She is just a joy, sometimes an aggravating nagging on, but a joy nether the less. LOL
hugs
Yeah for feisty dogs!!
Are you able to massage the knee with the luxating patella? That's what we used to do for Hamish when his back knee seemed to "pop" - the vet showed us what to do, and OH was much better than me, but it did seem to help. Alternatively is there some sort of knee support / elastic bandage you could use to help? (like the neoprene sleeves you can get for human joints)
I know someone who looped a stocking around the middle of their dog to help support them for a while. This allowed the stretched tendons (when the knee pops out, tendons stretch and the knee will pop out more frequently) to tighten back up. Their dog didn't need surgery and had no more problems from the luxating patella.
Molly's luxating patella on the left side is a grade 4. It won't come back even with exercise and surgery might get it to a grade 2 or not. The problem with the right side, while there is a grade 2 luxating patella on that side, is more due to the deformity from birth of not a deep enough grove and it just goes out from under her now. That is a very painful, long surgery and none of the vets want to put molly under for it, as the risk for blood clots they think will be high for her. So we are just going along doing what we can. She doesn't seem to be overly uncomfortable, other than being wobbly in the back legs and falling over sometimes when she is moving fast or steps wrong. Poor baby, she has such a good attitude and disposition through all of this.
The eyesight continues to get worse, and now I have to sometimes touch her nose with a treat for her to know it is in front of her. But once she knows she is happy as can be.
I feel bad as I am not able right now to spend as much quality time with her as I'd like due to the work issue. I work, and sleep then work, then sleep, then work then sleep and that is just in one day. Crazy! January can't come soon enough for me!!!
We put the tree up today finally as our daughter was making noises like you are Never this late. *(she forgets the year it went up on christmas eve hahahaha) kids. Still it is finally up, and i'm playing catch up on the forum.
so many new members. :( Hate to see so much cushings out there.
Hope everyone is enjoying the holiday season
Sharlene, one thing I noticed with both Hamish and Henry is that their near sight is not as good as their far sight. If there is a treat on the floor right in front of them they don't always see if, but if it's several feet away they would always spot it, and as for things moving in the very far distance.... they never missed that! How does Molly cope with distance things?
I do wonder if some kind of knee support would help Molly as it might stop the knee popping?
Sorry to hear that work is so busy at the moment. Will you definitely get some respite in the new year?
All work and no play is a bad, bad thing;)
I hope you and yours have a wonderful holiday season and a very Merry Christmas! Hard to believe it is fast approaching we have had no snow since Thanksgiving and almost balmy temperatures.:)
I hope things settle down and work. Miss Molly wants to play with her MaMa:)
Hugs
Wishing you a blessed Christmas also to lady Molly. Thank you for being there for me so often.
Love Sonja,Apollo, Karma
Merry Christmas everyone. Hope all is well with everyone and all are enjoying some special time with their families, friends and furbabies.
I will be back tomorrow to pop into threads and say hello.
Hugs, happy holidays and all our best. From the muffins family
Merry Christmas to you all from Henry & me
Merry Christmas and a blessed year, Sharlene and Molly.
Sonja,Apollo,Karma
Gosh, can you guys believe another year has passed already!!!! Where does the time go. sheezzzz
We got snow! bah humbug, guess winter is going to show it's ugly face after all.
Molly was not nearly as impressed as she was when she was younger. Probably because I pulled out the red booties to give her some stability. She hates booties!!
Hopefully there won't be too many fireworks around tomorrow night, as they do freak her out. I'm going for the melatonin before we go out to dinner and then coming back home to let her out, check on her before heading to a friends house (just up the street from ours) to bring in the New Year.
I hope that this finds you all safe and happy and your furbabies doing well.
Cheers gang!
Cheers to you too, Sharlene! Stay safe and tell Molly that Abbie says those mean 'ole fireworks won't hurt her! :D
I will try and say Abbie says. LOL I do tell her that every year, but she looks at me with that "liar, liar, pants on fire" look of hers that leaves no doubt that she doesn't believe a word of it!
What happening with our little red bootie hating diva? Haven't heard much lately?:confused:
Hi Kathy, there hasn't been much to tell lately. :) I guess I spend so much time answering posts, that I haven't thought about posting ourselves. :)
Molly continues to have really good days and some, now and then off days.
Her eye sight sucks frankly. She basically sees shapes, but between the cataracts for which she can't have surgery and the scarring, any detailed vision is gone. I use voice and smell, sounds to keep her oriented as to where I am. Since I don't move furniture or rugs or anything ever in the house now, she still can take off like a crazy thing. The only thing she ever seems to run into is my legs. Maybe it's not such a bad thing they got some cushion on them. ROFL!
She is definitely still a finicky eater, and has lot 2 lbs since this started. I'm trying to get about a pound back on her, but she some days she is less interested than others in food. Treats, are not food, since she is Always interested in those. hahahha
She still hates wearing her booties and will take off if she thinks I'm going to put them on her. You'd think she would be happy to not have wet feet. LOL
So the latest thing is something my hubby has started. He comes home, greets us both, then has a little talk with molly about how he is going to go upstairs and change out of work clothes, then come back and they will have treat time and for her to stay right there at the foot of the stairs in the foyer and wait for him. (she does it!!!) He says it gives him the illusion that she listens to him even a little bit. hahahahhaah She still knows how to rule us both.
smart girl!
Ohhhh look at you with your new Administrator tag!! Couldn't think of a better person to take on those demands... that old saying if you want something done ask a busy person!! Congrats Sharlene :):D
Flynn would like to send Molly some kittens :D xx
I think Flynn should keep the kittens :) lol
Thank you Trish! Whats a bit more busy in this life. LOL
So we had some test done and I was waiting to get the actual copy of the tests before posting as you know, over the phone they tend to just give you a sort of basic run down. So, here we are and I'm writing a book tonight:
ACTH
7/16/2015
pre 34
post 221
on 15mg
9/23/2015
pre 52
post 403
increase to 19mg
10/14/2015
pre 60
post 270
increase to 21mg
2/3/2016
pre 214
post 361
increasing to 24mg
Her one good thing is that her UPC is now 1.4 it's decreased from 3.1 in july to 2.2 to 1.4
However, her SDMA which was good in October in normal range is now not in range and went from 13 up to 21 range 0 - 14
Her BUN is 14.5 still range 3.2 - 11.
Creatinine had gone up 78, 114, now 148 range 44 - 133
Her calicium is out of range just a little at 3 range 2.2 - 2.8
her chloride is low at 105 range 108 - 119 (this was 10 in july also but had gone up to 109, now back down again)
ALT went from 199 up to 220 between july and jan range 18 - 121
ALKP went down a tiny bit 1769 in july now 1716 range 5 - 160
Cholesterol is up at 9.7 range 3.4 - 8.9
lymphocytes is down at .7 range 1.1 - 5.0
specific gravity has been dropping steadily from 1.035, 1.025, 1.012 now
Here is what the vet wrote and then I'll write out about the SDMA.
This is what IDEXX write about the SDMA and probably something that all of us with furbabies who have kidney issues and the new test should be aware of.Quote:
Molly presented to the internal medicine service for a recheck. On presentation, molly was bright and the physical examiniation demonstrated weight loss. Serum biochemical profile demonstrated azotaemia, elevated SDMA concentration, hypercalcemia, elevated hepatic enzyme activity and hypercholesterolaemia. Complete blood count demonstrated lymphopaenia. ACTH stimulation test indicated inadequate disese control. An increase in trolistane, the addition of an antioxidant to the treatment regime, and continuation of other medications as prescribed was recommended. Recheck ACTH stimulation test recommended in 10 to 14 days.
So, we're increasing the trilostane again, she'll start this week, retest in a couple weeks. Maybe, if we can get the cortisol back down, her kidneys will do better. I asked how they felt about the pharmacist I'm using and they said they are working well with them, so I guess this is a molly specific issue with the trilostane that she just adjusts to whatever dose we give her and then over compensates or something. I really don't know and tonight I'm probably not in the best frame of mind to figure it out.Quote:
If SDMA is increased and CREA is within the reference interval, early kidney disease is likely. Unlike CREA, SDMA is not impacted by lean body mass. Therefore, SDMA is a more sensitive indicator of kidney function in poorly muscled animals. Most animals with early kidney disease have an SDMA between 14 – 20ug. Since SDMA increase as kidney function decreases, SDMA results >20 are typically seen in more advanced disease along with an increased CREA. If both SDMA and CREA are increased, kidney function is likely impaired.
The other thought is that her kidneys are deteriorating and therefore her cortisol is responding by rising, which i wouldn't have thought it would be able to but then again, molly's cortisol has always had more of a mind of it's own, more so than I like. Every time I think we're heading down into the right direction, it goes up and we increase the dose.
She's not eating well and has lost about 2 lbs over all since the UPC went up, her eyes went bad and her BP went up. That all happened within that 3 month window back in what was it April of 2015? Her fur is thinning now, but yet, she is pretty happy. Her quality of life is good, even with all of this. She runs, she plays, she interacts.
I just want to sit down cry (actually already did that, because sometimes it just gets to you and seeing those results did me in today) and say WTH! (I might have said a bit more than that)
Then we went for a walk and molly had a great time even in the cold and snow.
I'm going to have a quiet night and just chill out with molly on the couch because I'm at the end of my rope today as they say and need some down time. Tomorrow we will regroup and go again.
BTW, adding in vitamin E in support of liver function, 100 iu every couple days but molly will be getting hers in a treat form of 50iu per day since she now refuses all gel caps no matter what i try to hide them in.
hugs to all