Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

Hiya stranger. I haven't posted on your thread for awhile. I do keep in touch though I hope on Facebook. I was just wondering with Molly's shivering if it could be some kind of seizure. I know Keesh had mild seizures, his body would quiver as if cold, but..... the only difference was he chattered too? Not hard but I knew from a distance he was having one as that was the first thing I heard. It was just a thought. Today is a sad day for Lesley..... my stomach gets sick literally when I hear of another passing, that's why I can't read much on here at all.
Give wee Molly a huge kiss and belly rub for me.

Hi Judi! Yes I keep up with you on facebook :)

I think it is cold. I put the sweater on her yesterday and she stopped shivering. No teeth chattering, thank goodness, don't want to have that "just one more thing" to try and balance.
Plus once she was warmer, she grabbed her cow toy and was attacking it, playing by herself in the living room, having a grand time.
So, don't you think that seems to mean more cold than pain or low cortisol?
That thin hair, a close hair cut and thinner skin is making a difference for her is what I'm now leaning towards.

I know, my heart just breaks when we lose one of our dear ones.

Well I used to be the hottest one in the house, but the last couple of years I get colder, easier. Must have something to do with getting older and thinner skinned. Glad to hear she's attacking her animals, that's such a good sign.

I've not posted, but have been following your thread and giving it some thought. It really does sound like she's feeling the cold and one thing I've noticed recently is that even if I move to a warmer place that I can feel colder for a period until my body accumulates to the new temperature, so it could be the same for Molly when she gets up in the morning.
It's good that she obviously feels better when you put a sweater on her, so I'd be leaning towards the thinner hair and haircut.

Well I rather do hope it is the cold as that is better than some alternatives that my rather vivid imagination can come up with.

I've booked her in for ACTH testing, full blood panel, UPC and urinalysis on Thursday the 12th. If something is going on hopefully we can get to the bottom of it. She will be seeing her regular IMS who is back at twice a week from maternity leave. I'll mention the shaking/shivering episodes, which continue.

However, shaking or not, in the evenings she is very playful, she loves her walks, so I think quality of life is good for her. If only the eyesight thing didn't cause her moments of freaking out. She recovers quickly but you can tell it disconcerts her sometimes as she will walk sideways practically around something that she doesn't seem to recognize fully.

On my side of things, I love that summer is here. Molly and I can take walks much longer and without doggie coats (she doesn't like to put the sweater on really but is fine once it's there).

We have started a walking group in the neighborhood of 6 of us, including me and my hubby. We go 3 times a week and it's wonderful. (I'm not nearly as sore now as I was when we started) (it's too long for poor molly to go :( ) and last night we had our first of the monthly girls night out with a group of us. We did a movie and then over to a coffee place which was so very civilized and much needed that I thought I'd cry tears of joy. LOL Sometimes you just need that girl time ya know. Hence, the we will try to do this once a month. It's a bugger to try to match up schedules but so worth it when it comes together.

My MIL arrives on Thursday of this week, so I'm planning a girls night at our house for her, with wine and maggie smith movies. Then there are birthday celebrations for the next couple weeks for my hubby. It seems that with the warmer weather, that life is once again full. I am happy and molly is happy and hubby is happy. Not sure if it gets much better than that. :) :)

Hope this finds you all well and healthy and happy too. Remember what Addy always said, find One good thing a day.

Hooray for summer, long walks and Molly being playful! :D

Quote:

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Originally Posted by molly muffin

I am happy and molly is happy and hubby is happy. Not sure if it gets much better than that :) :) .

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YAAAAAAAAYYYYY!!!!! Best update yet Sharlene. Everyone is happy!!!! :p:p:):):D:D

Thank goodness summer finally found its way to Canada, I thought it had stalled over us and we were going to skip winter altogether :) Molly loving her walks in the warmer weather, awesome to read!

Yes, I often think of Addy's saying.. the "one good thing" a good thing to live by eh! Or put it in the drawer, another goodie. I can always do with reminding to take one day at a time and savour what you have now as I know you do too xxxxxxxx

Hi all, so took molly to the IMS on 12 May, 2016. I just realized they never sent me the lab paperwork from March, so I've emailed to get both the March and May results from Internal Medicine.

My IMS did call me though and told me that the pre was high 103nmol and the post very low 41nmol. Almost feels like a mixup at the lab, although they said not. (I've asked about that again in my email to them)

They think she might be exhibiting some pain too.

I wonder if (and is this feasible) that if she is having pain she might have already secreted and be secreting a large of amount of the reserve into her system, regularly.

We stopped the trilostane for the last 2 days and I've noticed a decrease in the shivering (so maybe Dr. Peterson was right and it's low cortisol Lori). We'll go back to a lower dose of trilostane and see if that helps with pain (rear legs), can't stay it stops her running around. If not maybe get a script for tramadol.

Her liver values are actually a bit better,

ALT 185 down from 220 range 18 - 121
ALKP 1062 down from 1716 range 5 - 160

Calcium is 3.1 range 2.2 - 2.8

Kidneys are worse

BUN Urea 21.3 up from 14.5 range 3.2 - 11
Creatinine 183 upfrom 148 range 44 - 133

UPC is better at 1.0 down from 1.4
Specific gravity remains at 1.012 as before.

We also think she is displaying some stomach upset, so I need to get some pepcid and give her 2.5mg a day (this is due to the acid build up in the stomach due to the kidney problems)

They said lymphs are now within range.

So I'll have to get the actual lab results in hand before I know any more, but that was what I wrote down and considering I was outside, with a pen and paper and my cell it is a bit of a messy note taking.

So there are some things to think about here.

Well we all know that there is nobody that can look after the Diva better then you. Sure hoping you can get most things back to normal for her. Give her a belly rub for me, and I'm wishing only the best for the wee girl.

Wow Sharlene, You now officially know more than most vets!! ;)

Since Molly's shivering has stopped since stopping the Trilo, that could certainly indicate a side effect of the Trilo itself, or her cortisol dropping a little too low. Both have been noted previously. So maybe the shivering isn't a sign or pain. It's so hard to know.

Stomach upset is common with Trilo. It used to irritate Buddy's stomach something awful. So bad that he couldn't settle to sleep at night. Pepcid did nothing. SEB was the only thing that I found that helped.

Happy to hear that Molly is still happily running around enjoying life. As long as she is able to do that, she can't be hurting too much.;)

Big hugs,

Hmmmmm...I totally agree with you, Sharlene, those ACTH results surely do seem backwards. I don't know exactly what to make of them, either, or whether your musing may be right (about her cortisol running higher all the time due to pain).

I know you'd rather not see the creatinine increasing. It occurs to me that if her renal filtering function is becoming more impaired, the trilostane may not be exiting her body as efficiently. I think that's why Dechra warns about giving trilo alongside kydney dysfunction. So I guess that's a question I would want to ask your IMS: at what point would Dechra advise stopping the trilo altogether in the face of rising creatinine?

Aside from the stomach issues, though, I'm so glad that outwardly she is still a happy girl. I think we reach a stage where that's the most important barometer of all. I know, though, that it's awfully hard to keep the dang numbers out of our heads. :o

I certainly will ask her that. I did make a mention of what Glynda found as far as when impairment is involved along side cushings, that cushings meds should be stopped if the animals appetite is being adversely affected by the lower cortisol and the kidney issue. Higher cortisol increases their appetite. We didn't come to any consensus on that during our discussion that this is the time to move away from treatment, but I will bring up the issue of whether or not the trilostane is being filtered out enough.
I know Lori mentioned on our thread that they stopped the cushing treatment and focused on the kidneys.
I've ordered one of the new forumula for dry and wet renal today so hopefully will have those by end of week and I'm going to move her onto it slowly and even though I know it isn't HER preference, will try to keep her solely on renal food and see if that makes a difference.
She really does appear to be okay. No increase in drinking without the trilostane and her appetite seems to be okay for her. We haven't had any more of those really horrible, refusing to eat episodes since she drove us all crazy that time 2 months ago. Maybe she had some serious gastro issues at that point.

She does keep me on my toes and I guess I'm adding kidney issues to the cushings issues that I'm learning about. (no my choice at all)

oh I was going to say too, Marianne, that since we are rechecking in 2 weeks I'm not concerned about letting the cortisol levels come up for her and I am guessing that the next test will tell us what is going on. (I'm still betting on an switch of the pre/post results) We have seen enough cushing tests on this forum to know that is the most obvious answer as to why so high a pre and often times, the obvious is the right answer. But since molly has been known to be her own dictionary with cushings, I can't say positively. The repeated negative ldds comes to mind, never over drinking water, no ravenous appetite, perfect coat until recently and only after she was on medication for over a year did it go bonkers. argghhh

:)

Marianne, I had sent that email to the internal medicine department asking about the possibility of the vials being mislabeled or the lab switching the results.

Today even though my specialist isn't into the office till tomorrow she emailed me and this is what she had to say about the high pre and low post:

Quote:

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I saw your email about Molly and just wanted to touch base. I think it’s unlikely that the tubes were mixed up but we can’t completely rule that out. I have seen that before in other cases. One theory that I’ve read to explain it is that more trilostane has been absorbed from the intestinal tract since the pre so there is greater inhibition of cortisol production at the time the second sample is pulled. I am back in the clinic tomorrow if you want to call me to discuss further.

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That is an interesting possibility that I hadn't seen mentioned before so I wanted it on here as something to consider. I am going to mention your thoughts on renal filtration too and see what she thinks.

Have I mentioned how much I adore my specialist and love how much she loves molly. :)

Hang on to that specialist! You've got a real winner!
Love,
Sus

Yes I do love her. I didn't get a chance to get back to her on Friday as it's the May long weekend in Canada and we have been away.

I took molly off all trilostane for 4 days and started back in at the lower dose on last Wednesday. At this point, all shaking has stopped. That makes me wonder if that post number wasn't the main factor after all. Of course it is also warmer, but it didn't stop until I took her off trilostane for a few days.

We've been transitioning to complete kidney specific diet and today is her first day with this without any mix of the old food in there. Cross my fingers that she doesn't get tummy upset or diarrhea from the switch over.

Hey Sharlene.... just wondering how our Diva is doing and of course you too.

Hi Judi. Great to hear from you. Just been working and more working.

Molly goes back Wednesday for her follow up ACTH. I expect it will be higher. No more shaking episodes forma couple weeks now! She seems to be walking better. Not as many episodes of her leg giving out. Eyes worse. You can tell because she uses her hearing to tell where in the house someone is. You can tell she will be looking one way and unless you make a sound that you are I. A different direction she doesnt know. Even if yiunar waving your arms madly in the air. She needs that sound. So another area we are working on to get her more comfortable.

Big hugs. Hope things are going well for you.

Near the end as Keesh's eyes and mostly his hearing went... I started to clap loudly to get his attention. Only needed to do it once. He responded well and I was glad it worked. Of course I used hand signals all his life, but the single clap was new. Seems that sound wave traveled much differently then my voice. 2 claps meant "no" meaning he could not trot across the street.. LOL

Just dropped by to say hi. Molly is lucky to have you. You are doing the best you can for your little Molly, and she knows that.
Love Sonja, Apollo

Hi Sharlene...had to catch up with your posts on Molly while I'm here.. Hope she's been doing okay. Glad to hear that while off Trilo for awhile the shaking has stopped. Either it's the drug..or could be the lower cortisol is bringing out something that had been masked..joint pain or some other inflammation?
That was an odd ACTH result you had last time...it will be really interesting to see what the next one looks like. Hoping Molly is happy and feeling good. :)
Barbara

Took molly for follow up ACTH today so should have those results tomorrow. We also did a mini renal profile (IDEXX), added on a urinalysis and checked the BP. BP was very high, 240. Which isn't good. (this was on the second test, the first wasn't as high as that)

Anyway, will post more once we know what the values are from today.

Darn that BP! I can't remember--is the vet who is doing the BP using a doppler or a cuff? My vet uses a cuff and usually takes 5 or 6 readings and takes an average. When at the hospital they use a doppler and do one or two readings. Just wondering if Molly's numbers would be different using the averaging.

Thinking good thoughts for the rest of the results!

I think they use the doppler judy. They took a couple readings all where over 200, so we are increasing the amoldipine to 1.25mg twice a day instead of once and will recheck in about a week.

Also she has a UTI. The urinalysis showed some white blood cells and would explain the licking and increased peeing. So tomorrow I am taking her to the local vet for a cysto draw (clean) which will be cultured and we'll start her on antibiotics tomorrow to get a start on the weekend and adjust if we need to when the culture comes back with what type of bacteria it is.

Her ACTH was
79nmol pre 2.86ug
149 post 5.4ug

Since the shaking has stopped so we are thinking that she will do better at this range perhaps and in 8 weeks we will retest and maybe talk about going to a twice a day dosing or something. Dependent upon molly She will stay at 20mg till next test, down from the 24mg.

Her Creatinine was 185 just a small increase from 183 last time
BUN was 16.9, down from 21.3 I think it was last time.
SDMA 26, think that is up a bit. I'd have to look at spreadsheet to know for sure.

So, she is holding steady for the moment and things might be improved once we get rid of the UTI but all will be rechecked in 8 weeks.

I feel better knowing how she is doing and that things aren't getting worse right now. Just will need to see what things are like minus a UTI.

Thanks for hanging with me while I freak out. :) Molly is still doing the 48 hr ACTH spazz.

I thought molly was looking better but my IMS said, no she looks the same to her, but her hair is growing out a bit, still thin though and her weight isn't going back up. sigh.

Whew, so relieved to read your report, Sharlene! I've been thinking about you guys all day. Sorry about the UTI, but out of all the things that could be wrong, I'll take the UTI. ;)

Many belly rubs to our girl (that's Molly, of course, even though you're our girl, too :p).

No belly rubs for Sharlene? But ... what if she wants them, too? ;)

I too am grateful that you've got an answer to what's been going on, and that is "just" a UTI. Funny how perspective changes your outlook on these things.

Hugs to you! :)

Sharlene--aside from the BP, the stable lab results are a big relief, I'm sure. The UTI can be dealt with and I bet Molly will be more comfortable when the meds kick in.

Hugs to Molly!

Yea, I'm glad she is stable, that is a plus. I'm sure that with some antibiotics in her she will do much better too. And hopefully we can get the BP down. :)

I'm rather partial to back and neck rubs. LOL So I'll let molly have the belly rubs. Shes a hog about them anyway. rofl :)

How was Abbies BP?
Abbies creatinine is okay right? I haven't seen that you mentioned it as being high on the last test so her kidneys are actually doing okay other than the dratted UPC.

Sharlene--Abbie's BP is in the 140-150 range. The neurologist took it yesterday and it was 146 so at least the telmisartan and amlodipine are helping in that regard even though not helping with UPC. Yes, creatinine is normal. Only abnormal kidney marker is the ridicuously high UPC!

yea molly was doing good on just the amoldipine and was at 140 but when her creatinine went up and the UPC actually came down (how WERID was that!) her BP has sky rocketed.
So guessing it might be kidney related.
That is good that Abbies kidneys are doing okay other than the UPC and that BP is fantastic.

Bahaha... Back and neck rubs for you, then. ;)

Thinking of you and hoping you are heading out the door to spend some time with your grandson, it will be just the tonic you need.

Got Molly amoxicillin yesterday and a culture sent off.

She is acting fine A bit more trips out but that is tha nature of UTIs.

Yes am going to see grandson this afternoon and with friends later this afternoon.

I have my freak moments over Molly. I think that is the way of it with pets in your life. But eventually I do adjust just as she does.

Like it is so comical the expressions she uses now that she uses her hearing so much. She looks at your voice and cocks her head this way and that. Just too cute. Or when she is attacking either her treat or toy and misses by a mile but goes right back at it till she finds it and throws it in the air like ah ha!! Got you!! Lol

As if a little lack of hearing going to hold our Molly back. Hope the antibiotics sort that UTI quick smart, our hearts cannot stand any more bad news this week. So Miss Molly, drink lots of water to flush it out and get back on track you hear!

Your Mama and us do not need any more freak moments :eek:

Sharlene, thank you for all that you do... you know what I mean xx

Just dropped by to see how you and Molly are doing. You do so much for other's on this site.
Thank you
Love Sonja, Apollo, Karma and little Ariel

Good Golly, we need an update on Miss Molly.;) I hope our diva is holding her own and continues to enjoy life for a very long time. They adjust to their new normals much easier than we do.

Hugs,
Kathy

Molly continues in her diva ways. Lol. I'll know something is wrong if that ever stops. :).
She can be standing right near me and looking for me in a different direction and sometimes not even get the direction right when I talk to her. Takes a bit to figure out where I am.
I tap the step up to the front door now so she knows where it is and she will wait for that tap if she is unsure. Sometimes she can gauge it but not often.
She got groomed on Saturday and that step down is a bit bigger than hers at home and she misjudged it. Luckily I had a good grip on the harness and pulled her up from a face plant. She has had a few of those in the past month so not fun and she gets a bit iffy of things afterwards. I like to keep the confidence high.
We have had contractors in the house the past two weeks getting estimates for various jobs. She seems to be hamdleing thT okay.
I interviewed for a different position at the company I work for today. I just feel the need for a change as the last two years have been a bit stressful. I don't know if this is jumping from the pan into the fire or not. It might be as you are essentially needing to be available all hours while still maintaining full time work days but it would allow me to be home with Molly even more than I am now and as she is getting older and the issues more with her health it is important to me to be with her as needed and not on my jobs schedule. If I get the job I would still maintain a space at the office but can work from home every day if I need to. Molly first. :).
The fire part is that it is more hours probably but a complete change from the more technical that I do now. More responsibility but not the same exact thing every day. Hopefully no more working at midnight although I do have a week of that coming up in August. Ugh. That schedule is worse than ,monitoring for some problem that might come up at any hour I think.
Anyway we shall see if I get it. Others are applying too of course as this position doesn't come available very often. So I m not going to hold my breath. It's a possibility is all at this point.
We have family coming. My sister who hasn't been to,Canada since I got married. If things work out with my BIL who is back in hospital and likely heading to a rehab hospital after another fall. Nothing is simple eh. If my sister comes then my niece will come too and Daniels mom will be in and out before and after her trip to Budapest All in August. It's going to be a crazy month I think.

I love it-Molly the Diva! What a sweetie. Hope you get that job, working from home sounds wonderful.