Zoe By My Side- Our Journey with Cushings

Well, I did find a doctor that worked with Dr. Feldman. I guess I will see IMS after Thanksgiving and then go interview this new vet. He seemed quite confident about using Trilostane with Zoe. Can't hurt to talk to him:confused:

Even hubby is worried now and wants to move forward instead of this limbo we have been in.

She had an accident in the house this morning. It is always in the morning around 10:00am. Always when her schedule has changed for the day. She has not had an accident at any other time. Weird huh? She gets her melatonin around 7:00-7:30 am.

She scans the street now looking for something to eat. Maybe the dietary indescretion will get better when she is treated, she won't be looking for junk to eat outside.

I think I have made up my mind. We will see if I change it. I think I will try the Trilostane. If she is 18 to 18.5 pounds could I go with 20mgs so I don't have to compound? I thought it came in 10mgs.

Hugs,
Addy

Quote:

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Originally Posted by addy

Thank you for the link, Lori. I reread it last night. The problem is whenever we run tests for the colitis everything is normal. IMS thinks it is frequent infections from the Cushings and once we control that, flares will be less. I remember someone else on the forum had an IMS with the same thoughts on their pup but it did not play out that way...


If I get her well and she stays well for a month, will the metronidazole show up in her blood work? I would assume it would affect anything to do with the liver. I wonder if I could retest her anyway.

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Hi Addy,

I believe I'm the person you're thinking of -- my IMS was also hoping that my Cushpup's GI issues would improve once his cortisol was brought under control. It didn't turn out that way, but my dog was no worse after starting on trilostane. There really didn't seem to be any big difference to me. He still had periodic episodes of diarrhea, so I ended up guessing that it was just unrelated to the Cushing's.

In our case, we did not delay starting the trilostane treatment due to the diarrhea. My dog was extremely symptomatic and extremely miserable: excessive appetite, thirst, and urination; panting; hair loss; muscle wasting. Sadly, he was a "poster child" for the disease. So the other issues trumped any concern about diarrhea. And as I say, his diarrhea didn't worsen with treatment. It just didn't really improve.

I'm not certain as to what you are asking in terms of the metronidazole affecting Zoe's test results. I don't think the medication itself would skew any of the hormone results, if that is what you are wondering.

I, too, don't want to be pushing you into trilostane treatment prematurely. However, all I can tell you is what my own experience was with my dog. And if and when you reach a similar point -- where the Cushing's symptoms are becoming problematic -- you may want to go ahead and opt for treatment regardless of Zoe's diarrhea. Once again, if the treatment doesn't help or creates more problems, you can always stop.

Marianne

Thank you Mariane, it helps to hear your story. Is Zoe having frequent infections-no, is she drinking and peeing buckets-no, is she panting-no, does she have muscle wasting-yes, does she seem hungrier-yes is she drinking more water-yes for her but not more than what is considered normal for a pup her size, is she peeing more than in years past? yes, we do take her out more but we have gotten into that habit because our Koko has to go out more so we always took her too, she has gotten used to it. But she also has had a few accidents in the house,Is Zoe's hair and skin thin-yes.

Last March she flew around the house, jumping on the bed, in the car, she no longer can do those things. The melatonin slows her down, I notice a difference if I forget to give it to her.

Zoe is not a poster dog for Cushings but I can't help but start to feel an urgency to help my dog as I see the changes in her.

I wondered how the metronidazole would affect her blood work, her blood chemistry test, etc.

If the Trilostane ends up increasing her intermediate hormones, if you withdraw the trilostane, do the intermediate hormone levels come down or do they stay elevated? Does anyone know? Should I ask Dr. Oliver?

It has been a hard month here on the forum, perhaps that is pushing me to act as well.

Hugs and thank you so very much for your opinions. I can't tell all of you how much your ideas and thoughts and help mean to me.

Addy

quick question: HMR lignans- is it still 1mg per pound? UTK site is vague saying 10-40 mgs for small to large dog. Want to purchase in U.S.

want to switch until test is done, don't have time to email Dr. O.

thanks,
Addy

Quote:

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Since HMR lignan’s bioavailability to the body is better than SDG flax hull lignan, this allows reduced doses to be used.

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According to this statement that I copied from the LIGNANS (Phytonutrients) sheet, my guess, would be no.

It also goes on to say:

Quote:

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The above products can give different dosing levels depending on the number of capsules used, but total doses of 10 to 40 mg daily should be adequate for small to large dogs.

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http://www.vet.utk.edu/diagnostic/en...Revision03.pdf

So, I gather that dogs getting HMR lignans get doses ranging from 10mg to 40mg daily depending on their size?

For Zoe, I believe, I would give her 10mg.

Not much help, am I???...Sorry. :(

Love and hugs,
Lori

Lori, you are always a help. I thought perhaps 10 mgs as well.

Great minds think alike.;)

Thank you and I hope you have a wonderful Thanksgiving!!!!:)

At least I can see how she does until we can get in to see IMS. She said it would be hard over the holidays :mad:

Hugs and BIG thanks!!!
Addy

It is not the lignans. She has not had lignans for a week. I tried to go to every other day again with the Metronidazole and same thing happened. Watery mush this morning. Yesterday with no metronidazole, she was fine. it is always the next day a problem when I don't give it.

It has never taken this long to taper off to every other day. Trying to not twitch and stay positive. She lays as if her tummy hurts her. She walks slowly to go outside. Yesterday with no metronidazole she was not as slow.

It will be a long holiday.

Addy

Oh Addy,

I am so sorry Zoe is not feeling better and I hope she is feeling herself soon...sending healing thoughts your way for sweet Zoe.

I am just wondering if her system is getting used to the metronidazole, and if switching to the Tylan would be an option?

Please keep us posted, ok?

Love and (((hugs)))
Lori

I wish I had some answers for you, Addy, but I've never used any of the things you are giving Zoe.

I hope you will be able to get some positive answers soon.

(((HUGS)))

Finally heard back from IMS. We are to go back to twice a day dosing of metronidazole for 2 weeks, add the lignans back in to the mix and see how she does. If she does not respond then we will switch to tylan.

Lori, she brought up switching to tylan, I did not have to;)

She said the change in routine and excitment of Thanksgiving and company could be a problem for her so definetely give her 2 doses a day.

She seemed a bit better today but still lays as if her tummy hurts after she eats. She did want to walk a bit this afternoon and I had to fish a crabapple out of her mouth:eek:

One day at a time, I guess. We will see how the next 2 weeks go.
She still looks thin but she has not lost weight.

I am going to call the local vet I found who worked with Dr. Feldman. He said he could overlook Zoe's care and work with her IMS and me. I want to interview him and move forward setting that up.

I should feel better I have a short range plan. I don't.:(

Happy Thanksgiving everyone. Love you all:)

Addy, Zoe and Koko

Addy, hang in there. I think you are doing great. I would be sooo happy to have a local person that had worked with Feldman. That is great. Keep up the good work! Happy Thanksgiving! Kim

Hi All,

If I am being anal, just be honest and tell me. I need to give Zoe probiotic once a day, metronidazole (antibiotic) twice a day and lignans twice a day. Since they all work with the bacteria in her I am worried about the timing of the doses.

I know I can give lignans and probiotic at the same time. I thought I could give probiotic and metronidazole (antibiotic) a minimum of 2 hours apart ( twelve being ideal)

Not sure of the metronidazole and lignans.

Any input? Does it not matter?

IMS mentioned how "thorough" I always am. Other vets also comment on that. I am starting to get a complex:rolleyes: I worry they don't want to deal with me. It took IMS two weeks to call me back.:eek:

If I am being anal, just be honest and tell me the truth, the truth does not bother me.

Love you all,
Addy (Ms. It is in the Details)

Moderator's Note: Addy, I have merged your recent post concerning scheduling Zoe's medications into Zoe's original thread. We, normally, prefer that all posts on a pup be kept on the original thread as it makes referring back to the pup's history easier for other members.

Addy - you are wise to think of these things. I know that you do need to give the a/b and probiotic 2 hrs apart (more or less) as I researched it. I have no idea about the lignans. Kim

Dear Addy
Hope you had a restful Thanksgiving. Doesn't look like it from your posting.
I am praying for you and Zoe. Apollo throw up on the bed yesterday morning just vial. But my alarms are up. He has always had stomach issue. Will post his progress on my thread also.
His hind leg weakness is not getting better. All I can say is it started around June. Since starting the Trilostane his coat has grown, his tail is scatter with hair and bold here and there. I started the Duraclin yesterday and keeping a log on to any changes. I will stop the Trilostane when I finish the liquid . Which should be by Monday.
To reassure you if you start Trilostane you can always stop it without any major side effect. Also Apollo weighs 10lbs and started ate 10mg. He is on 12.5 mg now for the hind leg weakness. Zoe's stomach issue could improve with the Trilostane. It has for Apollo, other then the occasionally throwing up. I then give him a quarter of a table of Pepsi bismol.
hugs Sonja and Apollo
On the lighter side, while walking yesterday, a man came up to us and said"Dogs are angels with paws". I gave him the thumbs up.

Thank you dear Sonja. Zoe slept later today, more like the old Zoe of last year and her eyes are bright today. She seems happy and alert. She made it throught the commotion of Thanksgiving without much todo except for soft stool. IMS thought it might be worse than that but Zoe handled the stress and excitment of company and bountiful food better than we thought she would;)

We will continue the meds for two weeks and call IMS for further instructions. I have only started back on 1/2 dose of lignans, I know I can't give her full dose yet, no matter what IMS says.

Then we have to evaluate when to redo UTK test and blood work. Then I want to start the Trilostane unless the test or blood work changes something.

Sonja, she looks so thin but weighs the same. Is that muscle wasting all over her body or is it that her coat is so thin we can now see how tiny she really is? She had such a thick, dense undercoat. It is gone now.

I hope the Duralcin helps Apollo. Let me know how he is doing on it. I hope the tummy problems get better for sweet Apollo, too. That is one thing I have about Zoe and the medication. She never throws up so if she would start I would know something is seriously wrong. For Zoe, the problems always come out the other end:eek:

I love it that Apollo has lots of clothes:D Did you take a photo of him in the red and green sweater? I should have Zoe's new sweater from Etsy next week.

Hugs,
Addy

Hi Addy,

I'm glad that Zoe is doing better. It's always so nice when they start acting like their normal selves.

It's possible that the thinner hair could make Zoe look thinner. My friend's ShihTzu gets groomed once a month, and after he gets groomed he looks so much thinner. I hope that's all this is with Zoe, and that it's not muscle wasting.

Dear Addy
Glad to hear Zoe is doing better.
Apollo used to have the cutest little rump before all this and nice hind leg muscle. He weighs more now and yes it could be the muscle wasting. His hind legs are so thin. The neurological specialist I went to about the muscle wasting said he has very little muscle in the inner thigh. He still has the jaw trembling.
Hug Sonja and Apollo

Thank you Terri and Sonja, for all of you support.

I worry about Zoe being on the metronidazole so long. IMS says no problem but I worry about that drug. IMS says we can change to tylan so I don't get so freaked out. Maybe it will be better for her. She likes the metronidazole because it also has anti inflammatory properties.

Zoe has never had to be on it this long. IMS says she may just have a really bad bacterial infection (i'm thinking mouse parts) and needs it longerthis time. She does seem better on it twice a day now. She isn't always laying like her tummy hurts her. She still walks slowly outside but maybe it is because it is cold and she really doesn't want to be out there. If I tell her "let's go get some chicken" she walks really fast;)

That is what is bothering me. Why does she need it for so long this time? I can't get past that.

Hugs,
Addy

Addy - maybe she has developed a resistance to the antibiotic since she has been on it so long? I remember reading that a lot of dogs just don't do well with the metro. and that is why they switched over to Tylan. I read lots of good things about it. If you think it is best to make a switch it is OK to take a stand with the vet and say "enough" and on to the next. At our dog's ages every day needs to be quality and Zoe deserves the best, as do you! Good luck. Kim

Hi Addy,

If you do decide to switch to Tylan, I just noticed this sentence about related side effects from the Marvistavet site that Lori cited earlier (http://www.marvistavet.com/html/body_tylosin.html):

Quote:

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Tylosin [Tylan] may falsely elevate certain liver blood tests (ALT and AST).

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This is not to say that you wouldn't want to try Tylan. But just so you'll be forewarned about its possible effect on liver testing results.

Marianne

Hi Addy,

In looking into your question about the lignans and ABs, the only thing I have found is that the Abs may prevent the plant lignans from converting into the mammalian form that can be used. I have found nothing on the timing of dosages.

In light of the problems Zoe has with her digestion, I think I would hold the lignans until she is through with the ABs. If the ABs are preventing the lignans from working as they should, then they may be supplying too much plant fiber for her system. Again, just navel gazing here, but it is a thought worth pondering. ;) Have you talked with UTK about Zoe's problem?

Wish I could help more! :(

Hugs,
Leslie and the girls - always

Thank you Leslie, I took her off the lignans and IMS wants her back on them. I did not think to ask last Wednesday night when she finally called me about the timing. She wanted me to put her back on the lignans and put her on the metronidazole twice a day. I had weaned her down to once a day of metronidazole but could not get her off once a day to go to every other day as in the past.

IMS wanted me to go back to what I was doing when she was well only add the metronidazole to the mix twice a day.

I have added the lignans at 1/2 dose since Thursday and her stool is soft. I am afraid to add the other 8 mgs. IMS said she did not think the lignans were bothering her:confused: I thought I would see how it goes with 1/2 dose for a week and then try the rest of the lignans. I have been giving them almost 4 hours apart. I give her the whole capsule instead of emptying in some food to make sure she gets all of it. Maybe I should go back to the way I used to do as I changed something and changes muddy the waters.:(

The problem is a night. I used to give her half her dose of lignans lat e morning and the other half two hours after dinner. But now I have to give her the ab two hours after dinner.

I never gave Zoe all of her lignans at one time. Kind of worried about doing that.

Thank you so much for your help and all your work.

If she has to go on Tylan does anyone know is that once a day or twice a day?

I am driving myself crazy.
Hugs,
Addy

I don't know what the dosage is you are talking about but I gave tylan twice daily. Same thing as any other antibiotic... give a few hours before or after food and other drugs etc including probiotics.

Dear Addy
Wish I could help. All I can say is listen to your gut instinct. Then go over with IMS. They don't always know what is right for our little ones. I believe less is better. Some IMS have a tendency to over prescribe medication in large dosages. I have had battle with them over dosages and not always giving medications for every thing. If I think back , God knows how many medications they put Apollo on for stomach problems, eye infections, ear problems etc. I trusted them.
I have my cape crusader outfit on with sword ready to fight.:eek::D Just kidding. We need to laugh through the tears sometimes.
Hug Sonja and Apollo

Thank you all for you input.

Sonja, you are exactly right. I am going to listen to my gut. I am here with Zoe and I can see how things affect her. I wish I had a dollar for every time I have heard "well, she should be able to eat that" or "well, that should not bother her" BUT IT DOES:mad:

I'll try putting her other 8 mgs of lignans in with her supper. That was a problem before, don't know why, but we will try again starting Wednesday. If I see soft stools right away I will rethink it. When I gave her the capsule of lignans for 2 days rather than mixing in with fod, she had soft stool. Yesterday I went back to dumping out of the capsule and her stool is firm last night and today. Go figure:rolleyes:

I don't know why her system is so touchy but it is what it is as I well know.

On a happy note:Yesterday, I went for my riding lesson and I cantered for the first time in 20 years. Boy, was I out of breath but it sure felt good. Then I actually got up on a really big Belgian Draft Horse over 17 hands tall and trotted and cantered a bit.

After all the stress of figuring out Zoe, it totally cleared my mind and I came home on cloud nine. In restrospect, I took a bit of a risk on that Belgain but the risk felt soooooo good;)

Have a great week all.

Addy

Hi Addy,

I am so glad you got to have some fun riding. My husband and daughter love to ride--me not so much. They get a lot of friends together lately and go for trail rides. Maddie was a present from my husband good buddy who is a horse shoer (sp.), didn't know if I could spell fairer correctly either.:D Our friend's family is really into the rodeo scene.

Good luck with getting back into giving Zoe all her stuff again.

We up'd the dose on Maddie to 2500mg a week see if that helps, but I am sure we will have to load--my gut--haha!!! Her blood work came back good except for that darn liver number up in the 2000's.

Well I better get to working--too many days off in a row--why did it have to end....:(

Hi Marie,

I know, why did it have to end, didn't it feel good not going to work?
Boy, my bubble burst this morning big time:mad: My pups' bubbles burst too when I had to leave.:(

I hope the new dose works for our Maddie girl and you don't have to reload. Is she still panting? Never a dull moment. Did you find a new vet?

I emailed Dr. Oliver today about lignans and antibiotics. Some literature I read seemed to indicate giving both are a waste of time but figured Dr. Oliver should be able to tell me how it all works and what to do. If not, maybe Zoe can be a new case study for him:p:rolleyes:

Yup, my riding lessons are cheaper than a psychiatrist;) better than a xanax too:D Margaritas, well, that is a toss up:p

Hugs,
Addy

Hi Addy,

Yes we did go to a new vet--still had the wait of a life time again--I think it must be a vet thing if they are good ones....:confused: This vet is a lot more knowledgeable about Cushings--lets hope so because she is an IM vet. She was very nice and took her time with us, checked Maddie out. Of course wanted to do tests $$$$--haha!! I opted out of the ultra sound at $300 because I wanted to see what the blood panel test showed. I cannot believe how a blood pressure check can cost almost $50, but then maybe our precious ones are not so precious when they are trying to get a bp cuff on them and in such close range of the teeth:D:D I didn't get a chest x ray also because she said her lungs sounded fine and again wait for the blood panel results. It must have taken an hour and half to get Maddie back after I let them take her for the test. I think I am going to back charge for my time from now on--let's see I had an appt at 10:15am on a Sat morning and got out of there about 1pm most of that was waiting of course--waiting room, in the room, and then the paycheck room (there are 2 different rooms to wait in). I heard someone in the 2nd room say it takes 45 min to check out---oh I can believe that one. I had no idea since it was my first time there. Glynda had recommended them--it is where she takes her little ones. I was promised the results the next day--guess what Tuesday I finally talked to the vet again after 2 messages from me wondering what the results were. Glynda said she would talk to the vet, but I said let's just wait to see how things go the next time.

The vet said everything but her liver looked good, but that is from the Cushings. She talked about possibly changing Maddie to Trilo, but I am not so sure I want her to go a month without anything because of the wash out period. Always confusing. Atleast I know nothing else seems to be wrong. She still is panting, but most everything else seems good. She goes running with my husband--all last week--he is on the bike. She doesn't run as far as she use to, but she still wants to go. I think the arthritis is a little annoying for her, but I opted not to give her anything--she doesn't complain and I still want her alert--didn't like the side effects it might cause. If they could talk it would help.:)

Take care!!

I Just heard back from Dr. Oliver. Bless that man for always answering our questions:)

He said antibiotics and lignans should not be a problem, two hours apart dosing should be fine, mix the lignans with the probiotic.

He said consider switching to HMR- I cannot find small enough dose here in the states though

He also said I should consider adding maintenance dose of lysodren.:confused:

which brings me back full circle to my thoughts of 2 months ago:eek:

when I asked IMS about it she said "we usually only load"

and I was confident in my decision to start low dose trilostane after her next UTK test.:rolleyes:

now I am confused again:eek:

Vacillating Addy

Dear Addy
So glad to hear about your riding. Pretty sad when a friend tells you , you should go out for dinner with them and have some fun. What's that?:eek:
I am going through the same with Apollo. All I know about TRilostane is it does not destroy the adrenal glands which the other drugs can. And it is easy to stop . Why don't you email Dr. Allen at Decha/Trilostane, and run it by him .
Office: (913) 327-0015
Direct: (913) 748-4836
Fax: (913) 327-0016
Toll Free: (866) 933-2472
Cell: (785) 979-0227

tim.allen@dechra.com
www.dechra-us.com
He has always been very kind in responding to my emails and will even talk to you.
Hugs Sonja and Apollo

Oh Sonja, what a great idea. Thank you so very much. I will do that Monday!!!!!!

I know I have to change her lignans, the SDG lignans are bothering her. She does not do well with alot of fiber. She tolerates it for a bit and then she cant.

Tonight I gave her full dose of SDG lignans:eek: Figured well, she still has 2 does of metronidazole so I should get a way with it. I think the metronidazole is bothering her. She has never been on two doses for this long.

After I give her night time dose, she just goes and lays like her tummy hurts.

Tuesday I am going down to one dose a day and then calling IMS about the Tylan and her retest schedule.

Wishing us both luck:)

Love,
Addy

Hi Addy,

I'm sorry that you're confused again. Sonja is right about Dr. Allen's responding quickly. I have spoken with him on more than one occasion, and he has been very helpful. I hope that you will get good answers to your questions and will soon be able to start Zoe's treatment.

Hang in there. We're here for you and Zoe.

Dear Addy
Will be praying for you and Zoe. That is what is nice about this forum , we help each other and can get different prospective from each other.
Hugs Sonja and Apollo

Hi Addy,

Dr. Oliver rarely recommends Trilostane for pups with elevated intermediate hormones because Trilo has been shown to further elevate those hormones. This is more than likely why he said you should consider a maintenance dose of Lyso - it will not raise those hormone levels but rather will lower all of them with the possible exception of estradiol, which is where the melatonin and lignans come into play.

With Atypical pups, a loading phase in not needed as the goal is not to erode the cortex of the glands but rather to kinda stun them a bit on a consistent basis with a maintenance dose and schedule. If it were Squirt and her cortisol were normal, I would flat refuse to allow her to be loaded.

Based on Squirt's last UTK panel, and assuming nothing else could be causing the increase in her cortisol level, we will be looking at starting Lyso ourselves. There will be no discussion of using Trilo with her. It makes no sense to me to give her a drug that will raise the very things I have been working so hard to lower. I KNOW the Lyso will have a positive effect on the hormones, all of them except possibly the estradiol. The melatonin and lignans have worked there for her - her estradiol is normal again.

I think it comes down to who we place our faith in for what. In the arena of Atypical and intermediate hormones, I trust Dr. Oliver and his staff completely - over and above anyone else. This is his bailiwick, his focus, and he and his team have lead the research in Atypical Cushing's. Yes, there is still much that is not known, much to learn and discover, and as a result, much controversy. But I place the treatment of my baby's condition with Dr. O and UTK because I believe they know and understand more about these hormones than anyone else today. When I read or hear of someone poo-pooing Atypical, the treatment, and/or Dr. Oliver, my weird old mind can't help but wonder how today's scientific community would look at Fleming and others who discovered penicillin by playing with rotten food. :eek:;)

Just MHO here, sweetie. Zoe is your baby and you have to decide who to trust, with what, and when. Squirt doesn't have the problems with her digestive system that Zoe does; they are bio-individuals so what works for one may not for the other. I do know that you are an exceptional mom who is going above and beyond to do the right thing for Zoe - so whatever you do, will be the right thing for her.

Hugs,
Leslie and the girls :D - always

Important : If I load her with Lysodren and her digestive system can't handle it besides causing diahrrea what else could happen?

Her numbers were sky high across the board and if it were not for her digestive issues, I agree she should be loaded and put on lysodren. But because of her digestive issues I firmly believe she will have problems with it, IMS figures she will mostly likely have problems as well.

I am terrified there is something else going on with Zoe and I pray it is not diabetes starting to rear its ugly head. I HAVE to have her retested with all blood work, urinaylsis, UTK panel. I had planned on doing it now but then her latest flare up started and I could not wean her off the flaygl so I did not want to test again when she is sick as I firmly believed it skewed the numbers somewhat the first time. last May.

I see a change in my little girl from where she was last March when this all started. I fear it is her Cushings progressing. I don't want to keep waiting and waiting to get her tummy well because it will never happen for very long.

I don't want to start her on either Trilostane or Lysodren without new tests.

I need to change her lignans and change her to tylan but I can't make all those changes at once because I won't know where I am at. I can't start the new lignans until I see if I can wean her off the metronidazole to one dose. I refuse to keep her on twice a day metronidazole, it is bothering her, I know it is.

Everthing takes so long and in the mean time she needs help and now I am really getting stressed because i am pouring out my heart's fears and frustrations because how can I do this all when it takes so long and she needs help now?

Leslie, Lori, how do I do all of this and not take another six months to treat her Cushings? It already has been six months.

Okay, having major melt down now. I held all that in too long:eek:

Addy

Addy, can you remind us as to Zoe's cortisol level when she was last tested in May?

Thanks,
Marianne

Yes, Marianne it was 304.4 but you have to convert it and I thought when we converted it, it came out to 32 post. But she was extremely stressed trying to bite everyone, she was that bad, and have diahrrea so I thought that may have contributed to her high numbers or is that wishful thinking on my part? That was the end of May.

That was why I wanted her retested when her diahrrea was controlled and to do the test in a way to limit her stress. They shaved her, did ultra sound then did lab draw and then finally did test for UTK panel. We had been at emergency for 3.5 hours by then with no food since night before. She does not do well when fasted.

I must sound like a broken record to all of you. I'm sorry. :o

addy

Deep breaths, Addy ;):) ...These are Zoe's UTK results from 5/27/2010. Her post cortisol, when converted is 30.4.

Quote:

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Originally Posted by addy

Zoe's test, sky high numbers, she was severly stressed and had colitis flare up going on for over a month, her symptoms are still mild,mostly coat and tail as they were then:

UTK Adrenal Panel Thu, 5 /27/2010 11:27 AM
Results/Comments
Endocrinology Lab Case# EN 10-4088
Test: Result: Normal Range** Result Normal Range**
(post ACTH)
Cortisol ng/ml 47.7 2.1-58.8 304.4* 65.0-174.6
Androstenedione ng/ml 1.05* 0.05-0.57 7.69* 0.27-3.97
Estradiol pg/ml 114.8* 30.8-69.9 102.2* 27.9-69.2
Progesterone ng/ml 0.99 0.3-0.49 5.91* 0.10-1.50
17 OH Progesterone ng/ml 1.18* 0.08-0.77 20.33* 0.40-1.62
Aldosterone pg/ml *** 33.9 11-139.9 357.1 72.9-398.5
* Above or below reference range
** Mean normal range values for spayed female dogs (N=36). QNS = Insufficient sample.
*** Normal range values for male and female dogs (N=72 baseline, N=23 post-ACTH.
These results indicate presence of increased adrenal activity. (SIGNIFICANT)
Comments: Values are increased as indicated.

Addy

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IMO, if you think the Lysodren will bother Zoe's colitis then I would treat her with a low dose of Trilostane.

I respect Dr. Oliver immensely but like I've mentioned before...one has to figure out which of the two evils one needs to fight and the one evil that they believe will do the most harm.

So many published studies by many Drs. done on elevated cortisol doing harm on our pups but I can not seem to find any concrete studies on elevated hormones doing the kind of damage that elevated cortisol can.

With my boy Harley, he has kidney disease now...I am sure this is because I waited too long to treat him appropriately.

Sending big, loving hugs your way, Lori

Hi Addy,

The number one side effect listed for Lysodren is gi upset so if I were in your shoes and wanted to start treatment, like Lori, I would start with a low dose of Trilostane. If you feel more comfortable with additional testing, then I would suggest you do an acth stim test for both validation and a baseline to use in monitoring treatment. I seem to recall that Zoe is stressed out at the vet's office but the pre cortisol draw number of 4.7 ug/dl done back in May is well within the normal basal range, which would not be indicative of a dog that is highly stressed out. However, if you are worried that Zoe's stress levels could skew the test, why not ask the vet if you can stay with her during the entire process.

Everything I've read indicates that a dog with elevated cortisol will also have elevations in intermediates. Therefore, if one believes that Trilostane should never be given to a dog with elevated intermediates, then Trilostane should never have been approved by the FDA and nobody on this forum with a typical cushdog should be treating their dogs with Trilostane. I too have a lot of respect for Dr. Oliver and trust his judgement relative atypical cushing's but even then, it's difficult to not be swayed by convincing arguments presented against atypical and it's treatment presented by some of the world's top specialists in endocrinology. I believe these specialist acknowledge that there is something called atypical wherein dogs present as a cushingoid dog yet have normal acth and low dose test results but nobody seems to know what atypical really is and what causes it. I think it's a given that UTK needs to go a lot further in providing the veterinary community (and Lori and me :D) with supporting evidence via sanctioned studies/clinical trials.

Glynda

Addy - Throwing in my two cents because I know you have read Annie's 'saga'. Remember how we had her on lysodren? Her inappetance episodes before lysodren were very rare - like once every 3 mos she would skip ONE meal. Once on the lysodren it got bad and fast. Of course I have no idea how much of it was the bleeding ulcers from the helicobacter but regardless... a part of me just wonders if the lysodren hasn't affected her sense of taste. I know that I might end up in your shoes up the road and I have to say... as of right now... I would elect to put Annie on trilostane because I wouldn't want to disturb the eating habits any more than they already are. Hugs, Kim