My big boy Gable - sweet Gabe is now at peace

Raising the dose to 10 mg in the morning and 5 mg at night is definitely worth trying, and testing in two weeks, I believe, is the way to go.

Thanks, Lori!

I, too, agree that the dosing change is definitely worth a try. Certainly you can’t go wrong by testing in two weeks. If he seems to be doing well at that point, though, you could decide then whether you wanted to go ahead and wait for one more week.

Either way, good luck to you guys!

Thanks, Marianne! Are you back?

Not yet, but still trying to check in as often as I can ;-).

How's Gable doing? And was a pre-pill test done?

Still drinking and panting. He's eating fine and no stomach problems....We did the test Saturday morning and have not heard back yet.

Finger crossed for good test results!

Test results:

4.2 ref range 1.0 - 5.0

Maybe he's just a big drinker. I looked back at the first post I did here when he was 7 and it looks like I had been worried about the way he breathes for a while, so I don't know.

It was the other vet who left the message, my vet had already left. He'll probably call me today.

The only other thing I can think of to try is getting Trilostane compounded into 1 mg capsules and than adding 1 mg to his nightly dose to see if this helps with the drinking/panting. The big drawback to this option is the cost of the constant monitoring for the additional 1 mg capsule.

Hugs to you both, Lori

Thanks, Lori...I'll think about that.

The vet called after he spoke again with the specialist and the suggestion was to add an additional 5mg at night, so that he would be on 10mg in the am and then 10 at night. At first I thought we should wait until we get back from our trip to Williamsburg (9/26 - 9/30), but then decided we would start it the other day and I'll have him tested before we leave. So far, so good. No change that I can see, but I did get him a cooling vest, which he loves!, and does seem more comfortable. He actually lets me put it on without any fuss and then lays down and enjoys it.

So we shall see around the 19th or 20th whether the extra 5mg is doing anything.

Hi Joan, that’s great about the cooling vest, and we’ll all be hoping the increase will help some, too. Per the guidelines associated with pre-pill testing, an increase is indeed consistent with Gable’s resting cortisol level in the face of unresolved symptoms. I know it’s been quite a roller-coaster with him and his cortisol levels, though. Hopefully this dose will finally turn out to be just right! We’ll be watching for further updates, that’s for sure.

Marianne

Yes Marianne, I remembered you had said that before, so I figured we would go for it.

My son Jeremy is watching them all while we are away and I know he will be keeping a close eye on him. He's already been told he has to pick up the poop in the backyard every day so he can be sure Gable doesn't get diarrhea (I really just said that so he wouldn't leave me five days of poop to clean up when I got home!)

Well, I came home to a mess Wednesday after work...poop in the kitchen and vomit in the back room by the door. Wasn't sure who did the pooping, but Gable always throws up at the back door. He didn't want dinner, so no pills for him. But I decided that since I had raised him to the extra 5mg a week ago last Monday or Tuesday, bringing him to 10am and 10pm, I would run to the vet and have them do a resting cortisol test. He called me last night to let me know it was 1.5. So now I don't know if Gable did the pooping or Cooper. Gable would throw up, thinking I would hit the ceiling with the mess in the kitchen, and he would be too upset to eat.

Vet recommended we stay on the 10 and 10. What are your thoughts? He's still drinking like crazy and he did eat breakfast and a lot for dinner yesterday, some breakfast this morning.

Well darn :-((((. Honestly, Joan, if it was me, I’d probably discontinue the added 5 mg. again, at least until after you’re back from your trip. Gable has shown himself to be quite sensitive to increases in the past, and the drop in two weeks from 4.2 to 1.5 is pretty dramatic. Plus, 1.5 is the “basement” — you don’t want him going any lower at all. I just wouldn’t want to risk a crash in your absence, so I think your original instinct was the best one — just leave him at his original dosing level for the time being, and then reconsider the path forward when you’re home again.

That's exactly what I thought, Marianne. When I said that it was a huge jump and that it would continue to go down, I think he got offended and said we should still do it!

No way....I gave him 10 this morning and 5 with dinner tonight. I'm not taking any chances and I don't want Jeremy to have to deal with an emergency when we are away.

Came home tonight to no messes and two full water bowls...I am losing confidence in my vet. If it wasn't for you all, and how much I've learned since Lena died, I would've done what he said. It makes me wonder how many have been misinformed by them...and that makes me very mad.

Marianne, remind me how the pre pill testing goes with twice daily dosing. I think you just do it before the morning pill, and not skip the pill the night before? That would not have made a difference from the test results the other day since I thought it was an emergency and he had his morning pill, but I can't remember how I did the one before where it was 4.2. I know I waited until after to give him the morning pill and I think I gave it to him the night before, but now am wondering...

Joan, my understanding is that for a dog dosed twice daily, you’d give the evening dose as usual prior to a morning pre-pill test. So if you didn’t give the evening dose prior to the 4.2 reading, that could account for the higher result. Also, now that I’m rereading what you had written about the resting cortisol taken this week, it sounds as though it was taken during the afternoon after having been given his morning dose. How close it would have been to his normally scheduled evening dose would determine how accurately it would have reflected a pre-pill reading. For instance, if it was only 4-6 hours after his morning dose as opposed to eleven hours, you’d expect it to be a lower cortisol reading because the medication was still most active in his system. If it was closer to eleven hours, it would more accurately reflect his pre-pill status. Hope that makes sense!

It does. I think I gave him his evening pill before the test that gave the 4.2 reading. And the last test was probably close to 12 hours after his morning dose.

Thank you, Marianne!

Gosh Joan, I am so sorry to hear that Gable had some issues and am relieved to read that the extra 5 mg dose is discontinued. Unfortunately, even with treatment, PU/PD doesn't resolve in some cushdogs and just maybe this is the case with Gable.

Like I mentioned before, the only thing I can think of trying is getting the Trilostane compounded into 1 mg capsules and than adding only 1 mg at a time.

Sending huge loving hugs, Lori

I may have to do that yet, Lori...but for now I just can't afford all that testing. He seems okay. He's eating, no more poop or vomiting in the house. He loves his cooling jacket and I think he will be okay while we are away. Jeremy is very capable of handling a crisis should one arise. I've gone over and over all the signs to watch for and I will write it all out for him. He'll have my CareCredit card for an ER visit if needed and the vet can wait until we get back if he has to take one of them there. I got a pill case that has AM and PM sections and have already loaded it up for him, so there should be no problem there, not that there would've been anyway. Jeremy is HIV+ and is used to a pill regimen. Doree just need liquid antibiotic for her cold, that might be hard since she only lets Victor give her anything, but I told him to just mix it up in her food if she won't take it from him.

Sibbie is the one I'm most worried about. I've never been gone overnight since we got her and she is not happy when I am gone. When we go out, she freaks out even if I have someone hold her while I go to the bathroom. She just lays by the front door waiting for me. I'm not sure how she will react to me being gone for 5 days. Jeremy says he will not be responsible if she goes into a deep depression! :).

I'm going to buy her some new toys and he can give her one a day when he thinks she can use a distraction and maybe she'll be so tired she will sleep all night. I am taking off the day after we get back to make it up to her, hopefully she will forgive me!

The new toy idea is a great one, I bet she'll love that! Tell Jeremy he can always log on here and we'll help in any way we can! I hope this is a vacation full of fun for you as you really deserve it!

Thank you, Lori!

Well, let's just say that this was the vacation that barely happened!

I started getting texts from Jeremy about how much Gable was drinking; then about how Sibbie was sitting at the front door waiting and not coming to bed; then how they were all going out every couple of hours all night long; then how Jeremy couldn't get comfortable because of his back; and how he had only gotten one hour of sleep in two days.

I had him stop the Vetoryl on Friday night (we had left Thursday). Told him to take him to the vet Saturday if there was any vomiting or diarrhea (which there wasn't), then we decided Saturday morning that it just wasn't worth all this anxiety and stress and spent the morning trying to figure out how to leave early. We couldn't change our plane tickets for anything under $700 each (the original ones were $200 each), so we decided to keep the rental and drive home on Sunday morning. Left at 5:45am and were home by 2:30pm.

They were all fine...

Aww Joan, I’m so sorry!!!! I don’t have any two-legged kids myself, but it sounds like sometimes the four-legged kids have more sense than the human ones.... :-(((((

Aww, Joan, I am so sorry too :( Please do vent here all you want, we sure do understand...sending loving and comforting hugs ♥

Thanks, girls! I'm almost over it :) I was just looking forward to sleeping all night for the first time in years!

uhhmmmm I think I would remember this when it came his time to have some fun. But I am old b____. :D I am truly sorry this happened - it wasn't fair at all.

You are so right, Leslie! And I am an old b____, too! But he doesn't need me to do anything for him. He lives alone and can get up and go wherever he wants, whenever he wants. Someday I will let him know how disappointed I am about this, but it's too soon and it won't really matter.

My babies are all well and happy that I'm home and I guess that's not a bad thing after all! Gable seems good. I think I'll have him tested again next week. He's been on the 10mg in the morning and 5mg at night for almost two weeks and I am curious to see where his levels at.

Okay, we have had another episode. Gable was up all night Monday, going out like every hour, drinking like crazy all weekend. I shouldn't have given him his pill yesterday morning, but I was so sleep deprived that I wasn't thinking, and I should have stayed home.

I came home from work to a kitchen floor covered in poop, vomit and pee. Cleaned it up in a hurry and ran to the vet before they closed. I had them do a resting cortisol test and blood work. The results won't be back until this afternoon, but I'm pretty sure he's gone too low again. I didn't give him anything last night, including dinner.

He slept all night, didn't get up until 6am this morning...that doesn't happen very often. He usually has to go out at least once during the night. He's had breakfast, no meds and seems fine. I'll wait to see what the numbers are and decide what the plan will be. I just might have to give him 5mg am and 5mg pm. It seems the 10mg am and 5mg pm just might be too much for him.

Oh Joan, I'm so sorry to hear this, poor Gable and poor you...sending hugs

Help! I don't know what to do. His stomach issue is better, but he is drinking like crazy. He peed in the house and then stepped in it and walked all over the house. With that resting cortisol number, should I start the vetoryl again?

He was on 10 am and 5 pm

Hey Joan, what was the resting cortisol result? Also, how many hours after dosing would the blood sample have been drawn?

It was 2.8 and he had his 10mg pill in the morning, probably around 5:30 or 6:00, Marianne, and we did the test around 6:00 or 6:30. I had to clean up the mess before I took him.

I am shaking, I'm so upset. He's walking around behind me with his head down. I keep telling him I'm not mad at him, but I don't know what to do. I gave him 5mg with dinner tonight just in case he needs it.

Oh Joan, I feel so bad for you guys!! Yeah, I think I’d try the 5 mg. twice daily for a while again, too. I just hate it that you’re on such a rollercoaster. Poor Gabie, and poor you! Fingers crossed that things go OK overnight, and tomorrow, too.

It's killing me, Marianne. I'm getting all kinds of flashbacks to Lena.

He's such a good boy, he doesn't deserve this. He keeps looking at me like he's wondering why I can't make him feel better. If I could quit my job and stay home to take care of him I would. He starts getting anxious in the morning when I'm getting ready for work; he lays down on the bathroom floor while I'm showering and dressing, and then stands at the door while I'm leaving.

AND, AND my husband just got home and told me that he thought he left him out this morning when he left for work and sent Jess over to check around 2 or 3...2 or 3!!! when he left around 10!! and told her not to make any noise coming through the greenhouse. I'm sure Gable heard her and then got up thinking he was going out. That's what happened...I could kill him right now! I spent an hour cleaning up all the pee after I had taken two trains home from the city.

I didn't get my vacation, I can't depend on anyone and I'm working in the f@#&ing city and can't get home to the ones who love me the most!

I'm venting again... :)

You have every right and reason to vent, and that’s exactly what we’re here for!

As annoying as it is, at least maybe you have an explanation for yesterday’s episode. Although with that much pee, your central issue remains as to why Gable is still drinking/peeing so excessively. And for that, I just don’t have an answer. It’s so darn confusing. Maybe the GI upset wasn’t related to the Vetoryl at all, and he’d really do better staying on the higher dose. But maybe it was, and for that reason you want to stay on the lower dose. I just dunno, and I surely understand why you want to throw your hands in the air at this point. All we can do is take one day at a time, and for now, I agree with you about going with the 5 mg. twice daily again for the time being.

I can so resonate with your flashbacks of worry, though, and I so wish I could reach out to give you a big hug. Our dear Leslie often refers to “twitching” — the second sense we caregivers have that remains on high alert for signs that things are going wrong. And the more traumatic an earlier loss, the harder it is to escape the worry. I haven’t shed the worrying myself, so I’m afraid I can’t give you any advice in that regard :-((. But I surely do understand, and I’m right here alongside you. At least this is Friday, so you’ll have a couple of days at home to spend with the whole crew, and especially to monitor Gable. My fingers surely remain crossed that things will settle down for you guys!

Thanks, Marianne...I'll keep giving him the 5mg twice a day and see it helps. If not, I'll go back to the 10am and 5pm. I think I have wiggle room with that 2.8 resting cortisol result.

He needed to go out at 2am, but then stayed asleep until we got up at 5:45.