Kirby, Boston Terrier with PDH on Trilostane (Kirby has passed)

[Harley PoMMom]

Hi Tricia,

My suggestion would be to get him peeing on the pee pads while he is urinating outside...meaning, slip the pee pad under him while he is peeing then bring this already soiled pee pad inside for him to go on.

My thinking is if he smells an urine odor on the pee pad it might entice him to use it again.

Hope this helps.

Love and hugs,
Lori

[Squirt's Mom]

Hi Tricia,

Good to hear from you again and to know Kirby is holding his own, and still content with his life.

You are on the right track by putting something where he is already used to going - tho I can understand not wanting it right in the front entrance. Like Lori said, get some of his scent on a pad then place that pad down for him. I would also go ahead and put enough pads by the front door covering the tiles. Once he is used to the pads, you can SLOWLY start moving them over a bit so that hopefully he will follow the pad and not insist on the tiles. You can expect to go through quite a few pads this way but in time he may catch on.

When he does use the pad, you will praise and reward him just as you did when you were house breaking him. I had a friend once who tried putting treats on the pads to encourage the use of them....all her dog learned from that was that she ate there... and never did learn to use pads.

Some older dogs won't learn to use pads so you might want to look into a belly band for him while you are away.

Hugs,
Leslie and the gang

EDITED TO ADD:

I just read on another thread where a member put grass on a peepee pad to encourage her babies to use one. You might try that!

[kapohotricia]

Thanks, Lori and Lesley,

Those are some good suggestions I hadn't thought of. We'll give these suggestions a try and I'll report back in case it can help someone else.

Aloha,
tricia

[kapohotricia]

Hi again,

We settled on the belly band type "diapers" from Drs Foster and Smith because I couldn't get him to use the pads no matter what I tried. But he pees such volume he soaks through several liners and the wrap and I still have a little to clean up on the floor and wash Kirby. Ah well, I'd rather have him with us having accidents than not have him any more, that's for sure!
He had his 3 month ACTH test on Monday and I got the results today. Pre is down to 1.1 and post is down to 3.9 (from 2.6 and 4.6). He is still only on 10mg of Trilostane but has lost weight. He's down to 18 lbs now so the vet says to reduce the dose a little. I'm supposed to try 8mg and see how he does. Do those numbers seem low to you all?
Cognitively and in other ways, Kirby is aging fast. The vet commented on the difference since she last saw him 3 months ago. I suppose the tumor keeps growing and pressing up into the brain. But he is quite content, enjoys his food and cuddles, sleeps pretty well at night and still has happy moments when he runs on the lawn. I feel more sorry for Winston because he is still very active and energetic and he really misses all the chasing and roughhousing and playing they used to do together.
Aloha,
Tricia

[labblab]

Tricia, thanks for this update about Kirby, although I wish the little guy was feeling better.

If nothing else was involved, I would not say that his most recent ACTH numbers were too low. But since you have other issues going on -- the inappetance, weight loss, and likelihood of an expanding tumor -- I can't disagree with your vet's advice. His numbers have drifted downward a bit while remaining on the same dose, and you probably don't want to risk them dropping much lower. You are trying to balance several variables, and I would hope that the dosage change may help stimulate Kirby's appetite a bit more.

Please give your sweetie-pie a special hug for me,
Marianne

[Squirt's Mom]

Hi Trish,

Thanks for the update on sweet Kirby. That he still enjoys his food and cuddles is a great thing. I can just imagine how much your heart swells when he feels like running and playing in the yard for a minute. We learn to treasure the most seemingly insignificant things, folding them up and tucking them away where we can find them again.

Letting his numbers run a bit higher might be best for Kirby all things considered. Marianne has explained the whys and wherefores much better than I ever could but, for what it's worth, I agree with her assessment.

Know we are here any time, sweetie.

Hugs,
Leslie and the gang

[kapohotricia]

Thank you so much, Lesley and Marianne. Kirby enjoyed the extra hugs. He just loves to be cuddled and nestles in with a big, contented sigh
My country vet is as inexperienced as I with Cushings and I do appreciate her being willing to give him these tests and prescribe the Trilostane. But we are both concerned that the numbers don't get lower. If this were your dog, how much would you reduce the dose? Would you even consider giving the 10mg only on alternate days?
I appreciate any thoughts anyone might have on this dose question. I am very concerned not to let the numbers get dangerously low, especially since my vet will be out of the country from the end of Feb for a month and I have no one else to take him to in her absence.
Thank you so much for being there!

Aloha,
Tricia

[Cyn719]

Hi Trish

Just wanted to stop by to say hello!! Leslie and Marianne gave you good advice and I have to say when Penny was on trilo she always did better when her numbers were higher - when they were low she didnt want to eat and was very tired - give it a try and if you can get the numbers up alittle Kirby might feel better and eat better like they said-that would be great

hugsss xo

[labblab]

I'm being lazy and not looking back through your thread , but can you remind us of any previous ACTH results? If Kirby has been pretty much stable since starting treatment, then I think dropping to 8 mg. daily sounds reasonable. Is the trilo in a liquid form so that you can make that teensy a dosing change?

Just remember, you can always stop the trilo at any time if Kirby seems to be reacting poorly. So if he seems to decline even more while your vet is gone, you can temporarily discontinue it altogether. Also, just make sure that you have some prednisone on hand while your vet is away. That way, you'd be prepared to give him supplemental steroid in the event of a serious cortisol drop.

Marianne

[kapohotricia]

Hi Marianne,

Kirby's previous ACTH results at 10mg were Pre 2.6 and Post: 4.6. That was 3 months ago. The vet said that was perfect so he has continued on 10mg since but has lost another lb in weight.
I have compounding solution and mix the dose from 60mg caps in a 10 ml syringe through a luerloc, following my pharmacist's instructions. It makes it easy to adjust the dose. I do have prednizone on hand but it is hard to tell if he is oversupressed because he has had trembling and lethargy symptoms since last April even when his cortisol levels were good, and the incontinence seems to be caused by CCD. I do stop dosing on the days he doesn't want to eat and resume a few days later once he is back to enjoying his food.
So, I am back to wondering how low a dose I should be giving him now, based on this week's numbers.
Aloha,
Tricia