My big boy Gable - sweet Gabe is now at peace

[labblab]

ACTH results from yesterday:

1.9 reference range 1.0 - 6.0
5.7 reference range 8.0 - 17.0
Thyroid: 2.5 reference range 2.5 - 2.6

All in all, not bad ;-). Gable’s resting cortisol is now back up above 1.5, and his post-ACTH is only a sliver higher than the ideal therapeutic range, and is well within the acceptable range for a trilo dog as long as symptoms are being well-controlled. Remember, that post-ACTH range you’ve listed is not applicable to a dog taking trilostane.

His cortisol levels now are a bit higher than back when he was taking the 10 mg. once daily. But he’s also only been back to taking the trilostane for about ten days now, so his levels may still drop a little more over time.

Re: his thyroid, I see his last reading at the start of April was 2.3 with a normal range of 2.5 - 6.0. This time, he tested at 2.5, so he’s still right at the low end of the normal range. Did the specialist comment on his thyroid level during your appointment? Have you been staying at the same dose since April?

Most importantly of all, how’s Gable been doing, symptom-wise?

Marianne

[Joan2517]

He's panting and still drinking like crazy, but I'm not going to raise it just yet. I'll give it the full 30 days, I think. He's still on the same dose of soloxine. They will be sending her these results, so i'll wait to hear from her.

Thanks, Marianne~

[Harley PoMMom]

Those numbers look good to me too. Joan, is he urinating more too? Just wondering if the output equals the input of water?

[labblab]

One quick question from me, too. I can’t remember (and am too lazy to look back through your thread...), but has diabetes insipidus ever been considered as a possibility with him? With the never-ceasing thirst/urination, a trial run with the medication might be worth considering (unless, of course, you’ve already done that!).

[Joan2517]

Specialist never said anything about that . wouldn't that show in blood work?

[labblab]

DI would not show up in blood work. The chief lab abnormality is extremely dilute urine. There are more scholarly links elsewhere, I’m sure, but I quickly found this pretty decent explanation (if you just ignore the accompanying ads!):

https://wagwalking.com/condition/diabetes-insipidus

As you’ll see, pituitary tumors can cause this condition. So even though DI is uncommon among dogs, in general, we do see it here periodically among Cushpups. The classic diagnostic procedure is a water deprivation test, but that’s somewhat dangerous. So more often, vets will just give a trial administration of the eyedrops for a few days. If they work, then the diagnosis is kinda confirmed through that backdoor manner. I think Lori may be thinking about the possibility of DI, too, with her question. It definitely might be worth discussing with the specialist.

Marianne

[Joan2517]

Well Gable's test results are :

Sample 1: 2.0 Ref range: 1.0 - 5.0
Sample 2: 5.7 (LOW) Ref range: 8.0 - 17.0

Maybe he's just a big drinker and a heavy panter...I don't know. It has been hot and humid. No accidents in the house, but he stills pees like a racehorse when he goes out. His fur still looks good, a little dry maybe, but no bald patches and he still plays with his toys and with Cooper.

Vet is going to talk to someone else about him and get back to me...he just seems so uncomfortable. He hasn't gained much more weight, he's at 76.3 or 74.3, the scale kept changing. He'll still beg for food, but is not finishing off the two bowls I put down for all of them anymore. In fact, I come home from work and there's still some left in one bowl. He eats a half a bowl while I get his pills ready, gets a forkful of the Caesar wet food with the pills that I give the girls, gets to lick the container clean and then finishes off the rest of his dry food. So he's getting the pills with a full meal.

Keeping him on the 5mg, twice daily for now....

[Harley PoMMom]

Those numbers are pretty good. You could try the eye drops for DI as Marianne suggested. Unfortunately some cushdog's increased drinking/urinating never return to normal even with treatment.

Hugs, Lori

[Joan2517]

My husband reminded me that we did the eye drops last year and it was negative. He was doing so much better up to December, Lori. Glynda thought that the over stimulation of the thyroid meds is what made him crash in January, but that has been resolved. I feel so bad for him, he's got that frantic look on his face, that he had before the meds kicked in over last summer.

Let's see what the vet gets from the other guy he's going to consult with...

Thanks, Lori!

[Joan2517]

My vet spoke with a specialist who suggested increasing Gable to 10mg in the morning and 5mg at night. Then doing the pre-pill test in 3 weeks. I don't think I will wait for 3 weeks. I'll test him at 2.

What do you think?