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Thread: My big boy Gable

  1. #401
    Join Date
    Jan 2016
    Location
    Glen Cove, NY
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    1,779

    Default Re: My big boy Gable

    I had an ACTH done yesterday, he's still panting a lot, drinking a lot and breathing very heavy so I just wanted to make sure his cortisol didn't drop too low.

    Cortisol Sample 1: 3.9 ref range: 1.0- 5.0
    Cortisol Sample 2: 7.6 LOW ref range: 8.0 - 17.0

    Does that sound weird? Vet said it was great, keep doing what I'm doing, but it doesn't sound right to me. He's getting 5mg morning and 5mg at night, and the extra Soloxine at night. I didn't have the thyroid panel done because I wasn't too worried about that, not yet anyway.

    He seems so uncomfortable and he's having trouble getting up and walking. When we got to the vet yesterday, they were running about 10 minutes late so we walked a little over to my husband's office to pick up his mail (we've done that walk before), but this time I didn't think we would make it back and that I might have to call them to come get him. We did make it back, but he was so tired. He backed up when they went to bring him in and the leash slipped off his neck and he turned around to run, but couldn't move fast enough and I grabbed him before he could get out of the parking lot onto Glen Cove Road, which he could've done at any other time. They weighed him and he's lost almost 10 pounds even though he looks really heavy to me. I think I might start him back on the Gabapentin 300mg and see if it helps. I also got that supplement that someone mentioned but he's only been getting it a week or two.

    I'm getting this panicky feeling that I had with Lee the week before she died...
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  2. #402
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,737

    Default Re: My big boy Gable

    Oh Joan, I sure understand your worry and Iím so sorry. I think itís impossible not to flash back to other bad times in situations like this. But as far as Gableís cortisol, no itís not too low. The range youíre citing above is the one for the ACTH when itís being used for diagnostic purposes. Thatís the ďnormalí range for a dog who doesnít have Cushingís at all.

    When used for monitoring trilostane, you want the post-ACTH result to be between 1.45 and 9.1 ug/dL for safety purposes. And if the Cushingís symptoms are not being well controlled, the range can be dropped even further, down to between 1.45 and 5.4. So as you see, Gableís cortisol is not too low. If anything, you might be hoping that it will continue to drift downward a bit more over the next couple of weeks if, in fact, his cortisol level has anything to do with his current symptoms. I think you started adding the extra 5 mg. about three weeks ago, so thereís still some time for it to lower a bit more. Since heís been so sensitive to increases in the past, Iíd agree with your vet and not yet want to add any more trilostane. But as far as his cortisol, if it stays where it is after another month or so, you maybe could consider another little increase if his symptoms donít improve at all.

    But of course the big question is whether itís the Cushingís causing the symptoms or something else. And that is the million dollar question. I so wish I could relieve some of your worry but I know thatís impossible. But Iím definitely thinking about you guys and hoping that Gable will start feeling better again soon!!

  3. #403
    Join Date
    Jan 2016
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    Glen Cove, NY
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    Default Re: My big boy Gable

    Thanks, Marianne...so that post LOW in okay?
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  4. #404
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,737

    Default Re: My big boy Gable

    Yep. It’s annoying that your lab report doesn’t print the range for the ACTH when it’s being used for trilostane treatment monitoring. Most lab results these days have the three different ranges printed for all ACTH tests:

    Normal range for initial diagnostic testing to see if a dog has Cushing’s (this is the range you were given)
    Therapeutic range for monitoring dogs taking trilostane
    Therapeutic range for monitoring dogs taking Lysodren

    The range is different in all three cases. For Gable taking trilostane, his post-ACTH would have to be less than around 2.0 (technically, 1.45 according to Dechra) to be considered too low.

  5. #405
    Join Date
    Jan 2016
    Location
    Glen Cove, NY
    Posts
    1,779

    Default Re: My big boy Gable

    Okay, thanks!
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

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