My big boy Gable - sweet Gabe is now at peace

[Joan2517]

I won't be able to do that yet. I am out of money...what if they aren't balanced? How do you fix that?

I can't get over how amazing his tail looks. I hadn't realized that it had lost a lot of fur. It looks like a raccoon's tail. Even my husband noticed! I hope he doesn't lose all his beautiful fur again.

[labblab]

Joan, from now on, whenever your vet does an ACTH, I’d ask him to automatically just tack on a simple blood chemistry panel. If the blood is drawn all at the same time, a simple chem panel should be relatively inexpensive and the information can be useful. In a situation of adrenal oversuppression, the chief concern is whether the potassium and sodium levels are normal. If not, a dog might need a hormonal supplement, at least temporarily, to replace the function of an aldosterone level that has dropped too low. If the ACTH shows that Gable’s cortisol level is starting to rebound, then there’s likely less need to worry about aldosterone, too. But a basic chem panel can always give peace of mind and can be a valuable addition to every cortisol monitoring test.

As far as his coat, we’re counting on the fact that ongoing monitoring tests will tell you whether, and how quickly, his cortisol may be increasing again. If it does start climbing higher again, you can restart the Vetoryl but just at a lower dose. So that should help you to preserve all the positive changes that you’ve seen with treatment, but without driving his cortisol too low.

[Joan2517]

Thanks, Marianne. That sounds good. So I am not doing the pre pill testing anymore. Back to ACTH tests.

[Joan2517]

Results are in:

Sample 1: 4.2
Sample 2: 4.6
Ref ranges the same as the last test.

So, no Addison's, thank God. If I have any money left over from paying bills on Friday, I'll get blood work done. The vet I spoke to said a urine too.

[Harley PoMMom]

I'm relieved and so glad to see his cortisol levels are coming up! The vet's recommendation on having an urinalysis done along with the electrolytes is a good one, an UTI could be a cause for the increased drinking/urination.

Joan, I'm not sure how well this hack works for testing a sodium deficiency but I'm gonna put it out there anyways; you could put some salt in your hand and see if Gable licks it up, if he would than those electrolytes may be off.

Hugs, Lori

[Joan2517]

I'll try it, Lori. But I did take him about an hour ago for blood work and brought some urine for testing anyway. His vet is perplexed and said he'll consult with a specialist. We'll see what the blood work shows. Gabe's been outside since we got back; he stayed outside most of yesterday, too.

[Joan2517]

Well, I tried the salt. He took a little lick, then shook his head, gave me a dirty look and walked away.

I just spoke with his vet. He spoke with an endocrinologist specialist. She wants to start him back on 10mgs, once per day, beginning today, and to lower his thyroid meds to 1 pill in the am and 1 at night (was 2 in the am and 1 1/2 at night).

Blood work:

ALK Phosphates 247 (H) ref range (5 - 131)
Triglycerides 670 (H) ref range (29 - 291)
Precision PSL 154 (H) ref range (24 - 140)
T4 7.2 (H) ref range (2.5 - 6)
Urine Specific Gravity 1.002 (L) ref range (1.015 - 1.050)

What do you think about the plan?

[lulusmom]

Joan, I think the mystery of the continued drinking and peeing is solved. It is most likely the over-supplementation of thyroid meds that flipped Gable from "hypo" to "hyper"thyroid. I think the plan is a sound one. I just went through something similar with my cushdog. An internal medicine specialist finally got his thyroxine dose figured out and he is stable. His triglycerides were 3500+ and are now normal after putting him on very low fat food. As I recall, Gable is a bit overweight and that can cause high lipids in the blood as can a recent meal. Was Gable fasted?

[Joan2517]

No, he wasn't fasted, Glynda, and he's not overweight anymore. He was down to 64 pounds a few weeks ago. He's a big guy. We didn't even know he had a waist!

Okay, so you think he was just over-medicated with the soloxine. I can live with that. That would be such a relief, Glynda. But that wouldn't account for the .3 and .4 results on the ACTH test, would it?

[Joan2517]

Thank you, Glynda~