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Thread: Emma - New Member Post

  1. #111
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,315

    Default Re: Emma - New Member Post

    Hi Sharon! Welcome back to you and little Emma. I’m surely sorry that you had problems trying to log in and post today, but it looks as though you finally got it straightened out. You’ll see that I’ve added your new post to your original thread about Emma, and for your own privacy I’ve removed your email address from your posting. Since this is a public forum that can be viewed by anyone around the world, I just thought you’d probably rather keep your email address private.

    Now as to your question about monitoring testing, yes, there is an alternative to the ACTH that is being offered especially in the U.K. It involves simply taking a baseline cortisol reading right before the administration of the morning dose of Vetoryl. It is not as widely known in the U.S., and it appears as though the method is still being “tweaked” for optimal use. But given Emma’s extreme stress during vet visits, it might be a good option to be considered. If you click on this link and scroll down to the bottom of the second reply, you’ll find the heading: “Pre-Vetoryl Cortisol Monitoring.”

    https://www.k9cushings.com/forum/sho...ushingoid-Dogs

    This is a link you can also pass on to your vet. Unfortunately, the U.S. offices of Dechra aren’t offering official technical support for this monitoring method since it has not yet cleared the FDA approval process for published Vetoryl literature here. However, I think your vet can learn enough from the U.K. link posted above. Anyway, I think it’s worth considering.

    Once again, it’s great to see you girls back here once again!
    Marianne

  2. #112
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,219

    Default Re: Emma - New Member Post

    The pre-Vetoryl test may not be optimal for Emma after all. It is not recommended for stressed dogs, dogs who are not well, or aggressive dogs as these things can impact the cortisol level naturally. So you want to talk to her vet about which test would be best for Emma since she does get so stressed at the vets. Sadly the ACTH is also impacted by stressed dogs. Will they let you take her in and out of the clinic between draws? That will sometimes help the pup calm down a bit. We even had one member whose vet came out to her car and did the draws because her baby got so very upset just walking in the door. Some things to think about.
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  3. #113
    Join Date
    Feb 2018
    Location
    Eastern NC
    Posts
    62

    Default Re: Emma - New Member Post

    Thank you for the link Marianne! I searched everywhere for info on it and came away with nothing, once again proving how valuable this site is!

    I will send my vet the link and talk to her about the possibility of using it. I haven't read it yet, but hopefully its a little easier for little dogs that dont have much room on their little legs for getting blood samples. I think it hurts me as much as Emma, since I cannot sit still once they take her "in the back" for the testing.

    She has just gotten over the worst part of 2 different skin ailments that 3 vets could not identify. She had brown spots, more like crusty spots, the size of a pea, on her chest, and they were spreading around her neck. Then on the inside of both rear legs some sort of black strand-like stuff. Both of them could be lightly scratched off, but not completely. She was put on 2 different antibiotics, but I think what really helped was frequent bathing with Dechra's DermabenSs shampoo that is specifically for seborrhic skin conditions. Its also a follicular flushing shampoo. It started in November and gradually just got worse. I wish I had started the shampoo earlier. It didnt seem uncomfortable for her; she hardly ever scratched, but it was right after her bout with that when the cushings symptoms started. First I noticed the excessive water drinking and then came the constant hunger. it's a nightmare to see those symptoms again. Especially worrying about her going through the testing again. But hopefully we will be through all of the tough stuff soon.

    Thank you again for your help and I hope I can post good news very soon.

    BTW, do you know if most of the members use Trilostane compound or the brand Vetoryl? Just wondering. Take care and I'll be checking in soon.
    Sharon

  4. #114
    Join Date
    Feb 2018
    Location
    Eastern NC
    Posts
    62

    Default Re: Emma - New Member Post

    Hi Squirt's Mom, I cannot remember your name, so sorry for the tag!

    I thought about her stress affecting the test also. Of course her vets said its minimal if results are affected at all, but with all the reading I do on it, it only makes sense it would! . After all, cortisol is a stress hormone! Yes, I found a vet that let me sit and wait for Emma, and take her out for an hour in between draws. The others said, No, drop her off at 7:30am and pick her up at 4pm. Yeah, right! like either one of us could handle that!

    Thank you for replying, you guys are the best.
    Sharon (Emma thanks all of you too!)

  5. #115
    Join Date
    Feb 2018
    Location
    Eastern NC
    Posts
    62

    Default Re: Emma - New Member Post

    Hello again everyone. I'm happy to say that my vet agreed to the Pre-Vetoryl Cortisol Test, and she was very accommodating in letting me stay with Emma the whole time. They took her from the exam room to draw her blood, but she was back in 2 minutes. I was so relived that she didn't have to get 3 sticks for an ACTH test. We followed Dechra's instructions and moved her Vetoryl dosing time up a bit - instead of 6am she got the dose at 7am Saturday, 7:30am Sunday then none before her 8am test on Monday.

    The results were good, unless the reference range for cortisol is different for this test compared to ACTH test. Her cortisol was 4. Ref Range is 2>6 is that right? do you know if its different from ACTH test? i looked all over and couldn't find the range for Pre-vetoryl testing. Thanks so much guys! And thank you for telling me all about the pre-vet testing. Emma thanks you too

    Sharon

  6. #116
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,315

    Default Re: Emma - New Member Post

    Hello Sharon, and welcome back to you and little Emma! I’m so glad the testing went more smoothly this time around :-))).

    The published therapeutic cortisol range for the pre-pill testing is just slightly different than what you’ve listed. The pre-pill range is 1.45 - 5.0 ug/dL. But the very good news is that Emma is indeed within that range. An important question, though, is how is she doing clinically? If her symptoms were being well-controlled, the recommendation would be to stay on the same dose. However, you’ve mentioned that you’ve seen a rebound in her symptoms. If that’s still the case, then a dosing increase can be considered.

    Here’s a link to the pre-pill monitoring chart that you’ve been looking for. The cortisol levels on the chart are reported in the units that are used in the U.K. where it was published. To convert the units to those here in the U.S., you divide the numbers that are given on the chart by 27.59.

    https://www.dechra.co.uk/Admin/Publi...%2fDVP1287.pdf

    So once again, I’m so glad that the testing was easier this time around. And we’ll be anxious to hear more about how sweet Emma is doing. Thanks for checking back in with us!

    Marianne

  7. #117
    Join Date
    Feb 2018
    Location
    Eastern NC
    Posts
    62

    Default Re: Emma - New Member Post

    Hi Marianne, and thank you for your reply!
    It seems the rebound symptoms that I observed were all on me. I thought her symptoms were coming back one other time, and it was the same thing. i think it starts with me doing something i dont normally do, like giving her something off my plate during dinner. That will trigger her to beg & whine the next few days to see if will do it again.

    If I stand firm and dont give in she will usually forget about it in 1 or 2 days. But sometimes she keeps trying and I forget what started it in their first place and start to think it might be a “rebound” of cushings, maybe she is beyond hungry, and i start the cycle by giving her “a little more” canned dog food.

    When she gets EXTREME with little whines and those big EYES staring at me I am convinced she is so hungry it hurts so i give in and before you know it she DOES have ravenous hunger. It just doesnt take much for her to forget that we ever HAD a schedule. So I have to be more careful not to mess up her training and cause this whole situation.

    The one needle stick was so much easier on her. Im really lucky to finally have a vet that works with us, and also blessed with you and the other smart ladies on this site!

    The excessive water i must have imagined also, because the vet asked me to measure it for a few days after the test and it turns out she is really not drinking enough. most days around 5 ounces.If we take a walk she will drink maybe 8 ounces. Ill be telling the results to the vet on Monday.

    I read that dogs get water from their canned food and that is the largest percentage of her food. She gets very few dry kibbles with it. One day i added salt-free fat-free chicken broth to her water and she wouldn’t stop drinking it! I picked it up after what seems like 2 ounces so she doesnt drink too much at once.

    So i cant let myself jump to conclusions anymore about her cushings rebounding. In all other aspects she is A-ok. I would like to say all the happy signs i see every day but i don't want to jinx it. You know, like bragging you haven’t had a speeding ticket in years and you get one the next day!

    Thank you for the link today, and the links for the pre-Vetoryl testing helped my vet very much ☺️ Emmas cushings would have been so much harder without the valuable information I gained on this site. Keep up the important work you all do; so many fur babies and their moms/dads would be so lost and afraid without your guidance and caring.

    All my thanks,

    Sharon & Emma
    3/1/2020

  8. #118
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,315

    Default Re: Emma - New Member Post

    Oh Sharon, thanks so much for your very kind note and also for adding your new photo of sweet Emma to your album! What a cutie pie she is!

    Im so glad to hear that things are really going well for you girls. I surely do understand how easy it is to get tricked into worrying that something is going wrong. After theyve been sick, we watch our babies so carefully that we tend to notice every little detail. I do the same thing with my own. But for the time being, were all grateful to hear that Emma is holding her own!

    Well love to continue to hear back from you girls, just to know how things are going. Do take care, and give Emma a gentle hug from her family here on K9C :-).

    Marianne

  9. #119
    Join Date
    Mar 2020
    Location
    Allen, Texas
    Posts
    8

    Default Re: Emma - New Member Post

    Welcome to you! I am also new and new to this Cushings thing. My boy, Jake, is 11 yrs old and he was diagnosed about a month or so ago.

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