Hi Leslie,
Thank you for your perspective, and thank's for the quote from John O'Donohue. Very helpful.
It's good to hear that it was nothing I might have done that would have caused Kobe to develop this malady. He is such a comfort as our canine companions always are, so you can't help but wonder if our troubles weigh on them. It's only been over the last several months that he'd gone from his happy-go-lucky self to being so lethargic and disinterested in the things he's normally likes to do, preferring now to just lay around and sleep. And of course eat and drink (and drink some more) and potty.
I'm the same with Kobe as you are when we go out for walks. He's pretty much the boss, and decides which way we're going to go, and gets to stop as often as he likes to sniff whatever he likes. Sometimes just wanting to stand in one spot for 5 minutes only sniffing the air. I can only imagine what the neighbor's think when I'm heading in one direction and Kobe decides "Nope. We're going this way." Stops me and makes me go in the direction he wants to go. LOL Now they know who wear's the fur in that house.
And Joan, you're right, our dogs are so good at sensing our emotions, and wanting to make us feel better when we're down or upset.
So.... today was the day to get Kobe's 8-hour test results from the vet.
But... before that, this morning, after Kobe was let back in from his morning business, we noticed that his jowls were VERY swollen (as well as some swelling around and above his left eye). When I felt them, they weren't all soft and fleshy as they normally are but felt very thick and firm. It was clear he was having an allergic reaction to something, but didn't otherwise seem in distress. We've been having an issue with wasps trying to build nests around the deck, and I can only imagine that Kobe had a run in with one of them. I immediately called the vet, and she said to give him four Benadryl tablets (Kobe is 94 lbs), and if the swelling hadn't gone down in 30 minutes to an hour, or it seemed like he was having any breathing issues, to bring him in for a steroid shot.
Well after an hour with the Benadryl it seemed like the swelling might have dissipated a little bit, but not much. So, since I was waiting on his test results, I figured I'd best take him in, and could consult with the vet directly since the test results were expected to arrive soon anyhow. She examined him and agreed it appeared to be the aftermath of an encounter with a bee or wasp. I decided that it would be best for him to get the steroid shot to get the swelling down sooner and the vet said it wouldn't interfere with what she also informed me WAS a positive test result for Cushing's disease (and the fact that he already has too much cortisol floating around in his blood). Fortunately Kobe is always very good about getting shots. Barely seems to notice when they are given.
As for Kobe's Cushing's diagnosis, here are the test results from his LDDS test.
Cortisol Sample 1 .... 2.4 .......... (Ref 1.0 - 5.0)
Cortisol Sample 2 .... 2.0 (HIGH) (Ref 0.0 - 1.4)
Cortisol Sample 3 .... 2.1 (HIGH) (Ref 0.0 - 1.4)
Diagnosis : Hyperadrenocorticism: Cortisol level greater than 1.4 ug/dl 8 hours post-dex.
So now I'm told that Kobe will need an appointment with an Internist to have an ultra-sound done in order to determine if it is Pituitary Dependent or an Adrenal Tumor, which apparently is important to know.
They want to start him on 60mg of Vetoryl (trilostane), and then test him after 2 weeks to see his response. Isn't 2 weeks too early? I thought it was 30 days to retest. I didn't want to question the vet at the time. Since it's $300 I don't want to have to do have to test too often (I honestly don't know why these things need to cost so much ).
As you said, it's not like he needs to go on the medication immediately. Once I'm comfortable that I'm doing the right thing, I can proceed. I just want to do this in the smartest healthiest (and ideally most cost-effective) way possible. The vet referred me also to an online pharmacy which can supply the Vetoryl at substantially cheaper prices. She said they have it for $65 for a 30 day supply, as opposed to $100 through the clinic since they need to special order it. I simply need to have the online pharmacy Allivet send them the prescription for them to authorize).
So I may wait until after Kobe has had his ultrasound and I know more about where we're at before ordering that.
The vet said they do have some other patients with Cushing's, so it would seem they are familiar with treating it. And interestingly enough the vet ALSO has a dog with Cushing's, and has been on Vetoryl since February (only 10 mg as she's a little dog). The vet said her pup has responded well to it, though has recently started drinking more water again, so she is getting retested to see if her dose needs adjusting, though it could simply be the warm weather.
Anyhow, right now Kobe is sleeping like a baby comfortably having wedged himself between pillows on the bed, making him look supremely comfortable. Heh.