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Thread: New to Cushings

  1. #171
    Join Date
    Feb 2019
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    Spring Valley, Il
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    178

    Default Re: New to Cushings

    Kathy. I showed your post to the hubby this am and he is out running errands, including going to get some Cosequin for Annie and and some extension rope foe my garage. I think the universe has put a curse on us sometimes because every time Jerry leaves for a fishing trip or just an overnight quick business trip, something goes wrong! I’m not kidding...either the pups were sick or the power went out because our line was cut from building behind us.....you name it it’s happened and I always collapse in a pile of tears first, dry my face and then I call him.

    Anyway, the garage door is fixed. Today was Annie’s Lysodren day, and I’m always hyper-vigilante as far as reactions. She always seems to drink more, sleep more, move move more to to stretch out, like she’s uncomfortable. But no tummy upsets or diarrhea. I just hover—can’t help it. Blessings to you all and your pups. Karen

  2. #172
    Join Date
    Mar 2013
    Location
    California
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    4,435

    Default Re: New to Cushings

    Glad it worked out! My local fire department/ police never would've responded for something like that. I would have been told to call a cab or an Uber.
    Last edited by Budsters Mom; 05-18-2019 at 07:08 PM.
    Kathy and Angel Buddy. The mightiest of all lizard hunters!

  3. #173
    Join Date
    Feb 2019
    Location
    Spring Valley, Il
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    178

    Default Re: New to Cushings

    Hi Kathy, all I can say is we live in a smaller community and I am on a first name basis with our local police because of the people who live behind us. I have had to report them for pet neglect three times in the past two years. It has just been a nightmare.

    Anyway, the hubby added an extension to the garage door cord and for right now, all is well. I do have a question for you on behalf of your late great Buddy. What species of lizards was he after. I ask because I ‘ve always had a side profession in herpetology and spent many of my younger years taking my son and his two best buddies on field trips all over the state of Kansas looking for toads, turtles,lizards,skinks,snakes and anything else in the creepy crawly world. Anything but spiders——they scare me to death! Your Buddy must have been quite the guy and I could have utilized his talents on our field trips. In my imagination right now I can see him leading us up a south facing rocky hillside, then suddenly stopping and barking to signal a lizard under a rock. You did have the best of the best. Blessing, Karen

  4. #174
    Join Date
    Feb 2019
    Location
    Spring Valley, Il
    Posts
    178

    Default Re: New to Cushings

    Here’s the latest since her stim test. Doc is trying to balance out her insulin with her food intake and has had two bg curves in the past two weeks and they were both basically the same. The big difference is she has gained a pound in the last week. I’ve already posted this info on the k9D site but wanted to post it here too.

    If doc was going to raise her insulin, which he didn’t, I was going to ask for another stim test. He had an emergency so I didn’t have a chance to visit with him. My next thought was maybe it’s time to cut back her food intake and leave the insulin dose the same. Instead of one can of Glycobalance 2x a day I’m going to split 1.5 cans between her two feedings.

    It’s been really strange though because she has been acting hungry all the time. Water intake is ok and no other symptoms. She has been a “chow hound” ever since she was a real puppy so maybe I’m once again seeing shades of the original,but new and improved Annie.

    Blessings to you all and your pups. Karen
    Last edited by Katy1; 05-23-2019 at 07:55 PM.

  5. #175
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    Mar 2013
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    California
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    Default Re: New to Cushings

    Buddy has been gone almost 6 years. We have many lizards species and they are EVERYWHERE, year round! He was kept very busy. His lizard of choice is the Alligator Lizard because they are bigger and slower than the smaller ones. Buddy didn't just locate the lizards, he went in after them and pulled them out of their hidey holes. In the bushes, under the bricks, or fence. He would dig until his paws were raw if I let him. It was not unusual for him to catch several in one day.


    Quote Originally Posted by Katy1 View Post
    I do have a question for you on behalf of your late great Buddy. What species of lizards was he after.
    Kathy and Angel Buddy. The mightiest of all lizard hunters!

  6. #176
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    Feb 2019
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    Spring Valley, Il
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    178

    Default Re: New to Cushings

    Oh Kathy, that memory of your Buddy just made my whole day better!!!. Blessings, Karen

  7. #177
    Join Date
    Feb 2019
    Location
    Spring Valley, Il
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    Default Re: New to Cushings

    Everyone please excuse me for asking, but why is Trilostaine preferred over Lysodren? Is it safer, less expensive—- except for Leslie, I feel like I ‘m the “Lysodren loaner”.

    I’ve looked online for answers but not much help there. I just notice that about 4 hours after Annie ingests the Lysodren with her breakfast, she seems slightly uncomfortable. She changes her resting spots more frequently and she drinks more as well as stretches out more to make herself more comfortable.

    I’m such a hyper-worrier anyway....do I need to add this to my growing list or just accept this as part of her med day response? Blessings to you all, my worrier warriors!
    Last edited by Katy1; 06-02-2019 at 03:20 AM.

  8. #178
    Join Date
    Apr 2009
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    Georgia
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    15,292

    Default Re: New to Cushings

    Hey Karen, no need to apologize at all about this question — it’s perfectly reasonable to ask.

    Here are my personal short answers to your questions, with a couple of links to give you more in-depth information. Historically, Lysodren (mitotane) has probably been less expensive than trilostane. Once you got past the daily loading phase of Lysodren, the monthly cost for maintenance doses of the drug were probably less than the monthly cost of trilostane taken daily. However, that may be changing now that the manufacture of Lysodren has been taken over by a new company with what appears to be a significant cost increase per pill. Aside from the cost of the drug itself, trilostane may typically require more dosage adjustments over time, necessitating a higher number of expensive monitoring ACTH tests. However, as is the case with many aspects of Cushing’s, there’s a lot of variability from dog to dog. Some dogs taking trilostane stabilize quickly and require few monitoring retests, while some of our Lysodren pups have needed repeated ACTH tests throughout extended loading periods or when maintenance levels have been erratic. Plus, data that I saw today suggests that fully half of dogs treated with Lysodren experience cortisol rebound that requires a full reload within one year of initial treatment. Less favorable Lysodren results may be associated with treatment overseen by GP vets, because they may tend to be more fearful than specialists of using truly therapeutic doses of the drug.

    However, from the studies I’ve seen, generally both medications can provide effective symptom control, with little difference in terms of life expectancy. So the preference for trilostane simply seems to boil down to this: many clinicians who treat a lot of Cushing’s dogs report fewer and milder side effects among their trilostane patients.

    Both medications can cause serious side effects, including adrenal damage resulting in a permanent Addisonian condition. For this reason, both medications must be monitored equally carefully. The risk of irreversible adrenal damage is apparently quite low with both medications, but it is higher with Lysodren: the figures cited in the article I’m giving you by Dr. David Bruyette state a 5% risk of complete Addison’s with Lysodren as opposed to 0.10% risk with trilostane. And apparently side effects, in general, are less commonly seen with trilostane. This differential is especially cited in relation to treatment of dogs with adrenal tumors. Especially high doses of Lysodren may be required to control symptoms of dogs with adrenal tumors, with an associated higher incidence of side effects. For this reason, trilostane now seems to be especially favored for adrenal vs. pituitary Cushing’s.

    I’m going to give you links to two different articles that I think may be helpful. The first is a 2018 review of trilostane treatment studies accumulated over the past twenty years. I found it very interesting, and highlights both what we know and what we still don’t know about best practices with this medication. The second is a 2016 article by noted endocrinologist, Dr. David Bruyette, that provides some of the statistics I’ve included here. In the interest of full disclosure, he’d be the first to let you know that he has provided direct consultation to Dechra, the company that makes Vetoryl, the brand name version of trilostane.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855282/

    http://veterinarymedicine.dvm360.com...-should-i-turn

    As for Annie’s possible discomfort after taking her Lysodren, it may be the case that it’s mildly upsetting her stomach. However, at least it sounds as though it is transitory and not especially severe. You might ask your vet about giving her some type of stomach-soother on her Lysodren days. Otherwise, she seems to be tolerating the medication well, so I’d see no need to make a switch just so long as the Lysodren is truly doing its job as far as providing consistent control of her cortisol. But that’s why I keep sounding like a nag in terms of monitoring her cortisol level. I just want to keep you guys from joining the statistic of those folks who have to turn around and reload again after just a few months of treatment ;-).

    Marianne

  9. #179
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    Mar 2013
    Location
    California
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    4,435

    Default Re: New to Cushings

    Hi Karen,

    I will not pretend to know a fraction of the science behind all of this. I chose trilostane because it leaves the system within 12 hours, or so. The idea of Lysodren loading terrified me. This is probably because I didn't know much about either of these very dangerous medications. Vetroyl (brand name for trilostane) was more expensive than Lysodren, but that wasn't the reason I chose Trilostane. Trilostane was very hard on Buddy's stomach, so it may not be much better than Lysodren in that regard. Lysodren prices have signifantly risen, so I have no idea which medication would cost less now.

    Again, others have more facts and science behind their posts regarding this issue.
    Kathy and Angel Buddy. The mightiest of all lizard hunters!

  10. #180
    Join Date
    Feb 2019
    Location
    Spring Valley, Il
    Posts
    178

    Default Re: New to Cushings

    Well, one would think that after 6 months of researching, reading, reading some more, and listening that I would have a clue about Cushings. NOT SO!!!!!!

    I think that I feel somewhat comfortable with the whole "lysodren thing" a little bit---I'm not sure I'll ever get there. I look at my little Annie sleeping peacefully on the floor, sometimes with all fours in the air as she sleeps on her back----oh yea, I have plenty of photos! The hubby and I feel so grateful to have her with us each and every day.

    Now for the hard questions....What can we expect as we go forward with Annie and her Cushings? I need to know the down and dirty, the worst that could happen, and anything else that could go wrong, also factor in that she is also diabetic. My life has taught me to always be on guard and that's probably not a healthy perspective on life, but I have a real need to be prepared for whatever.

    After all my little baby has been through I need a a realistic view of what to look for, what to expect and what to ignore become I'm so obsessive. Blessings to everyone here and thanks for putting up with me. Karen

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