Buddy, The Mighty Lizard Hunter - Suspected Pituitary Macro Tumor

[Budsters Mom]

I researched hypoglycemia in dogs. It is common in smaller breeds especially Yorkies. Buddy is a yorky. It has a lot of the same symptoms as Cushings, so it could have been overlooked. Lethargy, muscle weakness, wobbly gait, to name a few. One of the main symptoms of hypoglycemia is FACE TREMORS! Buddy's tremors are head tremors. His whole body does not shake, only his head vibrates. I'm going to pick up a bottle of Karo syrup and rub some on his gums the next time he has a tremor, to see if that helps. I can't give him honey due to allergies. I have that on hand. His vet might know something about hypoglycemia. It is obvious they don't know much about Cushings. I'll call Tuesday to get his vet's schedule for the week, so I can take him in one afternoon after work. In the meantime, I will give him smaller meals more often.

[Budsters Mom]

Buddy's GLU Level on his last bloodwork dated 3/4/13 was normal.
GLU 99 range 70-143

This bloodwork was done after a fast of more than 24 hours due to bouts of vomiting. He had been given only water. His head tremors were occuring at that time, yet his GLU level tested normal. If he really is hypoglycemic, shouldn't his GLU level have reflected a significant drop???? Does this mean that he can't be hypoglycemic and the tremors are caused by something else? The more I read, the more confused I get.

Hugs,
Kathy and Buddy

[Budsters Mom]

It's 2:00 AM. Buddy has been restless tonight hasn't been able to settle to sleep. I finally broke down and gave him a half a tramadol to see if that helps. Usually when he's unable to settle that means he's hurting somewhere. I don't think Buddy has hypoglycemia because his glucose levels would not have tested normally if he had. He was having tremors when he had that blood work done. If his blood sugar had been low, that would've been indicated on the test and it wasn't. I keep going back to what Kim said. She said that the only time that we see tremors like this is when there is a macro tumor. I have read up on them and they are really bad news. If he has one, do I really want to know? There is usually someone there to talk to, but not tonight. It is going to be a very long night.. Well at least tomorrow is a holiday and I don't have to go to work in the morning. There is that.

Kathy

[Trish]

Hi Kathy
I am here, bit late logging in tonight. You sure it is not just trembling, Flynny does that on occasion. It used to just be in his back legs but sometime includes the rest of him, head included. I see his ears wobbling.

Isn't it always the worst, middle of the night and you fears get the better of you! Try get some sleep and see how he is tomorrow. They do seem to get aches and pains at different times. I have Flynn on a very small dose of Tramadol now, 12.5mg twice a day and it seems to be holding his arthriticy pains pretty good!

[goldengirl88]

Kathy:
I am so hoping Buddy does not have a macro tumor. That was my biggest fear with Tipper in the beginning as she exhibited many of the macro symptoms. When she just had her scan I told them I did not want to know as I would melt on the spot if she had one. This has to be the scariest disease anyones' dog could get. I saw another Jack Russell at my vets the other day picking up Vetoryl. This disease is so rampant it needs to be researched so people so not have to go through the heartache we have been through. I am going to start calling some universities and asking about how you get a study started. Tipper was up again at 5:30 this morning, it is wearing me out, but I just do it anyway. I know how you feel being up all night and you mind won't stop thinking of all this Cushings stuff. Thank God Tipper and I were blessed with knowing from her scan she does not ahve a macro tumor. Tipper has just not been herself for a few days, it really scares you when this happens, you think now what. Hope Buddy gets on the mend. Blessings
Patti

[labblab]

Dear Kathy,

I'm so sorry that Buddy continues to have these tremors! I can only imagine how upsetting they are for you. I remember when my Peg's grand mal seizures first began. I would pray that each episode would be the last. And then when she would have another one, my heart would break all over again. As things have turned out, though, we have been very lucky with her in that even though we have never determined the cause, her seizures have been totally controlled since she was placed on medication.

I know you are still totally uncertain as to the cause and even the true nature of Buddy's tremors, though. Have you ever gotten a response to your email from the neurosurgeon?

Your idea about the hypoglycemia is an interesting one, and I don't think it can be ruled out on the basis of a normal glucose level if the blood wasn't drawn at a time when the tremoring was occurring. From what I've been reading, there can be two types of hypoglycemia. One is referred to as "fasting hypoglycemia," and it is true that the glucose reading would be low at the time of a fasting test. But there is another type -- "reactive hypoglycemia" -- that seems to occur only episodically, especially in conjunction with meals. And with that type, a fasting blood glucose will be normal. Here's a link that told me more about this. I realize that neither onset profile fits Buddy to a "T," but otherwise the symptoms of hypoglycemia certainly do seem to fit what you are seeing. So I wouldn't necessarily rule it out yet.

http://www.americancanineregistry.co...poglycemia.htm

As another alternative to the notion of a macrotumor, I read back through your thread to see that the neurologists were originally debating whether Buddy may have suffered a stroke. If so, I would think the tremoring could be mini-seizuring that could have resulted from residual brain damage. If that's the case, perhaps an anti-seizure medication could be helpful for him in the same way that it has been helpful for my Peg. Phenobarb is the most commonly prescribed anti-seizure med for dogs, but may not be the best choice to be used alongside trilostane. There are other medications that that can be used, though, instead. The downside is mainly that they take a longer time to reach therapeutic level.

I guess my main point here is to try to reassure you that, even though it is very upsetting, the tremoring may not be as catastrophic as you are fearing. And if it were me, I'd first really try to pursue the notion of hypoglycemia with somebody knowledgeable. Since Yorkies are especially vulnerable, I'm surely wondering if that can indeed be the source of the problem and that there has been a hormonal imbalance associated with his Cushing's that is triggering the problem.

Sending many hugs,
Marianne

[frijole]

I keep going back to what Kim said. She said that the only time that we see tremors like this is when there is a macro tumor.

Kathy

Sorry if you took my post that way - the intention was that a macro is a possibility but it could be something else. The question is, as you mentioned, do you want to do the testing? I can understand if you elect to do skip testing - that is your call. I'm sorry that you are going through this. Hugs to you and Buddy. Kim

[Budsters Mom]

Good morning Angels. Sorry about the distress call in the middle the night on a holiday. I gave Buddy a small meal later in the evening last night, thinking he could have reactive hypoglycemia. I think tummy trouble was the reason that he was unable to sleep. He's been getting that occasionally since I started to give him Trilostane, but it has been better since starting the Pepcid. I give him 1/2 a Pepcid (5mg.) a half hour before breakfast and Trilo. He was able to rest and did finally sleep about a half an hour or so after I gave him the tramadol last night. This morning he is spunky, active, full of himself, and totally fine. I on the other hand are total wreck and did not sleep at all last night! This is where I am totally frustrated.....If Buddy was in a lot of pain and miserable all the time I know what I'd have to do. Those perimeters are unclear. 99 percent of the time Buddy is perfectly fine, active, happy and normal. He goes many days without any head tremors at all. When they hit, they're usually short lived, Buddy is disoriented for a bit, then fine once more. I am a googling fool when I have something to research and am on a mission. Last night my brain was on overload from inputting too much data and second guessing myself with what if's??? Now, I'm tired and feeling defeated because I can't seem to fix this and that's my job!

Marianne - yes, the neuro surgeon and other two neurologist thought that Buddy may have had a stroke. No, I never got a response to my email. It is possible that they never even got it. I called the specialty hospital to get the email address to send it to. i was told that they would forward it on to the doctor. I don't know if they did. I sent the email on May 3rd.
Thank you being there to offer guidance and support. I am surrounded by people who don't think I am doing the right thing. That includes my family. They don't understand any of it and don't see the point of trying to figure it out, so I'm on my own and it's hard. I have to work. I have special needs kids depending on me. June 19 is the last day of school before summer break. That is good and bad. Good because I'll be able to be home and monitor Buddy more closely. Bad because I won't have any income coming in until September. That is usually fine because I save for the summer months. Unfortunately this year my savings and then some, has gone to vet bills, so it's going to be a lean summer with more vet bills yet to come. This certainly is depressing and I am a glass half-full kind of girl. Do any of you angels have a magic wand that you could wave and make all of this disappear? At least one of you should have that power at your disposal!

Hugs,
Kathy and Buddy

[Tina]

Oh Kathy, ((hugs)). I too am sorry that Buddy keeps having these tremors, but I am glad he is feeling good today. Darn it, sorry I wasn't on last night, normally this night owl would have been. But we had severe thunderstorms through most of the night and a tornado warning at 1:30 am for crying out loud! So I was down in the laundry room with my little ones for a bit. Jasper gets pretty anxious with storms and high wind, so had to deal with that rather than be on the forum. I am a bit tired today also, but thankful I don't have to work.

Now that I see that it is thought that Buddy may have had a small stroke at some point, I too am wondering about the tremors being some type of seizure activity, maybe a focal seizure? I know those can cause trembling or shaking in specific areas of the body. I am sure you have investigated that, but it was just my thoughts.

You are doing an amazing job with Buddy, don't let others get you down. I understand all about that, my friends are supportive, but I know that they think I am crazy with all that I do for Jasper. My Mom gets it, thankfully, and is good for moral support, but she lives over 1000 miles away. So I am on my own for the most part also. It is really hard sometimes.

I wish I had a magic wand Kathy, I would use it freely for all of us and our babies!! I struggle with the financial aspect also as my savings has been spent down to the bare bones too. I had been saving for a couple of years for new carpet for my house (which it desperately needs). That is all gone, and then some. I know there are a lot of us in that boat. I got approved for care credit a few months ago, so I have that to fall back on thankfully. I am now trying to figure out how I can afford pet insurance for my 1 year old Shelby. I sure would like to get it for her, it would have been a godsend to have for Jasper.

Hang in there Kathy, you are doing a great job with Buddy. And we all have each other to lean on on this forum, which is such a blessing. I hope you are getting some rest and enjoying the holiday.

Hugs,
Tina and Jasper

[molly muffin]

oh Kathy, those sleepless, worrying nights are not fun at all. You said it well, Buddy for the most part is doing really well. A head tremor now and then that goes away with no lasting ill effects is at the very least manageable and seems to allow you time to save finances and try to figure this all out. As long as nothing gets any worse and the status quo is maintained, I think you'll be okay.
The problem is that really there is nothing in the blood work that is telling us what might be causing this and no side weakness that is indicative of a severe stroke either. On the next visit to the vet, have a chat about these tremors, instead of scheduling a new appointment that will cost more money.
I think you have a month or so right? Maybe the next tremor will be 10 days or never, you just don't know. I don't think he is in pain, he doesn't act like it.
You're doing awesome! Second guessing ourselves is our own worst enemy. I know I suffer from it too.

hugs,
Sharlene and Molly Muffin