14 year-old Shih Tzu With Recent Cushing's Diagnosis

[Squirt's Mom]

Hi Julie,

If memory serves me correctly, Dr. David Bryuette was involved in studies on Anipryl and I bet he can tell you if Hannah should have the Tramadol along with the Anipryl. If there are any serious contraindications, he should know. Here is an email addy I found for him but am not positive it is good. I would try anyway, tho.

David.Bruyette@vcahospitals.com

He is also a member here so you might contact him via a PM. He is listed as David Bruyette in the members list....you will find this under the "Community" button above.

I think you are very wise to research everything. You are a great advocate for Hannah!

Hugs,
Leslie and the gang

[jmac]

hi julie,

if memory serves me correctly, dr. David bryuette was involved in studies on anipryl and i bet he can tell you if hannah should have the tramadol along with the anipryl. If there are any serious contraindications, he should know. Here is an email addy i found for him but am not positive it is good. I would try anyway, tho.

david.bruyette@vcahospitals.com

he is also a member here so you might contact him via a pm. He is listed as david bruyette in the members list....you will find this under the "community" button above.

I think you are very wise to research everything. You are a great advocate for hannah!

Hugs,
leslie and the gang

thank you!

[jmac]

Hello-
I thought you might want to know that I did email David Bruyette, and I got a response from him. He said that it should be okay in dogs, and that there was an adverse response with humans. I wrote him back and included the information I found, as well as the link, to see if he believed it to be incorrect or outdated. There is nothing listed on the Anipryl drug sheet, but there is on the Tramadol info., at least from what I have seen. I also read a couple of questions written online with people reporting an issue with combining those two medications. I will see if he responds. As of now, I am waiting and doing nothing.

Tonight when I was putting a load of laundry in the washer, Hannah raced down the steps to see me, and then wanted to go back up too. I have still been limiting this (unless she does something like this without me being right there). She also jumped up onto our bed again out of the blue. I don't know if I should just let her do things as she wishes, or still try to limit and jumping and stairs. The vet couldn't seem to find anything wrong, so I don't know if I should mess with any meds period, or what. She is such a mystery to me!

-Hannah & Julie

[StarDeb55]

Julie, I don't believe I have posted to you before, but I have certainly been following Hannah's story. I do want to caution you about letting Hannah do much racing around like a "wild woman". Our pups seem to be very prone to cruciate ligament injuries in their knees. Whether this is due to the muscle wasting from Cushing's, I don't know. To show you, my 1st Cushpup, Barkley, ruptured a cruciate ligament simply chasing a toy that I was throwing for him through the house. I threw the toy up to the kitchen, B goes tearing up there, & has a bit of a slip on the linoleum. Bamn!! He comes up lame. He had to go to surgery to repair this injury, & the abnormal pre-op labwork is what put us on the road to a Cushing's diagnosis.

My Lhasa was given tramadol when he ruptured his cruciate a year ago, simply by jumping off the bed. I gave him the dose suggested by the ER clinic that night. I swear, it was like Chewy was "stoned", on drugs, or something, he was so out of it. Chewy is not a Cushing's boy, so I can't blame the ACL rupture on Cushing's with Chew.

Debbie

[jmac]

Thanks, Debbie. I just don't know how long I should try to keep her from doing anything, since I have no idea what hurt and she otherwise walks and acts perfectly normal.

This started last Saturday. Then on Friday (after having her anal glands expressed, which is what they thought might have caused her to not want to jump) she did jump on the bed twice before again seeming to be unable. Do you think I should try another week? I just don't know how to know when she is feeling better...since she makes it very clear when she does not want to/can't jump.

The vet manipulated her back legs around and said she had really good range of motion. She also said that Hannah didn't appear to have any muscle wasting yet, and otherwise looked very healthy. I just don't know what it is.

I guess for now I will continue to limit her jumping/stairs, and I'll wait to see what I hear from my vet on Monday. Maybe I can try to break off some of the Tramadol if we even end up giving it to her, but I just don't think I'll be able to evenly break a quartered 50mg pill.

Thanks for the information and for the advice. I truly appreciate it!

Julie & Hannah

[Roxee's Dad]

Hi Julie,
A belated welcome from me

Just wanted to re-enforce what Debbie said about ACL ruptures. My Roxee ruptured her's shortly before she was diagnosed with cushing's.

[addy]

Hi,

Just wanted you to know that I have been following along and am sending hugs. I think it is really good news that your vet does not seen muscle wasting yet and that Hannah has a good range of motion.

Zoe has a weak front paw that they never did figure out what was wrong with. It would bother her off and on. When it obviously bothered her, I limited her for a while. She had such a bad experience with Rimydal that I did not want to try anything else.

Keep up the good work!!!!

Hugs,
Addy

[jmac]

Hi Everyone-

I'm thinking of possibly taking Hannah to an IM specialist. I'm wondering with the confusion about the medications, etc. if it is time to just have her seen by someone else. I don't know if an IM would have any better idea about what is going on with Hannah's sudden inability to jump, but maybe they could recommend a better plan that won't interfere with her Cushing's issues.

My main concern would be cost. I am willing to spend money on my dogs, and I probably spend a few thousand per year (without even major problems), but I don't want to go crazy spending loads of money and do every test out there.

Aside from the jumping issue, she is doing relatively well with her other Cushing's symptoms (although I have noticed that she does not seem as interested in walking--tends to trot for awhile at a pretty quick pace, then really slow down, sometimes even stops, and this tends to repeat throughout the walk). I took her just down a couple of houses and back today and saw the same thing; however, I assumed that now something might hurt, so maybe it is worse.

For those of you who do see a specialist, do you then go there for almost everything, or do you still see your regular vet for other issues? I am assuming they could talk to each other about medications, or that I could then be calling to check out what my regular vet was prescribing.

Hannah is due for her next blood test on Aug. 1st. I believe he just checks the main things--not a complete blood count. I'm thinking maybe this would be one pro about seeing someone now...I could have the test done there and they would then have some fresh information.

I haven't checked the cost, but I do know there are options in my area, and that my vet even said he recommended one that is within 15 min. of us. (This is when we talked about me possibly getting another opinion).

Just wondering what you guys think.

Thanks so much!

Julie & Hannah

[addy]

Hi Julie,

Right now Zoe is seen only by her specialist. The main reason for that is I did not have a regular vet that I had a positive relationship with that I could trust to take care of her other needs and work with her specialist.

Her specialist does not have convenient hours, I have to take off of work and it is a further drive for us.

I have a regular vet in town I would like her to start seeing. He is willing to work with me and her specialist. If I like him, I would start taking her to him more often for routine things as it is more convenient and I would not have to take off of work. We have not yet gotten to that point. Call me paranoid

Not sure if that helped you.

Hugs to you and Hannah, she is sooooo cute.

Addy

[jmac]

Hello Everyone-

I finally talked to my vet today, and he did review some studies and looked for more info. with using Metacam and with using Tramadol with Anipryl.

He said he understood my hesitation not to use them. He said most of the studies are with long-term use, but admitted that since we don't know Hannah's cortisol levels, the Metacam could be more risky. (Glad I spent $31.50 on it; I should see if I can return it, as it has not been opened).

He said the contraindications with Tramadol and Anipryl are mostly human studies (which is what Dr. Bruyette told me), but said he understood my concern because it could translate into pets, but that since it was only going to be a few days, he thinks it would have been okay.

I have given her nothing and she still isn't "normal." I limit her activity, but I know she does not want to jump on the bed most of the time.

My vet and I decided it is probably a good time to see an IM specialist. He has other clients who go to this place and have been very happy, and referred me specifically to the doctor who has dealt the most with Cushing's, and was able to get me an appointment on Friday (thinking maybe they would have more of an idea about the jumping issues and what med to try, if needed).

I am starting to wonder if the disinterest in jumping (or inability to do so) is related to Cushing's. She also really drags some of the time during walks, and it seems to be worse lately.

I guess we'll see what the specialist has to say. I have such mixed feelings about the appointment. It will be good to get a second opinion and see someone who is more familiar with Cushing's, but I also dread getting bad news too. I'll keep you posted on what we find out.

Julie & Hannah