Questions about Cushings - Charlotte has crossed the Bridge

[LaurieS]

Sharlene, thanks for the aquatherapy suggestion, I hadn't thought of that. This morning she jumped up on our bed with no assistance and I couldn't believe it! I'm hoping since Charlotte is still fairly young she will get at least most of her strength back.

Joan, yes I think you are right, the trembling probably bothers us more than them. Charlotte does it most when she is laying down but awake. When she goes into a deep sleep it subsides and when she is active it also seems to go away.

Laurie

[LaurieS]

Charlotte had a bad day today. She has had no energy and hasnt been as interested in food, even though she did eventually finish her food she rarely leaves any in her bowl so that seemed odd to me. She has slept all day and hasnt had much interest in anything. Is this something we need to accept, some good days and some bad days? Since we cant rush in and test her cortisol levels everytime she seems a little down what would you guys suggest i do when she has a bad day? Or is there anything i can do?

Laurie, concerened doggie mom

[DoxieMama]

Hi Laurie,

Hopefully one of the more experienced folks will see your post and provide some helpful suggestions. Personally, since she did eventually eat, I would make a note of it and keep an eye out to see if that behavior continues. As it is possible for cortisol to continue to decrease during the first month of treatment, it could be that it is starting to drop a bit too low. In that case, it would be worth getting another ACTH test done sooner rather than waiting.

I know, I just said wait but don't wait. It's a fine balancing act. You know her best and I know that you'll make the right decision for her, even when you feel like you have no idea what to do.

[labblab]

I finally got Charlotte's ACTH Stim test results:

12/27/2016
Pre 4.6 ug/dL
Post 5.0

The vet was very pleased with this after less than 2 weeks on her full dose of 30mg of Vetoryl twice daily. Her original test results were:

12/13/2016
Pre: 12.8 ug/dL
Post: 41.5

Hi again, Laurie. I'm sorry Charlotte was feeling poorly yesterday and I hope she is better today. If not, I encourage you to contact the folks at Davis and let them know. It is very true that it is impossible to continually test cortisol levels, but this may be a time when it is very important to do so. Charlotte's cortisol lowered quickly and very significantly after beginning the Vetoryl, and as Judy says, it is common for cortisol to continue to descend further within the first 30 days of treatment, even when dosing is left unchanged. It is entirely possible that Charlotte's cortisol is now too low for her comfort and safety, and the dosage needs to be reduced.

The formal recommendation from Dechra is to test at both the 10-14 mark and again at the 30-day mark. So Davis was giving you a "break," if you will, by waiting until the six week mark to schedule the second monitoring test. And if Charlotte was doing well, this would probably be OK. But if she's not doing well, it is much better and safer to go ahead and retest now. Even if a dosage adjustment is called for, then you can have greater confidence that you are arriving at her truly optimal dose, at which time the testing window will lengthen.

Hope this makes some sense, and please keep us updated. But do please contact Davis, as well.

Marianne

[LaurieS]

Thanks Shana and Marianne! Today Charlotte ate well but she is no longer acting super hungry and scarffing down her food like she has since the day we got her. She is sleeping a lot and isn't very responsive like she used to be with a wag of a tail when we speak to her. I had hoped she would act a little happier by now but maybe I'm asking for too much too soon. But she was very excited to go for a short ride today and also slept 8 hours last night which is the longest she has been able to go without having to urinate so I guess that's a positive. And she is rolling around on her back like she used too which is super cute. I will email her Davis vet and ask him what he wants me to do but I have no problem going for the next ACTH test a little early.

Laurie

[molly muffin]

That drop was a pretty big one and the worry is that it has continued to drop into an area that is too low for her. So, watch her carefully, and definitely contact the Davis vet. I'm guessing her post cortisol number has dropped some more.

[LaurieS]

Ive noticed Charlotte's inner ear flaps and bottom of her paws get really pink sometimes. It usually doesnt last long and then they are back to normal color. Could this be related to blood pressure? Ill be asking her vet at Davis when we see him but thought id ask all of you if this is something you have seen in your cush pups?

Laurie

[judymaggie]

Laurie--the pink coloring you describe happens to my Abbie when she gets stressed so I usually see it at the vet. Since Abbie has too many other things that concern me, I let this one go. Have you seen any pattern with Charlotte as to when this occurs?

[djalbo]

Hopefully this works...Here is a photo of her blood and urine test results:

Oops, never mind. Didn't realize there were more pages to this thread.

[LaurieS]

Laurie--the pink coloring you describe happens to my Abbie when she gets stressed so I usually see it at the vet. Since Abbie has too many other things that concern me, I let this one go. Have you seen any pattern with Charlotte as to when this occurs?

I haven't seen a pattern with this and it's been at home while she wasn't stressed for any reason. I will keep a closer watch but she was sleeping in my husband's lap last night when we noticed it. It usually subsides after an hour or so. I have a message into her Davis vet and that's one of the questions I asked. I'll let you know what he says.

Laurie