Dad of Lulu - sweet Lulu has crossed The Bridge

[LabDad]

Thanks Lori, I will look at. I see they talk about the compounded product. Sow we can discuss this with Dr. Wilson, if it turns out that she needs to be on the drug.

As I write this our Lulu meant her young girlfriend from the farmer next door, a 1 1/2 year old female Jack Russell Terrier. It makes me wish that we had a small friend of our own for her.

[LabDad]

Well Lulu had a long day. Actually she was at the vet for 2 hours. She had her ACTH test and hopefully tomorrow or Thursday I should know the results.

She had a urine test, specific gravity. Dr. Wilson said the concentration of urine was not indicative of Cushings Disease, but will await the ACTH test.

Lulu's Na is 159.0 mmol/L (normal 144-160)
------ K is 5.0 mmol/L (normal 3.5-5.8)
------ Cl 118.0 (normal 109-122)

Lulu was glad to get back to me and we had a walk in the field by Wilson Clinic where the fasting Lab had a late breakfast of a plain McDonalds cheeseburger.

[LabDad]

Let me post the great news on Lulu's lab results here, then I have to paste them on two other sites, seems Lulu has quite a following!

Dr. Wilson called and talked to me about half an hour ago, he's an evening person. Lulu's pre-ACTH result was 3.3 ug/dl (normal 2-6 ug/dl) and her post-ACTH was 9.5 ug/dl (normal 6-18 ug/dl)

Dr. Wilson said that Lulu may have had Cushing's earlier, and the Lysodren decreased the adrenal glands function. That could come back and he said to repeat the test in 90 days. If Lulu relapses into Cushing then Trilostane should be given.

I have decreased Lulu's melatonin to just at night, but that could change if the weather gets stormy. The funny thing about storms, I was sitting on the front porch watching the lightening the other day, just before sunset, and Lulu was lying on the driveway and not bothered. She hears well and when we turn on our new tv, (lcd) we notice that she is hearing the initial turn on, which we don't hear, it kind of startles her. She also tries to moisten her mouth with her tongue often. She has done this for about a couple of years now, as her throat is dry maybe.

Anyway, I see by the new posts that seems like 10 years of age seems to be the entrance exam for Cushing's Disease.

[LabDad]

Just wanted to update on Lulu, almost a month later from her ACTH test. This is what I posted on my diet forum.

You know Lulu is doing fairly well with the disease in remission. But I think that it may come back again. But who knows. Cushing's Disease is a baffling one to treat, but fortuntately there are forums for it. The warm weather is harder on labs whether they are young or old, hence their name Labrador. Lulu was shedding back in January and February, so I think her fur is a bit thinner, and maybe that is good for summer. Part's of her fur is curly. She does take her tongue and act like she has a dry mouth. And she has done this for well over two years. But that is probably part of the disease and why they often drink more. Right now her drinking is fairly normal.

Lulu, seems a bit more subdued, not as playful at times and maybe a bit more laid back. She is 11 and I do give her a melatonin in the evening. I haven't given her one in the morning because of this laid backness. Though we are expecting some storms the next couple of days, so I may give her the morning dose. Many on the Cushing's Forum have mentioned this helps. http://www.k9cushings.com/forum/

Then Lulu is usually playful every day, but moves a bit slower now that the weather is warmer. She is more frisky on cool days.

[frijole]

Another good reason to give melatonin this time of year is the 4th of July! Scares my poor girl to death. So a bit of melatonin helps both with storms and fireworks. Glad Lulu is doing well. You are doing a great job! Kim

[LabDad]

Yes as I write we are having a bit of a light storm. I have my-cast radar open in the basement using my laptop on battery power. The storm is supposed to end in less than half hour. Lulu is doing okay, playing music on my desktop computer while the thunder roars in the distant. It is soothing us both not to have to pay attention to the storm.

[lulusmom]

Lulu's cortisol has consistently risen since January and according to the post stim numbers, I wouldn't say she is in remission. Her adrenal glands are regenerating and it is just a matter of time before she becomes symptomatic again. When I switched my little Lulu from Trilostane to Lysodren, she did not become symptomatic again until her post cortisol was 25 ug/dl and it took weeks and weeks for it to get that high again. It was nice having the time off during the washout period.

Please keep us posted.

Glynda

[LabDad]

Our second opinion vet, who did remarkable ACL surgery on Lulu 5 years ago wants to use Trilostane instead of Lysodren. He said he used to use Lysodren, but he and I and my wife seemed to think that Lysodren is a scary drug to use. But other vets use it, so I guess it's a matter of opinion.

Yes, I am enjoying Lulu's temporary remission. Maybe it will last a while. The vet wants her checked in 90 days, about two months from now.

[Squirt's Mom]

Cush pups drink a lot because the cortisol makes them pee a lot. Just as it stimulates the appetite to a frenzy, it stimulates the kidneys to function over-time. So cush pups drink to stay hydrated because the amount of fluids they lose via urination will quickly lead to problems if they don't.

If your vet is of the persuasion that Trilo is "safer", please know that is absolutely incorrect. It is just as dangerous and has the potential to cause all of the "scary" things that Lysodren does - from mild to fatal. Please don't be mislead if your vet tells you it is a safe alternative to Lsyo. The safety of either med is directly related to a correct diagnosis, proper administration and monitoring by the vet, and diligence and knowledge on the part of the parents. Both are extremely powerful drugs, both are life-savers.

I hope the break you and Lulu are experiencing will continue for a long time!

Hugs,
Leslie and the gang

[LabDad]

I guess the fact that Lysodren destroys adrenal gland tissue and is a strong cancer therapy drug, makes it scarier. There are shortfalls to any drug. And I'm sure better drugs will be around in 5 years, usually they are. Dr. Wilson said to research Tristolane on the Internet. And it can be more expensive, but he has had good luck with compounded (generics) though there will always be those that say to stay away. He has a lot of experience with this disease, which I wasn't aware of, because he is such a darn good surgeon, I didn't know you could both be a 'pitcher and a home run hitter' in the same person.

Anyway, the disadvantages ot Tristolane are of course more frequent dosing, and other things. It really is a judgment call, but I think the trend has been to going to less toxic drugs in the future.

I used to be a medical technologist in my past, so very familiar with drug dosages and interactions in the blood. I haven't been in that line of work for over 20 years, doing computer programming, though some of it in the new EMR field. I have to do the research on the drugs just as I did as a medical technologist.

Yes, Lulu seems to be doing better, though more laid back, which may be a result of the melatonin. I still have her on just evenings at 3 mg. Maybe a bit less I will try in the future when there is a long trend of fair weather.

And it isn't the storms themselves that bother Lulu, it's where she is at and possibly when the storm hits. She was in front of our garage on the concrete when a storm was approaching, with some lightening, thunder and wind, and she was as content as could be.

But you send out a tone in the frequency of a smoke alarm and it upsets her. I think I will take Warren Eckstein's (renownded animal expert from television) advice and download some audio of storms, wind and smoke alarm high pitched tones and put them on a cd, and play them at an increasing volume while massaging her. Can't hurt.