Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

[addy]

Hi Sharlene,

Just stopping by to say thank you for always checking in on us.

It took me a year to start Zoe on treatment. Her symptoms were not that strong. Take a day at a time. Enojy your Molly. Your avatar is so beautiful of that little girl

[molly muffin]

I think my vet has scared the bejebees out of me. She is basically saying that if we don't start treatment that the other cushings symptoms are going to show up and by the time they do that she will have other problems. She is very much an advocate of starting medication early to bring the cortisol levels under control and prevent them from causing any other organ damage. She thinks that this is the best option for giving molly as normal of a life span as possible and said that yes she would always be under treatment for the cortisol.

Gee Addy, look whose talking Zoe and Kodo are freakin adorable. So many absolutely darlin companions on this site and so sad to think of even one of them having health problems to deal with.
I'll add some pictures of molly to an album when I get a chance.

I'm still not sure when I'll start molly on treatment or when I'll get the ultrasound done. I'm just not ready to have another chat with the vet and molly is okay for the moment.

Hope Zoe's eyes start to get better soon! Poor baby.

[Squirt's Mom]

Hi Sharlene,

Is Molly showing more or stronger signs lately? I am just really, really uncomfortable treating a pup who isn't showing pretty strong signs since the signs are critical, vital, to monitoring treatment. If there are no signs, how will you know if it is even working much less have any indication that she is over dosed?

And I would want the U/S before starting as well...but that's just me.

You are doing a great job of educating yourself and keeping a hawk's eye on your sweet Molly girl!

Hugs,
Leslie and the gang

[lulusmom]

I think my vet has scared the bejebees out of me. She is basically saying that if we don't start treatment that the other cushings symptoms are going to show up and by the time they do that she will have other problems. She is very much an advocate of starting medication early to bring the cortisol levels under control and prevent them from causing any other organ damage. She thinks that this is the best option for giving molly as normal of a life span as possible and said that yes she would always be under treatment for the cortisol.

Your vet sure scares the bejebees out of me too. I don't want to sound like a broken record but the goal of treatment is to remedy symptoms and if a dog is asymptomatic, treatment should not be prescribed. I believe I provided you with some validating excerpts from some of the worlds most noted endocrine experts. Did you share these with your vet and ask her why her opinion is in direct conflict with them?

If what your vet says is true, almost every dog here would be diabetic and would have suffered with pancreatitis because they were not diagnosed and treated until they were overtly symptomatic. The majority of dogs diagnosed with cushing's are not diabetic nor have they had chronic pancreatitis. The only thing I can figure is that your vet has had minimal exposure to cushing's and the cases she's had were complicated by companion conditions such as diabetes.

I am pretty sure that you are feeling torn right now because your vet is telling you one thing and we're telling you another. My best advice to you is to not place your faith in anybody to know what is best for Molly. The best and only way you can do that is by educating yourself. We can only provide you with our own experience and point you to excellent reading material. You are Molly's only voice so make it heard. If you have questions, ask them and we'll try to answer as best we can, as well as provide you with links to reading material on the subject.

[molly muffin]

I don't think Molly is showing any more signs of cushings than she ever has.

It's like my vet could Hear us talking about Molly today. I got a call from the vet's office this morning after I posted here actually, asking how she was doing. I said, fine and that I hadn't started her on the Vetoryl yet. Which seemed to surprise them but I'm not sure why since I said I hadn't decided anything yet.

So I reiterated that point and said I won't do anything till she has an ultrasound to rule out tumors or any other disease. Since they don't do that at the vets office, she has to be referred to the Vet Emergency Hospital, so that is what they have done. Wow, 75 bucks for the referral.

So, Molly is booked to see an Internal Medicine Specialist and have an Ultrasound Friday morning.
I just spoke with the Vet Hospital and confirmed that this specialist has lots of experience with dogs with cushings or maybe having cushings and told them I'd bring her test results with me and that I'm concerned because of no real clinical signs of cushings. I want all other possibilities to be ruled out.

We'll see what happens on Friday and what the specialist says.

I did tell my vet about other findings, and the response was that I shouldn't be reading so much on the internet (that is the short basic version anyway).

I certainly appreciate all the valuable information that you are all willing to share with me. If not for this forum I probably would have just started her on the meds without any further testing or the ultrasound, thinking I was doing what was best for her and not even realizing the possibilities of something else.

[frijole]

Don't worry... many of us have been down this same path with vets. There is garbage on the web no doubt... but if you go to the links that Glynda referred to you will find that we are providing you with info that vets pay MONEY to learn in classes! These are the recommendations of world renown specialists in treating Cushing's.

Tell the IMS (or your regular vet) you have been reading articles written by Dr Feldman. If they have never heard of him then they know very little about cushings (its a way to screen ;0) Feldman (among other specialists) makes it very clear that we should not treat until there are symptoms.

Like I said - many of us have been in the same boat - myself included. You want to trust your vet because you have to be able to trust them... then along comes this site with conflicting info. It happened to me 7+ yrs ago. Obviously I stuck with the site and canned the vet. And I have no regrets. These people saved my dog's life and my sanity.

Hang in there and all will be just fine. Kim

[lulusmom]

I did tell my vet about other findings, and the response was that I shouldn't be reading so much on the internet (that is the short basic version anyway).

Oh my gosh, deja vu. The new gp vet I took my Lulu 10 days ago too told me exactly the same thing and that I shouldn't believe everything I read on the internet. I asked her if I should disregard all those peer reviewed studies in the veterinary journals and clinical trials submitted to the FDA for drug approval or the numerous audios of lectures I've purchased on how to diagnose and treat cushing's given by Dr. Edward Feldman, Dr. Mark Peterson, Dr. David Tweedt or Dr. David Bruyette, all considered experts in their field. I then told her that in my experience, more than few general practitioner vets need to sit their butts in front of a computer and start educating themselves. Keep in mind, this is the same woman who thought a dog diagnosed 7 years ago should have an ldds test done to obtain a baseline cortisol and that a post stimulated cortisol of 8.4 ug/dl is not only acceptable but normal for a cushdog being treated with Lysodren. The vet literally stammered then and I suspect she'll do the same when we finally connect to discuss Lulu's stim test, hopefully today. I will be offering up a copy of the Lysodren Loading Instructions and related tips in our Helpful Resources forum. These instructions are taken directly from a chapter in a veterinary textbook contributed by Drs. Steven Ettinger and Edward Feldman. I hope she won't be insulted because it will help her treat future patients effectively. Besides, I certainly wasn't insulted when she immediately assumed that I am an ignorant layperson who believes everything I read on the internet.

[Roxee's Dad]

Hi Sharlene,
Just wanted to add that I have had the same experiences. Some with cushings and with ear medications. My vet at the time applied Gentamicin Otic ear drops in Rozee's ears before I could tell him no. I explained that one of the side effects is loss of hearing. He told me I read too much on the internet. I insisted he change medications while he was insisting that is what he used on the local police dept canines. He went back and read the warning lables then came back and apologized, adding that he was going to change the meds for the police canines. Rozee did lose her hearing, but I'll never know if that was the reason.

I was new to the site and with the wonderful help of the members here, I was able to have a knowledgeable discussion on cushings and the treatment with our vet at the time.... we didn't always agree, but I insisted to go with the successful and cautious experiences I have gained here.

[molly muffin]

Thanks everyone.

It is hearing of your experiences on the board, that makes all the difference in the world when it comes to these one on ones with the vets. Peterson and Feldman are now staples of conversations involving cushings treatments with the vet. To think I'd never heard of either prior to this.

Wow John. You made a difference in a whole community of canines! Way to go! I couldn't be more proud.

Glynda, had to laugh at the thought of you marching in to the new GP vet armed with reams of material to explain very calmly how the vet is wrong. Road trip to Canada?

Interesting. I'm speaking with an acquaintance in Penn, who was told her dog must have cushings because the liver enzymes went up. Turned out after an ultrasound to be a large tumor on the liver, which was benign, has now been removed and her dog is fine.

[apollo6]

Dear Sharlene
Thank you for the kind words.
I am originally from Toronto, Ontario, Canada. Now in San Diego , Ca.
I tried a lot of things for almost a year, and waited a few months after Apollo's diagnos to research what treatment to do. Apollo is 4.9 kilos(10.75lb) and is on 10 mg. Trilostane. I started very low with him. I listened to my instincts and not the vets often. Question everything if you are not sure. Keep copies of all of Molly's lab's , take notes and write it down for future reference.
Each dog is different and treatment is different.
Below are some links about cushing and some references.
http://www.kateconnick.com/library/cushingsdisease.htm
references to internal medicine vets, just pu in the city and province.
http://www.acvim.org/websites/acvim/index.php?p=3
http://www.acvim.org/websites/acvim/index.php?p=3
You are not alone.
You and your sweet Molly are in our thoughts.
HUgs Sonja and Apollo