Tess, radiation therapy (Tessie has passed)

[Sammie]

The name of that underline disease that I could not remember is called
NYSTAGMUS. I have never heard of this. Will now be looking that up
Tessie is home tonight, will go back tomorrow for more IV. She is doing much better. She hate a little chicken. My vet said it was ok. She is drinking water and walking around slowly. She just tried to poop and a little diearea came out, but she has not eaten sense Friday morning, so i think that would be normal. She is sleeping here on the couch. My vet does not have 24 hour care so that is why she is home with me. PS. Tessie was to be on the DBL dose for ten days only, then she was to be dropped down to one dose a day or a week . I can't remember right now. The idea was to bombard the system, get a blood test in a week and then lower it or higher it. We all know now it was to much for her. Dottie

[StarDeb55]

These test results clearly indicate that Tess suffered from a critical Addisonian crisis. The results that indicate this are the elevated potassium, the decreased sodium/potassium ratio is even a bigger indicator. In a normal pup, this ratio should be between 27:1 to 40:1. This is a pretty severe decrease which is a clear indication of an Addisonian crisis meaning that the adrenal glands, besides not secreting enough cortisol at this point, are also not secreting enough aldosterone. Aldosterone is a very important hormone as it controls the sodium & potassium levels in the body. Serious imbalances in these 2 (electrolytes) can be life-threatening.

As Glynda mentioned last night, I am also very concerned that Tess is already home. Is she receiving some type of steroid, along with a florinef injection? The bloody diarrhea is another clear indication that Tess really needs to be at the vet's on IV fluid, where she can be closely monitored with regular labwork to monitor her electrolytes. The other thing that disturbs me on the labs you have posted are the elevated BUN & creatinine results. These are the 2 major tests that monitor kidney function. With these elevated results, there is apparently some impairment of kidney function, but it's hard to tell if this has also been brought on by the Addisonian crisis.

Please, please ask your vet for a referral to an IMS, & get Tess there ASAP as I'm very fearful that she is not out of the woods just yet.

Debbie

[AlisonandMia]

Hi and a belated welcome from me too.

I'm wondering if you've been given any tablets for Tess to take now. Prednisone is what is usually used. Or maybe the emergency vet has given her some sort of steroid shot? This is quite likely if she was vomiting and unable to keep pills down. It would be good if you can find out the name of any medications they are giving her.

Nystagmus is rapid eye movements caused by a disturbance to the balance mechanism in the inner ear. The balance mechanism is called the vestibular system and when it is affected this way it is called Vestibular Syndrome (http://www.vetinfo.com/dencyclopedia/devestib.html). No one really knows what causes it in most cases and it seems to be something that happens more often in older dogs than younger ones. Sometimes it is caused by an ear infection and I'm sure the emergency vet checked out this possibility. It isn't a symptom of low cortisol as such but we have seen a couple of dogs that seemed have it come on when their cortisol went too low so maybe it can be triggered by low cortisol in a susceptible dog. Other symptoms of Vestibular Syndrome can be lack of balance, circling, head tilt and nausea and vomiting (but not diarrhea as far as I know unless anxiety caused by the balance problems triggers diarrhea in a particular dog.)

It does sound like her biggest problem is that she is Addisonian at the moment as a result of the Vetoryl and that the vets are working to manage both problems - the Vestibular Syndrome and the Addisonian state.

Good luck - it sounds like you have all been through a rough few days - and keep us posted.

Alison

[Sammie]

Hi the test labs I posted was when she was in crises. My vet said today that almost all her lab work was back to normal. She is going to have more IV tomorrow and a x-ray of her Kidneys, lungs, and stomach. Her whites of her eyes are really blood shot and that is new. I had that in another dog. She went blind in one eye. Blood shot eyes was the first signs of the retina going bad. Tessie is at the vets from 8:00 a.m. to 5:00 P.M. on a IV he does not have 24 hour care so I have to bring her home to watch over her. I think it was all brought on by the Addison's. He would of told me today if she had a kidney problem. I will ask him tomorrow.

[StarDeb55]

Can you please post any repeat labwork that was done today & over the next several days? Also, Alison has asked a very important question, did the ER clinic either send you home with medication for Tess, & do you know the name of it? Did the ER clinic give her any type of steroid injection such as dexamethasone, and/or florinef?

Debbie

PS- I do realize that the results you have posted were from yesterday when Tess was so very ill. Just to let you know, I'm a medical lab tech with 29 years experience, so I am very used to looking & interpreting these types of results. The kidney values from yesterday do clearly indicate a kidney issue that you need to question your vet about.

[StarDeb55]

Tessie was to be on the DBL dose for ten days only, then she was to be dropped down to one dose a day or a week . I can't remember right now. The idea was to bombard the system, get a blood test in a week and then lower it or higher it. We all know now it was to much for her

From what you have said above, it appears that your vet may have attempted to do what is called a "loading" with Trilostane. If this is the case, this is absolutely inappropriate dosing for this medication. Loading is only done with lysodren. As several of the more experienced members who have used Trilo have pointed out, dogs are extremely sensitive to this drug, & need to be started on a low dose, working up to a higher dose as needed. From all of the information you have posted as to how your vet has managed the use of Trilostane for Tess, if I were in your position, I would be asking the vet some serious questions about his/her experience with using Trilostane. I'm not coming down on you, you did the best you could with the information you were given. You got Tess the help she needed as soon as you could. Your vet appears to have a serious lack of experience with using Trilostane at a minimum, if not treating Cushing's, & unfortunately, Tess has paid the price.

Debbie

[Sammie]

Hi the rapid eye movements has stopped. It stooped yesterday. My vet said the same thing and it was just dum luck that it was brought on at the same time she was given Vetoryl. Again the lab results I posted was when Tes was in crises and she is doing better, but she is still not out of it. It will take awhile. She is 12 years and soon to be on 7/29 13 years. She is safe a warm, she had her favorite food chicken. She is on the couch snoring and I am rubbing her tummy. With what ever we find out, cushings, Addison's, Kidney, or tumor you have all been a big help. Tess has had the best life. More Love from me and my husband. Lots of room to play in. Plenty of mom and me time. She was are first born, meaning are first dog. My husband didn't even want a dog. Tessie was his christmas gift 12 years ago. Now we have 5 dogs. She has been on lots of trips to the river, beach and chased lots of birds and possums. With all my love I will help her to get what she needs, but in the end she is a old dog with a young sprit that will need me to help her to doggie heaven when ever that comes. Thank you all for giving so much Dottie

[Sammie]

Can you please post any repeat labwork that was done today & over the next several days? Also, Alison has asked a very important question, did the ER clinic either send you home with medication for Tess, & do you know the name of it? Did the ER clinic give her any type of steroid injection such as dexamethasone, and/or florinef?

Debbie

PS- I do realize that the results you have posted were from yesterday when Tess was so very ill. Just to let you know, I'm a medical lab tech with 29 years experience, so I am very used to looking & interpreting these types of results. The kidney values from yesterday do clearly indicate a kidney issue that you need to question your vet about.

Hi yes the E-Vet did give Tes a steroid injection then we took Tes over to my doctor. I don't have the lab test from Doctor yet. I will have then 7/8/09 for you. I think that is why my doctor wants to have a x-ray done tomorrow 7/8 on Tes. I think he is thinking Kidney. I said to him when he said to me he want ed to x-rays. I said to rule out kidneys or tumors. He just looked at me. It took him by surprise. Thank you for reading the labs. I have know clue what they were saying. Ok tell tomorrow. Dottie

[StarDeb55]

Dottie, please do keep us posted as to how Tess is getting along. She has a lot of people worried about her & pulling for her. Yes, she is a senior, but once this emergency is straightened out, she very well could have several more years with a good quality of life. My Harley is a 14 yr. old Shih Tzu, who has been treated for a little over a year & is doing pretty well, so don't throw in the towel just yet.

Debbie

[BestBuddy]

Hi Dottie,
I certainly hope you have lots more "good times" left with Tessie. You did the right thing by getting her to the emergency vet. From what I know addisons can come on as a crisis and resolve after a few days of treatment or Tessie may be permanently addison. She has made some good progress so hopefully that will continue. There are a few members whose dogs have permanent addisons and it can be managed.
Jenny