Bagel - Beagle/Bassett - Lysodren

[stardeb55]

Re: Bagel - Beagle/Bassett - Lysodren

Sande, when you indicated that your vet was pretty set about only once a week maintenance dosing, I thought to myself that this was going to be an problem, but I realize you have to follow your vet's instructions. When Harley was first diagnosed, the IMS wanted him on twice weekly maintenance dosing. When I moved his Cushing's care back to my GP, the GP was pretty adamant that he wanted 3 times a week maintenance dosing. The GP felt that the more frequent dosing kept the blood levels of the lyso more uniform, & wouldn't allow the adrenals time to regenerate.

Debbie

[Bagel's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

Trying to remember everything in the last two posts...

She loaded at 1 and 3/4 per day...I think that is 875 mg? I am bad at metrics since I teach elementary school!..

He told me out of 90 Cush dogs treated, only 2 didn't make it ..

There are three vets there and they all follow what has proven best in their experiences I guess? The yare always gone to lectures and conventions to learn new stuff...

But when I asked about splitting the dose over several days he said he had never heard of that and "no"....

Being only a little over a month on here, I know you all continue to refer to Dr. Feldman. Is he a local person, or where do you get his name and his info? I did download his lecture on Cushings, but don't know who he is.

She is now taking 2 500 mg pills on Thursdays( 1000 mg) ...and the last stim was SAT when she got those numbers. BUT she did have a UTI a couple of days later which she could have had then when she was tested,,I am hoping that is why the numbers were up?

IF I decide to split her dosing...how would 1000 mg best be done....?
Just curious..
She IS feeling better and I can tell a difference in her in just a little over a month...
thanks!!
Sande

[Bagel's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

Bagel 1/2 pill on Mon, Tue, Thur & Fri.


Hmmmmm......Would that be morning or afternoon or would it matter?
AM THINKING......

She dosed on Thursday...

Sun Tues Thurs ???

[stardeb55]

Re: Bagel - Beagle/Bassett - Lysodren

1/2 pill, 4x per week sounds like a good plan. Time of day that you dose doesn't matter, you just need to give with food which you already know. Dr. Edward Feldman is one of the foremost authorities on canine cushing's disease in the world. This link gives you just a little more info about Dr. Feldman. You could probably find more detailed information about him on the UC-Davis vet school website.

http://www.wvc.org/content/?c=42&id=19&dc=n

Debbie

[Lulusmom]

Re: Bagel - Beagle/Bassett - Lysodren

I dose my dogs in the morning because it's convenient.

Dr. Feldman is a professor at UC Davis. He is extremely well published, well known and lectures on cushing's and other endocrine disorders all over the world. If your vets go to conferences, seminars and lectures to keep current on cushing's, I would suggest that they attend one of Dr. Feldman's lectures. The audio I listened to was a 2007 lecture in Seattle. He has been treating dogs with Lysodren for over 36 years and knows it like the back of his hand. He was adamant and used the words "never, ever" give a dog once weekly dose unless you absolutely have to. The example he used was a dog getting 500 mg maintenance which should be spread out as 1/4 pill on Mon, Tues, Thurs & Fri. In addition the reasons that Debbie has given you for spreading over the week, it also makes it a lot easier to adjust a dose whether it be an increase of decrease. In Bagel's case, it would be 1/2 pill on Mon, Tues, Thurs & Fri.

Glynda

[Wylie's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

Hi Sande,

About re-load vs. upping the maintenance dose: Late fall/early winter, my IMS wanted to do a maintenance dose and then kept raising the dose, while the people here suggested I do a mini-load. I did what the IMS vet said, it seemed to work for a while, but then his cortisol levels kept creeping up. When he posted at 9.2 last March, she wanted to double his maintenance dose - the people here warned me again - I spoke with my GP vet instead & decided to try a mini-load (2 weeks ago). The mini-load went well.

What Debbie & the others say about splitting the dose throughout the week makes complete sense to me. Also, I found for my, now 79lb pup, 500mg is just too much for him with one meal. During the recent mini-load, I tried 500mg twice daily, and it seemed that my Wylie couldn't handle 500mg with one small meal (he handled 500mg fine when he was getting 2 larger meals per day, but now he gets 3-4 small meals per day). He doesn't eat grass that often, but he did nibble a little of it when I gave him 500mg. During the loading, I started with the 500mg BID(twice daily), but then lowered it to 250mg BID. For his maintenance dose, I am currently going to do 250mg BID on Sun & Thurs and 250mg once on Tues. I'm sure I read that a maintenance dose should be minimally split over at least two days a week. If you do decide to split the dose, instead of the Tues & Thursday, you should try to have two days in between to even it out more - or split it out more as Debbie & Glynda said.

I really think your vet is not reading the protocol instructions carefully (or not at all).

-Susy
(In the time it took me to write this post, 4 new posts were made to this thread - I'm a turtle writer)

[Bagel's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

WOW you guys are great...
I did go research Dr. Feldman and I really see his words repeating a LOT about splitting the doses..
I think I am just going to do it. She has very loose stools today- the day after the 1000 mg and bad diarreah last Thursday after the morning pill.

My vet goes to conferences all the time.... I wonder if maybe they think they have this Cushings down pat so they go for other stuff?

ANYWAY....

I need for her last dose NOT to be on a Friday since the next STIM test would need to be 48 hours after the last Lyso dose and that would be on Sunday...right?? Does it need to be exactly 48 hours after the last dose or at LEAST 48 hours?

[maggiebeagle]

Re: Bagel - Beagle/Bassett - Lysodren

Just checking in and wanted to send happy wishes your way for you and Bagel. Maggie was a trilo girl (when she was being medicated) so I don't have any advice about the lysodren. You are doing great!
Virginia and Maggie

[stardeb55]

Re: Bagel - Beagle/Bassett - Lysodren

The stim should be about 48 hours after the last dose. You don't have to be exactly perfect on the timing. For instance, Harley is on a M, W, F, schedule, I try to have his stims done Friday mornings which would actually be about 36 hours since the last dose, since I dose in the evenings. If I happen to get the stim done on Thurs., both the vet & I take in to account that the numbers woul probably be a tad lower than what was reported because of the lyso being long-acting.

Debbie

[forscooter]

Re: Bagel - Beagle/Bassett - Lysodren

I have nothing to add but did want to let you know I am trying to catch up...reading reading reading...I remember you loading Bagel, then I got lost, and now here I am...I think you are doing just great and I will be hoping things settle into a routine for you soon!!!
Hugs, Beth, Bailey and always Scoobie

[Bagel's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

thank you ALL....

I have some thinking to do here and I really like the idea of splitting these doses! She is such a special girl and I know you ALL understand THAT!
HAPPY FRIDAY!

Sande

[Sabre's Mum]

Re: Bagel - Beagle/Bassett - Lysodren

Hi Sande

I just wanted to say hi ... I have been catching up on you. It looks as tho you have been in good hands. I haven't had a chance to look at Glynda's link about Dr Feldman ... but he co-authored a textbook with Dr Nelson which is considered to be the "bible" on cushings. If you search his name on the internet he has done so much research and lectures on cushings. We are about to restart on Lysodren on the same dose as Bagel - 4 x weekly dosing, 1/2 tab.

Now with the ACTH ... this is how I have done it if I do 4 x weekly dosing. If you wanted to continue with Saturday testing ... you could do Tues, Thur, Sat, Sun.

I know it is difficult with your vet being "fixed" in their way of doing things. Maybe when they have confidence in your expanding knowledge they may take a "team" approach which I believe is absolutely necessary in the case of cushings. you are the one that sees your dog everyday and can monitor their well-being. Your vet only sees them every once in a while. My vet used to be very fixed and adamant in the way I was to medicate Sabre. She now knows that I am constantly reading and keeping in touch with this forum that we now have "discussions" about our dosing changes and we come to an agreement of where to go next. Sabre has yet to actually stabilise on any maintenance dose ... unfortunately ... so sometimes we are playing a guessing game!

I hope that you are able to sort everything out for Bagel.

Take care
Angela and Sabre

[Bagel's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

Hi Angela!

Early Saturday morning and a great quiet time for thinking.
I totally adore and respect my vets- we have been together 10 years since they opened- they have the rep for being the best and are involved or in charge of so many local animal care venues along with their practices- so I feel that they have our best interests and are doing what they know best-

I did read a lot about Dr. Feldman and I am convinced that it's kinda like the old days of the pediatrician's advice....sometimes you have to do what you have to do.........and I am a researcher!

I am not locked in to SAT testing- in fact, they don't even do that on SAT but he does it for me because the last loading day was a Thursday- so that is when he wanted her maintenance dosing day to be-

When she loaded and I was sure she was- due to the appetite and water decrease- I talked them into testing her even though it was day 6 and he wanted her to do 8 days. Her post was 5.9 and I am wondering if we started maintenance when it was too high and I missed the signals?

ANYWAY....
five weeks into maintenance- she does have more energy- appetite is always good but not voracious- stools are very soft the next days after that huge one day dose...and then the UTI this week...

The bad day she had diarreah (week 4)- when I came home it was dinner plate size on the carpet which she had never done.I was so worried this week when I dosed her that I would come home and find it again- I didn't thankfully. But for the last two days after the 1000 mg day it is very loose.
So gut feeling- I want to spread these doses out.

He said unless symptoms or behaviors changed, we wouldn't test again for three months. By then nobody will remember what day(s) she doses.. by that time I will be out of school for summer break and any day will work for us...

So bottom line, if I go from 1000mgs on one day to 250 over 4 days, there will be less shock to her system and more continuity to the medication working?
I will continue to research and read this forum- it just makes so much sense to hear over and over how people spread the dosing out!
Sorry for the book here- I am more productive in the early hours! HA
Sande

[ChristyA]

Re: Bagel - Beagle/Bassett - Lysodren

We spread our dosing out also. It worked very well. Dexter didn't get the blahs when we spread it out that he would get if given a big dose on one day.
Christy

[Bagel's Mom]

Re: Bagel - Beagle/Bassett - Lysodren

Hey All,
Well. my brother says I am obsessing..and of course I am over this dosing thing.( His cat is 20 1/2 years old so HE would know HA)

I have read over and over the articles where Dr. Feldman has said 4 X a week when possible. ( what would "possible" mean?) Would impossible reflect on an owner's being ABLE to keep that schedule or what?

If the Lyso is a slow moving drug and stays in their system 48 hours, then
a schedule of 1/2 pill Tues Weds Fri Sat would keep her medicated all week long consistently and then be ok for a STIM on Monday mornings...which, unless she starts showing symptoms, won't be til July.

I guess if she gets symptomatic I would have to get her tested and have to confess not following his directions. BUT
a chance I will have to take? It just makes so much sense and the fact that Dr. Feldman has concentrated his studies to treating this disease for sooo many years...

Ok how does that sound for dosing, all ye who have this down so well?

Sande