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**Wylie's Mom** · 04-21-2009, 01:13 PM

Re: Nikki may need re-load

I hope she starts to feel better after being back with you!! They say you shouldn't treat a dog with Lysodren if they are sick or not feeling well. IMO, I agree with your vet that you will have to re-load, but I would definitely wait until she feels better. I can't comment on other factors influencing her cortisol levels - I would just be guessing - I can't figure it out with Wylie either!

I'm glad you found us!

-Susy

**Squirt's Mom** · 04-21-2009, 01:42 PM

Re: Nikki may need re-load

Hi Sharon,

I'm glad you and Nikki found us!

I second what Susy said about treating a sick pup. Typically, stress will cause the cortisol production to increase, but with these cush pups, you just never know. Some of them simply don't do "typical" !

Did the people where she was boarded have to dose her while she was there? Did they dose her with her not eating, etc?

Trying to get an accurate result if she is that stressed might be difficult. But if she is not improving steadily and fairly quickly, I think I would have her checked out just to be sure nothing else is going on. Maybe your vet's staff would let you and Nikki stay in your car until it was time for her to be seen and that might lessen the stress on Nikki.

Hoping she is better soon!
Hugs,
Leslie and the girls

**nikkismom** · 04-21-2009, 01:58 PM

Re: Nikki may need re-load

Thanks Leslie and Susy! They did dose her on Friday when she wasn't eating much.She's not eating dog food now but will eat any human snack I give her. She has terrible diarrhea, so it's probably best she doesn't eat today.Maybe her insides will get a rest, then I'll try pumpkin and Forta Flora tomorrow. If she's not getting better she will go to the vet Thursday, or I will at least talk to her.I knew when I left her she would have some problems. I just hope she can recover.

**stardeb55** · 04-21-2009, 02:57 PM

Re: Nikki may need re-load

Sharon, as we discussed before your trip, & the site went down, a reload is going to be unavoidable with that post of >8. Illness/stress will normal raise the cortisol level even further. As the others have already mentioned, you DON'T GIVE lysodren to a sick pup EVER, no matter what the problem is.

Debbie

**AlisonandMia** · 04-21-2009, 03:06 PM

Re: Nikki may need re-load

Hi Sharon,

I think it sounds like Nikki needs to see the vet sooner rather than later - it sounds like it is possible that she has picked up some sort of infection while at the kennel. If the diarrhea is bad she may well be quite dehydrated and her electrolytes may be depleted especially if she isn't eating and if the diarrhea has been going on for some time.

Until you can get her to the vet offering her some Pedialyte or similar may help her a lot. If it is late at night and you can't get hold of any then something like a pinch of salt and a teaspoon of sugar in 2 pints of water is a fair substitute. I'm not 100% sure on those measurements so I'll go check and edit if necessary.

Oops! Not enough salt - or sugar! Good thing I checked. See: http://rehydrate.org/faq/how-to-prepare-ors.htm
http://rehydrate.org/faq/how-to-prepare-ors.htm

and another one: http://www.recipezaar.com/Oral-Rehydration-Salts-230966

One other thing - be very careful regarding your hygiene while cleaning up and handling Nikki while she is sick - depending on what is causing the problem some of these things can be passed on to humans!

Good luck and keep us posted.

Alison

**ventilate** · 04-21-2009, 04:53 PM

Re: Nikki may need re-load

I understand what you are going through. I have to leave my dogs at a kennel 3 times a year at 10 days at a time. I leave them at the same kennel as they are very good to them. About a year or more ago, I left them,when I got home for the first time I had to consider the thought that I was going to have to set Nike free from her pain. She was lethargic, could hardly stand or walk. I cried and cried then gave her pred thinking it cant hurt and it did not. In fact within a couple hrs she was back to her normal self. So even though her stim numbers were excellent she still dropped down, I believe due to the stress. Have you talked to your vet about giving pred to see if it helps your pup now? Now when I leave them, Nike gets 5 mg of pred daily ( she is a 85 lb dog so the 5 mg is a tiny bit for her) but it has made the difference and I wean her off when I get home.
Good luck with your pup and I hope Nikki feels better soon.
Sharon, Nike and Kenai

**AlisonandMia** · 04-21-2009, 05:07 PM

Re: Nikki may need re-load

Another thing just occurred to me - you may want to check that Nikki's medication (Lysodren) was done correctly while you were away. Is it possible they thought it was an every-day med?

Alison

PS: I see Leslie has touched on that already but it might be worth double checking especially if more than one person was involved with her care.

**nikkismom** · 04-22-2009, 06:04 AM

Re: Nikki may need re-load

Thankfully, I only left one capsule plus a pill pocket. I am worried that it was probably given when she was not eating, ie empty stomach.But Nikki seems better today, but still won't eat her dog food.She'll eat anything else. I'll probably try cooking egg and rice with chicken broth if she doesn't eat her normal food later today. I do know she will never be boarded again.

**ventilate** · 04-22-2009, 02:05 PM

Re: Nikki may need re-load

Did you speak to your vet about maybe trying a bit of pred to see if that helps?

**nikkismom** · 04-22-2009, 02:32 PM

Re: Nikki may need re-load

I didn't because she is really against it except in emergency situations. Every time I've given it has been on my own. But Nikki is much better. She ate the dinner I cooked her and we'll see what it does to her stomach. So far so good.

**ventilate** · 04-22-2009, 02:40 PM

Re: Nikki may need re-load

Great; Hope it continues
S

**nikkismom** · 04-29-2009, 07:18 AM

Re: Nikki may need re-load

I need help! Just got off the phone with the vet and Nikki will have an acth tomorrow. The problem is Nikki feels better than she has in a while. I'm sure her post number is high because before our trip it was 8.7.My vet says there is no maximum dose of lysodren.She said she has had dogs on twice the recommended dose and they are fine. Nikki is already on 400 mgs/week and her number is creeping up. I asked if she ever splits the dose into three and she said it wouldn't make any difference. Is this right? She acts like she is very experienced in cushings, but I don't know. She did say she will treat the dog and not the disease, so if Nikki needs to maintain a higher number that's okay.When her post was 8.7, her pre was 7.8, which means she was really stressed,so that post number wasn't so bad, right? I'm so confused! She said Nikki isn't feeling bad because of the lysodren but because of the reduction in cortisol, but how do you know that? And if the reduction in cortisol makes them feel bad, how is that good? When her cortisol was 50, she felt fine except she was starving and drinking and peeing.She certainly had more energy. Wow, this is so hard! Sharon

**Wylie's Mom** · 04-29-2009, 08:32 AM

Re: Nikki may need re-load

(I'm trying to reply like Glynda sometimes does)

Originally posted by nikkismom View Post

My vet says there is no maximum dose of lysodren.
My first impression is that they are wrong, but maybe they need to clarify what they mean by this.
She said she has had dogs on twice the recommended dose and they are fine.
They need to specifically define (in mgs/kg) what they are referring to as recommended dose - and recommended for loading or mantenance - maybe they are misunderstanding the actual recommendation
Nikki is already on 400 mgs/week and her number is creeping up.
This is why we think she may need a reload
I asked if she ever splits the dose into three and she said it wouldn't make any difference. Is this right?
IMO, it absolutely does make a difference. Please read through Bagel's thread:
http://www.k9diabetes.com/forum/show...p?t=743&page=2
When her post was 8.7, her pre was 7.8, which means she was really stressed,so that post number wasn't so bad, right? I'm so confused!see below from Bagels thread
She said Nikki isn't feeling bad because of the lysodren but because of the reduction in cortisol, but how do you know that? I don't think she can know for sure, but maybe the stim test can give a leaning towards a reason
And if the reduction in cortisol makes them feel bad, how is that good?
I believe sometimes the pace of the reduction can make a difference
When her cortisol was 50, she felt fine except she was starving and drinking and peeing.She certainly had more energy. Wow, this is so hard! Sharon
Yes, that may be the case, but if left untreated over time, the high cortisol can do more visible damage - skin infections, ear infections, high blood pressure, liver issues...you know!

This is from Bagel's thread:

Originally posted by Wylie's Mom View Post

One thing I'm curious about, and maybe someone can please clarify this for me, is the pre of 7. I'm not sure if the high pre means anything. Does it matter that the pre-7 is only 1.8 lower than the post-8.8??

Originally posted by Lulusmom View Post

When interpreting an acth stimulation test for purposes of monitoring cushing's treatment, the pre or basal number is of little value. The normal basal range (most labs) is 1 - 6 so 7 is a bit high and is probably due to the stress of being at the vet's office. I hope this helps.

Glynda

**Wylie's Mom** · 04-29-2009, 09:09 AM

Re: Nikki may need re-load

Oh yeah - I think she wants to do another stim because you are going to re-load

? How long ago (in weeks) was her last stim where post was 8.7 & pre was 7.8?

I have to go now, but I will check back later

.

-Susy

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