Border terrier and Lysodren-UC Davis visit

[KatharineWeber]

I had previously posted about my 12 year old Border Terrier who really struggled with Lysodren. It just devastated her. After the loading phase, she never recovered enough to get going on the maintenance dose. I gave her 1/8 of the maintenance dose and **wham**, she could not tolerate it.

I was fortunate enough to get an appointment with Dr. Nelson, at UC Davis for April 14th. He is the Vet who literally wrote the textbook on Cushings in dogs (he told me he's treated over 1,000 dogs!). At the time I saw him, Zoe had not been on any medication (no Prenisone, no Lysodren) for two weeks. She was pretty weak.

He did the blood test and her values were very, very low. He decided the Lysodren may have knocked her adrenals completely out. Like: end of Cushings. He's seen it happen before. He put her on 5 mg of Prednisone twice a day for a couple of days and of course, she responded nicely. Then he tapered me off to 2.5 mg twice a day and now I am down to 2.5 mg once a day. We've been doing that for the last four days. I can honestly say, she's back 100%.

Dr. Nelson has kept in touch with me via email and always responds. He's very dedicated (a lot younger than I expected and quite cute, too!) Given that it is a teaching hospital, I intially saw a About-to-Graduate-Vet-student who spent an hour with me examining my dog. Then he consulted with Dr. Nelson, who came in with the student and spent another half hour with me. I only paid for the blood work and tests, about $300.00.

The plan is to taper Zoe off the Prednisone and see if her adrenals kick back in. He said if they do, and they begin overproducing again, he will try Trilostane (I may have spelled that wrong). If she begins to get week, he will just keep her on a maintenance dose of Prednisone.

So that's where I am at.

[Roxee'sDad]

Hi Katharine,
Wow, I am so happy that Zoe's is doing so much better. Yes, it sounds like she was overloaded to the point of addisons.

I am really happy for both of you and will keep good thoughts and prayers that it all continues to go well.

And .... thanks for comming back to updates us. It is amazing what a well informed vet can do. Hope some of his students move out here

All my best to you and Zoe.
John (Roxee's Dad)

[labblab]

Hi Katharine,

I just want to chime in with John to say how glad I am to hear about Zoe's progress! We are also so glad that you and Zoe have rejoined us here!!!!

I have one favor to ask of you. A number of us have been wondering whether UC Davis currently has a written protocol or set of guidelines that they follow regarding trilostane treatment and monitoring. If you look at this link, you will find an excerpt from a 2007 journal article that summarized the monitoring guidelines that UC Davis was using at that time:

http://www.k9diabetes.com/forum/showthread.php?t=745

But we are wondering whether they have changed their recommendations during these past two years. If you would feel comfortable asking Dr. Nelson whether they have any current published guidelines, we would surely appreciate reading them! But of course the decision whether or not to ask is entirely up to you.

In the meantime, all best wishes to you and Zoe, and please keep us updated!
Marianne

[Squirt's Mom]

Hi Katharine!

Glad to see you finally got all the kinks worked out and were able to post!

Sounds like Zoe is in excellent hands with Dr Nelson and I am so glad you got to see him! I hope the pred keeps Zoe feeling good and that her adrenals regenerate just enough to do their job!

Keep us updated when you can!
Hugs,
Leslie and the girls

[Sabre's Mum]

Hi Katharine

Fantastic that you found your way over here. I was looking forward to your update on Zoe then .. kapooffff... cc.net disappeared.

It is great that she is feeling better and that Dr Nelson has a plan of attack!

Just out of interest .... what were Zoes pre and post values for her ACTH at UC Davis?

Take care
Angela and Sabre

[ChristyA]

I too was wondering how Zoe was doing, glad you're here. It's good to hear she is doing well.

Wow a young, cute, vet, that knows about Cushing's - how lucky can you get!

Christy

[KatharineWeber]

The post test done by Dr. Nelson was 1.4 ug/dl. Uncertain what the pre-was. She had one done about 5 days before that and it was 3.3 and 3.5 but he said the Prednisone she had been on was giving inaccurate readings.

And yes, I will email him about the protocol issue so stand by.

It was hard finding you guys. I finally googled "what happened to the canine cushings forum?" and there you were!

[Sabre's Mum]

Hi Katharine

I wonder whether, once again, Zoe's pre and post numbers were non-stimulatory and therefore Dr Nelson's comment on her "Lysodren may have knocked her adrenals completely out". Generally a post value of 1.4 is "A" OK for a cushings Lysodren treated canine. As I posted on cc.net we generally only look at the post but when it comes to a dog "going low" the pre value is also looked at.

I don't know, and can't recall, your administration of pred and when the ACTH test results were done but it is my understanding that generally it is ok after 24 hours off pred before you can get reliable results for and ACTH.

Angela and Sabre

[stardeb55]

Katharine, I'm thrilled you & Zoe found us! I was truly heartsick with the terrible problems that Zoe had been having when the forum went off-line. I thought at least you had that appointment at UC-Davis coming which would give you the final say-so.

Unfortunately, I was very worried that this was going to be the case that Zoe may have been made permanently Addisonian when you posted her loading dose on the old forum which I think was around 72 mg/kg. Hopefully, her adrenals will regenerate on their own, but this may take quite sometime to occur. With her numbers being so low, did Dr. Nelson check her electrolytes & say anything about regular monitoring of her electrolytes for the next little while?

Debbie

[dees]

Hi Katharine! I am glad the UC Davis vet visit went well. Keep us posted. DeeS