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  #101  
Old 05-06-2009, 01:41 PM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

OH MY LORD!!!!!

I feel like the MAD Scientist!!!

I don't know what I would do without all of you

What do people do with vets that don't know any of this (Most of them)!!!
None of them that I've met!!!!!!!!!!!!

And Peterson and the (other) vet were going to start Jesse right off on 90 mg. once a day - and NO PREDNISONE!! Oh - I hate to think of it!!!

My mother called the vets last night at midnight (emergency vet) to get prednisone (we thought - maybe that's what is was - too much Trilostane for Jesse.)
I explained what was going on - the vets that are working with Jesse now work at the same place. The vet on duty said NO! He doesn't need prednisone with trilostane. Do you know I have asked (lets see) 6 , yes 6 vets and they all said they would not give me prednisone." You don't need it!!!" they insist.
He was drinking from his water bowl and he just fell over - can you imagine what we were thinking at that point.
We were both on the floor all night with him crying our eyes out - all night!!
We had never ever seen him like that. It was awful.

He is almost back to himself at this time today 4:30 - thank GOD.

Yes, 15 / 15. I wonder if I should wait another day. Start Friday - maybe??
Or 15 just tomorrow morning. I don't know.

I do know that his water consumption (I told you) went down to about 3/4 gallon from 2 1/2. Think about it.

And yes, I've learned about the arthritis from you guys and I have UP'D all of his arthritis stuff. Big time.

You don't have to take this personally - But I love you guys.

Thank you from the very bottom of my heart - Jesse's too, and my Mom too.

Patti and Jesse
  #102  
Old 05-06-2009, 01:49 PM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Sharon, Oh how I wish I could find someone.

I've been to the endocrinologist (specialist), he's the reason Jesse hasn't been treated till now - we saw him in January. He told us to NOT treat Jesse because the drugs would surely kill him, yes he said kill him.
When I asked him what would happen if I didn't treat he said "nothing" - Jesse would be just fine.
Well, that was a lie that I'll never ever get over.

This is my 6th vet - and not one of them has used trilostane. I called every vet around, believe me. (One did but he admitted he really didn't know what he was doing - dosing every other day)

Yes, I can see how trilostane could be extremely dangerous

Can that urine test tell "anything" at all that would be helpful till the next blood work gets done???

Thanks Sharon
  #103  
Old 05-06-2009, 03:22 PM
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Lulusmom Lulusmom is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Patti,

You aren't the first member whose vet has not used Trilostane. I can think of at least three members off the top of my head that helped educate their vet. Sooo, don't panic, girlfriend. It won't hurt to hold off on the Trilostane until Friday and then only do the 15mg twice daily. It's always better to take it nice and slow. By doing so, you may end paying for a few more acth stim tests but it's worth it to make sure that Jesse doesn't go through this crap again. I think somewhere back in your thread somebody (probably Marianne) told you that UC Davis uses a very conservative dosing protocol, something like 1mg/kg. I can't remember how much Jesse weighs but I would think 15mg twice daily is more in keeping with their protocol. I personally much prefer UC Davis protocol to Dechra's, the manufacturer.

A lot of vets do not prescribe prednisone when treating with Trilostane as it's half life is pretty short. Most dogs bounce back rather quickly by just withholding the dosing. I personally kept it on hand when I was treating my two with Trilostane but never had the need for it. If they ever got sickly, I just took them off of it for a few days. My vet and IM are more familiar with Trilostane and knew that I wanted Prednisone for sleep insurance. Just keep twisting your vet's arm. Tell him that Trilostane can throw a dog into an addisonian episode just as sure as Lysodren can and that while rare, there are documented cases of total adrenal necrosis.

Glynda
  #104  
Old 05-07-2009, 08:34 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Glynda and friends,

I am so happy to report that Jesse is Much better today, his legs are stronger.
He slept really good last night - which helps anyone. (not that I would know)
I'm waiting for the vet to call me today, I'll tell him that going up to 30 - 30 was overdosing him.
I'm not expecting him to tell me much, (remember he knows nothing about trilostane) but I'm sure he'll agree with sticking with 15 - 15.
I'm wondering about just 15 once a day.

I know some of you are saying to find and listen to a good vet, and I agree. But already, if I had listened to 3 of them, Jesse might just be a memory.
But he is HERE - RIGHT NOW - and I"M LOVING HIM WITH ALL I'VE GOT

Jesse is back up to 2 gallons a day - which is a bummer.

Having walking legs is a priority. I am so hopeful he gets better, thank you all for your wonderful wonderful support.

A friend of ours is waiting for the cush test report today, a beautiful husky named Sebastian. I'm hoping for best - his parents are incredibly dedicated to him - as all good parents should be. He's a lucky lucky dog and they are lucky lucky parents.

Patti and her boy Jesse
  #105  
Old 05-07-2009, 10:28 AM
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Lulusmom Lulusmom is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Patti,

I think Jesse will be okay on 15mg twice daily and at this point. Without having an acth stim test done the day a dog shows symptoms of overdose, it's almost impossible to tell if the adverse reactions are due to cortisol withdrawal or if the dose is too high. Jesse's acth stim will tell the tale.

I do hope you will encourage your friends to join our community. We'd love to hear about Sebastian and help in any way we can. My ears always perk up when I hear Husky and cushing's in the same sentence. They are a nordic breed like my Pomeranians, Lulu & Jojo, and are predisposed to adrenal hormone imbalances. They should never be treated with Trilostane without first having a full adrenal panel done by the University of Tennessee, so remember to pass that on in case we don't get the pleasure of meeting your friends.

Glynda
  #106  
Old 05-07-2009, 02:37 PM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Glynda,

If the dose is too high.........then wouldn't the cortisol withdrawal be too quick??
I'm confused.
Can you explain a little more.

Without having an acth stim test done the day a dog shows symptoms of overdose, it's almost impossible to tell if the adverse reactions are due to cortisol withdrawal or if the dose is too high.

I did send your response and the site to Sebatians parents.
I know they are extremely concerned.

Thanks so much Glynda
Yes, Jesse was on the 15 / 15 for 4 days with no problems.
I'm sure that's when the water went way down - so something positive was going on.
  #107  
Old 05-08-2009, 09:11 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi All,

Another question.

If trilostane is such a short acting drug, why is it recommended to wait 5 - 7 days before restarting ?? AGAIN

Patti and Jesse
  #108  
Old 05-08-2009, 09:29 AM
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Squirt's Mom Squirt's Mom is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Patti,

This is my understanding....even tho the active effectiveness of the Trilo stops after a few hours, it still remains in the system in a lessened or, perhaps, altered less effective form. While this lessor form remains in the system, it is not wise to add another drug that could very well kick the remainder of the Trilo into action, or interact in some other negative way. Remember, medicines are chemicals and each chemical has unique properties. These individual properties work as intended until mixed with some other chemical, and then they interact producing consequences neither chemical alone could.

Think of it like using bleach to clean. We know that it is very unwise to mix any other cleaner with bleach as they will react and can cause a gas that is quite harmful. You make sure the bleach residue has been wiped up good before using anything else. The same with Lyso and Trilo. We want to make sure the first drug (bleach) is completely out of the system (wiped up good) before putting something else (Pine Sol) in the system. Unfortunately, it takes a bit longer to wash drugs out of the system than it does to wash bleach off.

This washout period (which I would feel more comfortable at 30 days) gives you a good opportunity to learn as much as you can about Cushing's and the various tests/treatments. It is obvious that you are doing a great deal of thinking about all this stuff and doing a good job of asking questions. Questions are one of the best ways to learn!

I hope Jesse is doing ok today and that you are feeling a bit calmer about things now.

Hugs,
Leslie and the girls
  #109  
Old 05-12-2009, 11:37 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi, Its been a few days. Here's the update:

Jesse has been on just "15" mg of trilostane for 4 days now (this is day 4).
I know - its a very small dose - Jesse is 85 lbs.
He is sleeping and resting the best he has in a long time. Sleeping normally at night now - not wide awake till the wee hours of the morning.
He is walking much better (stronger) and he is just acting more like himself.

I'm going to keep him on 15 for one more day and then go to 15 am 15 pm.
I just do not want to risk making him weak again - it took too long for him to recover. (maybe 3 - 4 days)
The vet said that sounded good. (don't forget - he's never used trilostane)
Anyway, so far so good, I like what I'm seeing.
Thanks again everybody.

Patti and Jesse
  #110  
Old 05-14-2009, 07:19 AM
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Squirt's Mom Squirt's Mom is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Patti,

I saw your post on John the Grey's thread and wanted to give these links to you, too. They are more current than the one you posted on the lecture notes, tho that link has some valid info still for sure. These studies are the ones done in the US and the UK plus some other places and were apparently used to help get Trilo approved in the US. Kathy (We Hope) posted these a little while back:

http://www.fda.gov/cvm/CVM_Updates/D...ingDisease.htm

http://www.fda.gov/cvm/FOI/141-291o120508.pdf

How is Jesse doing? I hope you are seeing some improvement.

Hugs,
Leslie and the girls
 

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