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  #41  
Old 04-24-2009, 10:39 AM
frijole frijole is offline
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Default Re: Jesse just diagnosed with Cushings

Luckily that secretary already knows what you have been thru... I'd try to get the results straight from the expert and cut out the guy who bolted on vacation. That is unfair. You can't be expected to wait another week. I am confident you will get them to share the results. You are a great advocate for your dog Patti. hang in there and let us know what happens.

Kim
  #42  
Old 04-25-2009, 03:08 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

I picked this up yesterday at the office of my new vet that flew the coop till next Thursday

Corisol Pre 5.9
Cortisol 2 26.7

Some other vet up there told me that the adrenals were both very slightly enlarged but that was indicitive of pituitary.

Peterson's secretary said that Peterson did look at Jesse's test but would call the first vet (that also flew the coop for a week without telling me)on Monday or Tuesday.

By the way, I wish you could have all been there - the stand in vet told me to go ahead with trilostane - not to ever use lysodern - he said they don't call it ODD for nothing - he said the DD stands for DEAD DOGS, in fact every dog he's treated with lysodern has died. !! (That is exactly what he told me)
I could start with 120 a day if I wanted - I mentiond davis' protocol and he said well - if I want - start at 60 a day, or 30 a day, he said to go with whatever I felt more comfortable with - he would leave 30's 60's and 120's all at the desk - take whatever you want he said.

Are you beginning to see why I called Peterson, not that he is panning out either now. The vet thats returning from his vacation on Monday has never treated a dog with trilostane and he also has lost 3 dogs to lysodern.
Can you see where my fear comes from now.
Remember, this all started (or didn't start) with the expert specialist endo. in west hartford that told me to NOT treat cushings!! the drugs would kill him before the disease he said, reading the forum (whherever that went) is the only thing that kept me searching, and watching my dog - lets just say getting sadder. God - I LOVE MY JESSE BOY.
  #43  
Old 04-25-2009, 06:05 AM
frijole frijole is offline
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Default Re: Jesse just diagnosed with Cushings

Patti,

I can totally understand your frustration as those comments about all of their dogs dying from lysodren is crazy - unless of course they are not following protocol and are over or under dosing all of them. But you are armed with knowledge.

The results you shared are from the acth test. The first number really doesn't matter. The 2nd number means the cortisol is elevated and could be cushings. You mentioned the adrenals were slightly enlarged (both). I believe that does indicate pituitary but I am hoping to get confirmation from others. Did they ever do the 8 hr test (LDDS)?

So what is the next step? Wait for your vet to return or did you leave with the trilo?

Hug Jesse for me!
Kim

Last edited by frijole; 04-25-2009 at 06:09 AM.
  #44  
Old 04-25-2009, 06:24 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Kim, Yes we did the 8 hour.

here is what I'm looking at.

Pre dex 7.6
post 4 hour 8.4
Post 8 hour 8.8

Does that mean anything to you??

Thank you , Thank You, for responding.
Did I tell you 2 ultrasounds and both vets didn't see a problems with adrenals
(adrenal cushings).
  #45  
Old 04-25-2009, 06:29 AM
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Roxee'sDad Roxee'sDad is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Patti,
wow what a vet!!!!! Pretty much giving you the okay to use whatever dosage you want

As you know there are plenty of Lyso and Trilo success stories here

some do better on one than the other. I personally don't use Lyso but although I do see some improvements, I am contemplating depending on Roxee's next stim which I am also considering a UTK panel. I will be discussing future treatment soon with some of the other more experienced people here.

I caution you to not jump the gun here. As you know Cushings is not an immediate death sentance and it takes time to do it's damage. Be absolutely sure of the dx and the proper treatment with protocol followed correctly.

The stand in vet, well, I would mention your conversation to your regular vet as he is totally out place saying that and if all his dogs died from using lyso, I wouldn't let him check my pups heartbeat

Hang in there, I'm sure the others will chime in to help you sort this out. Your doing a fine job of learning and questioning everything. Knowledge is power (to save your pups life) and keep your sanity.

Wishing you and Jesse all the best. (Don't rush into anything)
John (Roxee's Dad)
  #46  
Old 04-25-2009, 06:43 AM
frijole frijole is offline
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Default Re: Jesse just diagnosed with Cushings

Patti - I do not have my LDDS chart "handy" right now but those numbers do not look indicative of pituitary to me. Unfortunatley I am heading out to an appointment but I will return later to check to see if anyone else has had time to look at those numbers and comment.

Cushings is sometimes difficult to diagnose and frankly thats why the forum was created to begin with... so you aren't alone. I would personally not give a drug yet.

I promise I'll check back in later today! Sorry I have to run.

Hugs
Kim
  #47  
Old 04-25-2009, 07:17 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Your the third person to say it may not be pituitary, if its not - then what?
These things always happen on the weekend it seems.
The ultrasound s don't come up with other organ problems, liver, kidney great, so they say, could it be something totally different, even with the potbelly, thirst, hunger, panting.??
  #48  
Old 04-25-2009, 08:04 AM
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Lulusmom Lulusmom is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Patti,

I think cushing's savvy vets should grow on trees right next to the money tree that cush parents need to get their babies correctly diagnosed.

Quote:
Originally Posted by Patricia ann Wh View Post
I picked this up yesterday at the office of my new vet that flew the coop till next Thursday

Corisol Pre 5.9
Cortisol 2 26.7

These numbers are definately consistent with cushing's. Some other vet up there told me that the adrenals were both very slightly enlarged but that was indicitive of pituitary.

You mentioned is another post that somebody said both adrenals were enlarged. Bilateral enlargement of the adrenals is common in PDH; however, there have been cases of adrenal tumors in both adrenal glands. I am assuming that the ultrasounds were done on a high quality, high resolution machine and that the findings were interpreted by an experienced radiologist? Did you get copies of the findings so you can post them here or did your vet(s) pass on the information? In your position, I would be very interested in the ultrasound as the LDDS results you posted are more inidicative of an adrenal tumor.


Peterson's secretary said that Peterson did look at Jesse's test but would call the first vet (that also flew the coop for a week without telling me)on Monday or Tuesday.

By the way, I wish you could have all been there - the stand in vet told me to go ahead with trilostane - not to ever use lysodern - he said they don't call it ODD for nothing - he said the DD stands for DEAD DOGS, in fact every dog he's treated with lysodern has died. !! (That is exactly what he told me)
I could start with 120 a day if I wanted - I mentiond davis' protocol and he said well - if I want - start at 60 a day, or 30 a day, he said to go with whatever I felt more comfortable with - he would leave 30's 60's and 120's all at the desk - take whatever you want he said.

Oh my gosh, this vet is unbelievable! Did you know that the actual percentage of dog whose death is attributable to Lysdoren is minute...something like 1%? Let me just say that there is no way on earth that I would let this vet touch one of my cushdogs.

Are you beginning to see why I called Peterson, not that he is panning out either now.

It sounds like Dr. Peterson is the only medical professional involved in Jesse's case that knows anything about cushing's and the appropriate treatment for your boy. I would certainly not start treating with Trilostane until you or your scarey vet gets direction from him. I so wish you could travel the 2 1/2 hours to meet face to face with him. You may want to reconsider doing just that. I pack a lunch when I take my two to the IM because the specialty hospital is far away and it's usually a several hour appointment. Just like you, I learned that not too many gp vets have the experience necessary to diagnose and treat a cushdog; however, I've never run into any that were quite as scarey as the ones you've had. It's worth the time and travel to me to make sure my dogs are in the best hands possible.

The vet thats returning from his vacation on Monday has never treated a dog with trilostane and he also has lost 3 dogs to lysodern.
Can you see where my fear comes from now.

Absolutely and I would also fear for any cushdog that might walk through his door.

Remember, this all started (or didn't start) with the expert specialist endo. in west hartford that told me to NOT treat cushings!! the drugs would kill him before the disease he said, reading the forum (whherever that went) is the only thing that kept me searching, and watching my dog - lets just say getting sadder. God - I LOVE MY JESSE BOY.
I really hope that you hold off on treatment until you can talk to Dr. Peterson. Sorry for forgetting to send that bio that I ran across. Better late than never ya know.

http://www.hypurrcat.com/bio2.html

Glynda
  #49  
Old 04-25-2009, 08:18 AM
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Lulusmom Lulusmom is offline
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Default Re: Jesse just diagnosed with Cushings

Quote:
Originally Posted by Patricia ann Wh View Post
Your the third person to say it may not be pituitary, if its not - then what?
These things always happen on the weekend it seems.
The ultrasound s don't come up with other organ problems, liver, kidney great, so they say, could it be something totally different, even with the potbelly, thirst, hunger, panting.??
If it's an adrenal tumor, surgery could be a permanent cure if Jesse were a good candidate for surgery. If surgery isn't an option, then Lysodren would be the appropriate treatment for an adrenal tumor.

Most often, dogs with cushing's have some type of liver abnormality. Are you sure the ultrasound showed a perfectly normal liver? I think there is pretty good evidence that Jesse has cushing's and that cortisol is elevated which would explain all the symptoms you mention above. However, any one of the other adrenal steroids and hormones can cause those symptoms too, especially if estradiol is elevated. Whether one or more of the other adrenal steroids and hormones are also elevated can only be determined by having a full adrenal panel done by the University of Tennessee.

Trilostane does a beautiful job of reducing cortisol but it always increases one or more of the other adrenal hormones. If a dog already has elevated hormones, you can rest assured that you'll probably see symptoms return at some point down the road as Trilostane will exacerbate the condition. I am a firm believer that, without exception, this panel should be done before starting Trilostane. Lysodren, on the other hand, does a great job of controlling all of the adrenal steroids and hormones so I wouldn't necessarily pay for this test if I chose to treat with Lysodren.

Glynda
  #50  
Old 04-25-2009, 08:23 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Jesse just diagnosed with Cushings

Hi Glynda,

Oh Thank You for getting back, Can you believe these guys??

Yes, I will have to wait for Peterson, it would have been nice if he could have talked to me too, in fact when I called he picked up the phone and asked my name, I recognized his voice from a much earlier (quicky) conversation. When I said my name he quickly handed the phone to his secretary.
I called back at 4:30 - he had just left for the weekend, to return - I believe she said Tuesday.

So - the numbers sound like pituitary. Both ultrasound people supposedly are very good, they've been around a long time. Both agreed on the adrenals.

It seems like lysodern does have more severe side effects ( if used improperly) and with the scary scary stories these vets have with lysodern - can you see why I'm leaning towards trilostane.

The more I've been reading - low dose seems the way to start out.
Patti and Jesse
 

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