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  #21  
Old 05-15-2009, 03:16 PM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi All,
Well it's time for a Roxee update:

ACTH Stim Test:
Yesterday May 14, 2009
40mg Trilo
Pre: 0.7
Post 1.7 (within range, not sure a celebration is in order)

March 12, 2009
40mg Trilo
Pre: 0.7
Post: 5.2

Feb 12, 2009
30mg Trilo
Pre: 0.9
Post: 10.2

They also ran a short bloodpanel, Can't believe her improvement in ALK and ALP

ALK 213 (23-212)
ALT 57 (10-100)

In 2006:
ALK 705 (10-150)

You can check all Roxee's records and history in an updated excel file at http://spreadsheets.google.com/pub?k...tafT0A0-ejnkOg
At the bottom of the excel page are tabs for acth, urine, bloodtest, weight and so one. Records go back to 2005.

Yesterday was stim day and it was rough with the panting and all. She recovered nicely by evening. She was very strong last night and very strong today

So is the cortisol going to continue to drop or stablize? I guess we have to continue to watch her for symptoms of too low cortisol I guess I'll keep my twitcher turned on

Bad news: Roxee is down a half pound to 12.2 She is eating 3 to 4 meals a day, get's little to no exercise Are the sex hormones involved

It looks like all her bio chemistry is lookin good but I am lacking the sex hormone information. Wish I had gotten the UTK in the begining still may have to consider doing it. Will discuss with our vet next week.

That's it for now. Maybe I will have a margarita tonight

Belly Rubs to all your furBabies.
John (Roxee's Dad)
  #22  
Old 05-15-2009, 03:28 PM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi John,
I would be a little concerned that Roxee's stim was too low......
In the Vetoryl flowchart it says for a post less than 50 nmo/l (1.8) to stop treatment for 7 days and restart at a lower dose.
I would be keeping a close watch on her like you already are doing. Was your vet concerned about the low number?
Jenny
  #23  
Old 05-15-2009, 07:51 PM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi John & Roxee,

There's always something, isn't there?
Hope Roxee's doing OK.

Best wishes,

Uncle John and Cousin Angelina
  #24  
Old 05-15-2009, 08:24 PM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi Jenny and Brother John,
Yes I am concerned and will watch her very closely. Vet said it looks good and to keep her on the 40 mg per day. Will talk to him early next week.

But the weirdist thing, Roxee is stronger, today and tonight than she has been in months. Just truckin along in the yard. and to think, two days ago I was begining to give up hope as she could barely stand. We think she may have hurt her front leg sliding on the very few bare spots on the floor. We've pretty much put throw rugs everywhere she walks but somehow she manages to find a bare spot.

Well, nighty night time.
Belly rubs to all your pups
John (Roxee's Dad)
  #25  
Old 05-18-2009, 07:46 PM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi All,
Sent my vet a fax yesterday, thought I would document my concerns and questions in writing giving him a chance to read it and prepare for our coversation. I expressed my concerns about weight loss, continued lowering stim results, UTK and a few other items. He called me this evening, thought the fax thing was a great idea and he agreed to contact Dr. Oliver to discuss Roxee's case and his opinion's on the next steps if any we should take with Roxee.

Quote:
In the Vetoryl flowchart it says for a post less than 50 nmo/l (1.8) to stop treatment for 7 days and restart at a lower dose.
I would be keeping a close watch on her like you already are doing. Was your vet concerned about the low number?
Hi Jenny, I read that the number was 1.45 So now I'm confused.

Belly rubs to all your furr babies.
John (Roxee's Dad)
  #26  
Old 05-19-2009, 01:11 AM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hey John,
There are so many numbers out there but the one I was talking about was in the Dechra product info for Vetoryl. The conversion is 27.59 so 50nmo/l comes to 1.8.(I hope my figures are right). Many dogs go below this number and are fine but if you have some strange symptoms at this or lower number then I would seriously consider the 7 day break.
Jenny
  #27  
Old 05-19-2009, 04:08 AM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Quote:
Originally Posted by Roxee'sDad View Post
Hi Jenny, I read that the number was 1.45 So now I'm confused.

Belly rubs to all your furr babies.
John (Roxee's Dad)
I think I can solve the mystery...

Up until just the last few months, we had been depending upon Dechra's UK published guidelines in making trilostane treatment and monitoring recommendations. In fact, Jenny was instrumental in obtaining and scanning a hard-to-find, detailed informational brochure for us (thank you again, Jenny!). That 2007 U.K. brochure and flowchart did list a "lower" limit of 50 nmol/l (or 1.8 ug/dl).

However, the newly released 2009 U.S. monitoring flowchart has shifted the "lower" limit down to 40 nmol/l (or 1.45 ug/dl). So I guess we must assume that is Dechra's most current recommendation.

http://www.dechra-us.com/File/vetory..._Flowchart.pdf

Hope that clears up the confusion!

Marianne
  #28  
Old 05-19-2009, 04:29 AM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Yep that's me, always behind the times.
John, I hope I haven't confused you. I don't like reading off the computer so I have been using the hard copy of the 2007 brochure. I guess I had better get with the program and get myself updated.
Jenny
  #29  
Old 05-19-2009, 05:28 AM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Regardless of the slight modification of the numbers, your observation was still "right on," Jen -- Roxee's test result is down there at the low end. So your advice remains well taken, to be watching her closely. And you are still very much with the program!

Marianne
  #30  
Old 05-19-2009, 06:07 AM
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Default Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi Marianne and Jenny,
It's really good that you are keeping me on my toes. Either way, it's a reference number and it is low, and as has been said, every pup is different.

Roxee is being pretty steady on her feet lately but her weight loss is worrisome. She has been very, very picky about what she wants to eat. I can't believe she gave up soft food for kibble. So now she will eat some "Taste of the Wild" Salmon formula. We'll see how long that last

She is still sleeping thru the night, I actually had to wake her up this morning. So we decided to not give her any Trilo today and see how she does thruogh the day and evening. Might skip a 2nd day too and see how it goes from there.

Hope the vet gets to discuss Roxee case with Dr. Oliver at the UTK.

I really rely on your inputs and opinions, that is why I post, so keep it up.

Belly rubs to your pups.
John (Roxee's Dad)
 

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