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  #41  
Old 05-08-2009, 08:07 AM
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Squirt's Mom Squirt's Mom is offline
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Hi John,

I don't post to you much as I don't have much to offer but I do keep up with you and Angelina.

Brother John is right on the mark with starting slow, tho, and I agree with him on that approach. We often see Trilo pups go through the withdrawal of a rapid cortisol drop and by going slow, Angelina may well be spared this.

I did want to let you know that some pups do have problems with the stims the day after or so. The purpose of the test is to stimulate all the things we are trying to control to see how they react under treatment. So, in essence, it is a stress test for the adrenals and they don't always appreciate it! Over simplified, but you get the idea.

You're doing a great job, John. Keep up the good work!
Hugs,
Leslie and the girls

PS. "John the Grey"....I just gotta know; is that a reference to Gandalf the Grey?
  #42  
Old 05-08-2009, 06:57 PM
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Hi Brother John II (The Grey) or is it Gray?

Long day today, did a mercy groom today, a 14 year old lab that's never been groomed or had a bath. Felt really bad for him, did a shave and removed about a million ticks that have been living in those mats for years. Soon as he got out of my van, he went and rolled around in the grass, I swear he was smiling, gave me a few licks before I left. Guess I made a friend for life

Anyway, I was wondering about cushings and the blood clot thing, haven't ever read about that anywhere so was wondering if anyone else has had that experience or knowledge?

Roxee has become very clingy also, follows me around, cries and moans (blood curldling scream) if we're not in the same room with her. Besides being totally spoiled, I think it just gives her a comfortable feeling to know we are here with her. Probably the same for Angelina, after all, you are her hero. Roxee does like to hang around wherever the food might be

How is Angelina's weight, have you noticed any decrease in her belly? We're still trying to keep the weight on Roxee, she get 4 full meals a day Managed to put a quarter pound on her in the last week. Up to 13.25 pounds now.

I guess you and Angelina are going to be a case study. I know alot of us will be watching to see how it goes. Starting with 30 mg per day (not enough), going to 30 mg twice a day (too much) and now 20 mg twice a day. Please do keep us up to date on any changes and results.

Hoping Angelina is doing better and continues to do so.
Take care.
John (Roxee's Dad)

PS: Have you heard from Scot and Yanni the other Sidney(ite)?
  #43  
Old 05-08-2009, 07:35 PM
AlisonandMia AlisonandMia is offline
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Quote:
Anyway, I was wondering about cushings and the blood clot thing, haven't ever read about that anywhere so was wondering if anyone else has had that experience or knowledge?
You saw that in that power point too. My understanding with the Cushing's and blood clot thing is that it is really quite rare in dogs although just occasionally a Cushing's dog will throw a clot - or it is thought that this is what has happened. However with cats clotting with high cortisol levels (or when on high doses of steroids like prednisone) is quite common and often is the first tip-off to the fact the cat is Cushingoid. I get the impression that cats are a particularly clot-prone species and seem to suffer from clots as a result of quite a few medical conditions, not just Cushing's. They particualry get something horrible and agonizing called "saddle thrombosis". With Cushingoid humans, clots are far more of a risk than they are in dogs but possibly not quite as likely as for cats.

Interestingly humans with high corticosteroid levels are very likely to develop psychiatric disturbances (mania, severe agitation, intense irritability and even rages etc.) whereas, thank goodness, dogs are not particularly prone to that type of symptom - beyond a bit of restlessness in the evenings they almost always remain more or less their usual sweet selves.

Alison
  #44  
Old 05-09-2009, 04:01 AM
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Hello All,

Hi Leslie and The Girls
Thanks for the information with regards to the stim test. And the hugs - need the hugs! The John The Grey is just a reference to my own growing greyness (although I have seen the movies so... maybe it stuck in my head )

Hi Brother John The Good,

In Australia I'm John the Grey, if I was visiting the US I'd have to covert that to John the Gray

Nice work on the Old Lab! You are truly a good man!

I hadn't heard about the blood clot thing either so it was all a bit "What next?" to me. I'm hoping she was just lying on the edge of the rug, it dug into her leg enough to cut circulation and put it to sleep. I'm hoping.

I think I read somewhere that Trilostane can cause behavioural changes - but whichever article it was - they didn't give examples. Of course, since late January, I've been taking over ALL the feedings - so that could be a factor

But then again - it's only been happening since the last testing. (sigh) lots of questions - few answers!

Angelina's weight was almost exactly the same as last time 13.02kg last Thursday versus 13.04kg the time before that. Her belly seems to be the same football it has been.

I'd much rather Angelina was a success story than a case study - but we have to wait and see how this all turns out. It's good to know a lot of fingers and paws are crossed for her.

Since Scott and Yanni's first contact, I haven't heard from them - which is a pity because I think Scott has a story to tell.

And Alison,
You are simply amazing with your inter-species cushings knowledge!

John The Grey & Angelina the White
(who is amazed that he managed to write all that before his computer could crash for the 7th time!)
  #45  
Old 05-09-2009, 04:31 AM
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Hi John,

Here's a link to a study that I had seen a while back that discusses the association between Cushing's and blood clots. It is directed towards the implications for humans, but as you will see, the study was performed on dogs with naturally-occuring Cushing's Syndrome. So if you are interested in plowing through it, it may help clarify the linkage between the disorders:

Biochemical Basis for the Hypercoaguable State Seen in Cushing Sydrome

I was interested to see that "our" Dr. Feldman (the UC Davis specialist who we so often quote here) was one of the authors.

Marianne
  #46  
Old 05-09-2009, 07:07 AM
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Thanks Marianne and Allison,
I learn something new everytime I visit here. I had to read the paper a few times to begin to comprehend but managed to get the jist of it.


John II AKA The Grey - How about a case study of a success story

John (Roxee's Dad)
  #47  
Old 05-09-2009, 02:37 PM
AlisonandMia AlisonandMia is offline
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

The weird thing with both dogs and humans showing the same biochemical changes re being in a hyperchoaguable is that clots are so rare (but not unheard of) in Cushing's dogs whereas in humans it is a very real danger that makes the risks of using heparin worth taking. There must be other factors at work. High cortisol levels seem to affect different species in slightly different ways.

Alison
  #48  
Old 05-13-2009, 04:39 AM
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Hello All,

Update Time.

On Monday afternoon, I got a call from The Specialist's Office that the 20mg capsules of Trilostane had arrived. I went to collect them shortly after - and resisted the urge to give her a dose that evening.

Breakfast time Tuesday morning, I started the 12 hour dosing of 20mg.

This morning (Wednesday) Angelina was interested in going for a walk, and walked with some improvement, compared to the last time (on Sunday). She seemed fine all day.

But... 30 minutes ago, after lying on her side for a while (post dinner snooze- and about 2 hours since her second dose of the day) she got up and was walking with difficulty. I'd say with a limp, but I'm unsure which leg to blame a limp on.

I just watched her get up to change position, and the limping continues. Very old lady.

This hasn't really happened to date.

Could this be:
* A slight increase in Trilostane?
* Progression of the disease?
* Arthritis being unmasked?
* A clot?
* A reaction to colder weather (currently 15 degrees celsius/ 60 degrees farenheit)?

I didn't want to be hopeful so early after a change in dose - but it's really unfair for things to get worse so quickly!

She wanted to go on the couch and I lifted her up and covered her up to keep warm - but a few minutes later she wanted to be lifted down again, and is back to lying on the floor. Seems she can't get comfortable.

John the Greyer and Angelina

PS: Thanks to Marianne for the clot homework
  #49  
Old 05-13-2009, 07:33 AM
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

An update to my update:

I forgot to mention that Angelina's abdomen seems to have more of a bulge to the left side. Is this familiar to anyone? I initially thought it might be a trick of the light (like when I thought her hair was changing colour) or just the way it appeared when she was moving - but now I'm not so sure.

Angelina has gone to bed now - but keeps changing position as if she can't get comfortable.

And I'm worrying that Trilostane is reacting with a pre-existing condition.
  #50  
Old 05-13-2009, 04:06 PM
AlisonandMia AlisonandMia is offline
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Default Re: Angelina 13.5 year old/13kg Maltese Cross on Trilostane

Quote:
I forgot to mention that Angelina's abdomen seems to have more of a bulge to the left side. Is this familiar to anyone? I initially thought it might be a trick of the light (like when I thought her hair was changing colour) or just the way it appeared when she was moving - but now I'm not so sure.
I think if you think you are seeing something then it is there - that has been my experience overwhelmingly. Some things are so subtle especially at first that you begin noticing them on an almost subliminal level but almost invariably it becomes clear that there really is something there. If she is sore it could be a result of how she is carrying herself - ie curving slightly to one side so a leg doesn't hurt. Do you notice it more at some times that others such as after meals or whatever? It sounds like something to draw your vet's attention to.

I believe that front-leg lameness (this is what Angelina has isn't it?) can be a result of a neck problem: http://www.dolittler.com/2009/05/12/...%99s-take.html (This is specifically about neck injuries from collars but it mentions symptoms of neck injuries and I'd think the same would apply with arthritic/degenerative neck problems.) Her inability to get comfortable sort of fits with neck pain/discomfort - there is nothing like an uncomfortable neck to make anyone restless.

Hope this helps.

Alison
 

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