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  #11  
Old 04-22-2009, 02:32 PM
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Smile Re: Nikki may need re-load

I didn't because she is really against it except in emergency situations. Every time I've given it has been on my own. But Nikki is much better. She ate the dinner I cooked her and we'll see what it does to her stomach. So far so good.
  #12  
Old 04-22-2009, 02:40 PM
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Default Re: Nikki may need re-load

Great; Hope it continues
S
  #13  
Old 04-29-2009, 07:18 AM
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Default Re: Nikki may need re-load

I need help! Just got off the phone with the vet and Nikki will have an acth tomorrow. The problem is Nikki feels better than she has in a while. I'm sure her post number is high because before our trip it was 8.7.My vet says there is no maximum dose of lysodren.She said she has had dogs on twice the recommended dose and they are fine. Nikki is already on 400 mgs/week and her number is creeping up. I asked if she ever splits the dose into three and she said it wouldn't make any difference. Is this right? She acts like she is very experienced in cushings, but I don't know. She did say she will treat the dog and not the disease, so if Nikki needs to maintain a higher number that's okay.When her post was 8.7, her pre was 7.8, which means she was really stressed,so that post number wasn't so bad, right? I'm so confused! She said Nikki isn't feeling bad because of the lysodren but because of the reduction in cortisol, but how do you know that? And if the reduction in cortisol makes them feel bad, how is that good? When her cortisol was 50, she felt fine except she was starving and drinking and peeing.She certainly had more energy. Wow, this is so hard! Sharon
  #14  
Old 04-29-2009, 08:32 AM
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Default Re: Nikki may need re-load

(I'm trying to reply like Glynda sometimes does)

Quote:
Originally Posted by nikkismom View Post
My vet says there is no maximum dose of lysodren.
My first impression is that they are wrong, but maybe they need to clarify what they mean by this.
She said she has had dogs on twice the recommended dose and they are fine.
They need to specifically define (in mgs/kg) what they are referring to as recommended dose - and recommended for loading or mantenance - maybe they are misunderstanding the actual recommendation
Nikki is already on 400 mgs/week and her number is creeping up.
This is why we think she may need a reload
I asked if she ever splits the dose into three and she said it wouldn't make any difference. Is this right?
IMO, it absolutely does make a difference. Please read through Bagel's thread:
http://www.k9diabetes.com/forum/show...p?t=743&page=2

When her post was 8.7, her pre was 7.8, which means she was really stressed,so that post number wasn't so bad, right? I'm so confused!see below from Bagels thread
She said Nikki isn't feeling bad because of the lysodren but because of the reduction in cortisol, but how do you know that? I don't think she can know for sure, but maybe the stim test can give a leaning towards a reason
And if the reduction in cortisol makes them feel bad, how is that good?
I believe sometimes the pace of the reduction can make a difference
When her cortisol was 50, she felt fine except she was starving and drinking and peeing.She certainly had more energy. Wow, this is so hard! Sharon
Yes, that may be the case, but if left untreated over time, the high cortisol can do more visible damage - skin infections, ear infections, high blood pressure, liver issues...you know!

This is from Bagel's thread:
Quote:
Originally Posted by Wylie's Mom View Post
One thing I'm curious about, and maybe someone can please clarify this for me, is the pre of 7. I'm not sure if the high pre means anything. Does it matter that the pre-7 is only 1.8 lower than the post-8.8??
Quote:
Originally Posted by Lulusmom View Post
When interpreting an acth stimulation test for purposes of monitoring cushing's treatment, the pre or basal number is of little value. The normal basal range (most labs) is 1 - 6 so 7 is a bit high and is probably due to the stress of being at the vet's office. I hope this helps.

Glynda

Last edited by Wylie's Mom; 04-29-2009 at 09:05 AM.
  #15  
Old 04-29-2009, 09:09 AM
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Default Re: Nikki may need re-load

Oh yeah - I think she wants to do another stim because you are going to re-load? How long ago (in weeks) was her last stim where post was 8.7 & pre was 7.8?

I have to go now, but I will check back later.

-Susy
  #16  
Old 04-29-2009, 09:14 AM
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Default Re: Nikki may need re-load

It was the first week in April- I had to do it because I was going out of town and knew she would be stressed. I also knew I would have to do another when I returned, but have put it off until now because she is just now recovering from that stress. Going to the vet upsets her so much. At least she's only there for two hours.
  #17  
Old 04-29-2009, 09:40 AM
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Default Re: Nikki may need re-load

Hi Sharon,


Quote:
When her cortisol was 50, she felt fine except she was starving and drinking and peeing.She certainly had more energy. Wow, this is so hard!
Just wanted to let you know. When our Roxee was dx'd almost 3 years ago, we chose not to treat. She felt great, swimming, running chasing balls and the cat on occasion. She was fine except for the normal signs. Thirst, panting, huge appetite, stealing food and hair loss. I could live with that. I didn't know enough about this disease or syndrome.

Mid to end of last year, Roxee started losing her strength. By Nov, I had to carry her outside to do her business. BTW, we have a doggy door with 3 steps leading down to her doggy yard. Had to replace the steps with a ramp. Finally could not use the ramp anymore so then the carring her outside 6 to 10 times a day.

Then I found cc.net and learned so much and found out that her muscle Deterioration was due to the cortisol eating away at her muscle tissue thus making her weak. So weak in fact that we had to hold her up to pee and poop in December.

So what I am trying to say is yes, the higher cortisol was making her feel good until it started eating away at her skeletal muscles and she then went downhill quickly. If I hadn't found this site when I did, she would be at the rainbow bridge already. I just wanted her to have one more Christmas with us.

Today she is improving, but it continues to be confusing as we all try to tweak and improve treatment, continuously watching for signs of improvements or declines, looking for ways to make our pups life better. This is what we do and why you and I and the rest of us are here.

In yours and Nikki's case it might have been cortisol withdrawl but there really is a long term price to pay for that feel good feeling they are experiencing today.

All my best to you and your Nikki.
John (Roxee's Dad)
  #18  
Old 04-29-2009, 10:50 AM
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Default Re: Nikki may need re-load

Great example, John!

Sharon,

If you want to hold off for a week or so to give Nikki more time to "recover", I don't see an issue with that (but, that's just my opinion). I did a mini-load on Wylie about 3 weeks ago, but I waited a week longer to do the (after mini-load) stim. He had a stim done 3 weeks previous, and I just wanted to give him an extra week longer before being a pin cushion again. They have a hard time finding his vein and he often develops a bruise afterward.

-Susy
  #19  
Old 04-29-2009, 01:56 PM
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Default Re: Nikki may need re-load

Thanks so much John and Susy. I have been treating since November and will continue to do so, but it is frustrating, to say the least.She's had one re-load already and we just can't seem to get control. I didn't mean to imply that I have any intention of giving up or not continuing with treatment.This forum has taught me so much! If we ever get on real maintenance I will be so happy! I will post results of her stim tomorrow when I get it.
  #20  
Old 04-29-2009, 02:49 PM
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Default Re: Nikki may need re-load

Hi Sharon,

Sorry Nikki is still having problems getting control. Bless her heart and yours too!

Refresh my memory...has she been tested for Atypical? the UTK panel? If so, what were the results and is she being treated for it? If not, talk to your vet about adding some melatonin and lignans. If her Estradiol is elevated and being produced someplace other than the adrenals, this could be playing a role in her difficulties. Just a thought I managed to grab!

Hugs,
Leslie and the girls
 

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