Too Cute!

Now what????

Well...baby just had her 3-ish month ACTH re- test on Wednesday.

Post ACTH cortisol was 5.5

BUT...

Her ALP was elevated again to 2100 ...it had been down to 600+ and she tested as Anemic at a 33 when normal range is 36-60.

Symptomatically she's doing fine...but the vet wants to do another ultrasound and possibly biopsy her liver since the last aspiration in March showed some abnormal cells, not cancer at the time but not normal either. She called it hepatic modular hyperplasia and it is seen in senior dogs often as part of the aging process.

Anyhow, she said it isn't urgent but it bears checking out.

Not exactly the results I expected.

Other than Cushing's and some minor cataracts, and whatever this could be, Baby is healthy and happy. We even went to obedience class for fun this week and to Petsmart which we have NEVER done and she was just awesome. Now I'm dreading the next phase...another dog with cancer would be devastating, but it is what it is.






:)



-- Post From My iPhone

kayak-0438_NI
Originally uploaded by dehmystic

Labor Day Paddle

kayak-0444_NI
Originally uploaded by dehmystic

This is me, enjoying a Labor Day paddle on our first cool fall-like day. Notice the shorts AND a sweatshirt...I was optomistic about the weather and it actually did warm up enough to shed the sweatshirt.

Sweet Old Girl

Baby is really coming out of her Cushing's funk. She's gaining weight and her coat looks better. She's lost her crazy hunger too. Still not wanting to be BFF with Ivy though. Still hopeful!

Not Fun...

Noticed the burned chip on this hard drive...

Ivy's Kill Stats

Rabbits - 1
Birds - 1
Squirrels - 0
Other - .5

Yes, our sweet Ivy is a killer. I'm dealing with it the best way I can...blogging her stats!

Good News!

Baby's Test results are awesome!

Most notable:

Her ALP was 2800 and is now 635!
Post ACTH test cortisol was 3.8!
Vet confirmed reduction in liver size!

All good news so we're going to stick with the dose and retest in 3 months.

Anyone have suggestions for getting their Cush pup's back in top form weight wise. Baby is still skinny. Can you weight train a dog? ;)

Labbie

A wet Labrador is a happy Labrador!

30+ Days Post Cushing's

Taking Baby in for another ACTH and liver enzyme test tomorrow. After 6 weeks on Trilostane she looks so good! Pot belly is gone, her dry nose is back to normal, thirst is gone, she still loves treats but the super hunger has abated! Very hopeful that these meds will work for her long term!

Vacation Pics

DH is going through and processing all the pics today! Here are a few that were on my phone:



St.Thomas



Towel animal!



Funky deck shots:






DH kickin it on deck 12:

Vacation Day 5

St. Maartin!

We all met on deck 0 around 10:30 to head onto St. Maarten! We got on a water taxi to get over to the shopping and beach area. The people were awesome and helped carry DH, chair and all onto the boat. Pics to follow...

We rented beach chairs and umbrellas and basically chilled for hours, spending lots of time in the water. DH and I applied SPF 70 and 100 but still got crispy!

I think I liked St Maarten better than St Thomas as it seemed more geared to chillaxin! Both are beautiful though.

In the afternoon we split up and did some shopping, me and Stephanie, Darrin and John, and Dawn and Steve but we struggled to find each other afterward! There was about 30 minutes of chaos but we all ended up back on the ship on time!

We then crashed in our room for 4 hours after rinsing all the sand off, and assessing our burns...

Recharged we headed to the Lido deck for the laser show, live music, deck party and the Mexican buffet...que bueno! Stephanie, Dawn, Steve, and us all grabbed a table and chilled. John was in the casino winning money.

I forgot to take my phone so this post will be updated later with pics from the cameras!!!

Vacation Day 6

Fun day at Sea!

Well, we had a late night and didn't get back til 1am!

So we've slept in!

Day 4

St. Thomas!






Sapphire Beach! DH taking a dip!

Vacation - Day 3

Today was "Fun Day at Sea" as we traveled toward St. Thomas.

Slept in today and DH has a rough morning but recovered by 1pm. I spent the morning walking the Panorama deck and sunning there for a hour or so...yeah SPF 70 sunscreen!

Then DH and I grabbed a salad, roamed Panorama deck, bought some tshirts, then grabbed some lounge chairs on the shady side and read our books or dozed until 5-ish.




Dinner at 8:15!

Vacation - Day 2

We got up and were grabbing breakfast by 9am, then headed out to Nassau....where we ran into Dawn and Steve! Took some pics! Then we wandered a bit and headed back to the ship (it was so hot)!

We were gonna meet Dawn and Steve in the Serenity bar/deck but then ended up elsewhere, so DH and I grabbed a cool shaded lounger and some frou frou drinks and killed the afternoon up there just chillin!


Awesome!





Leaving Nassau!

Vacation Day 1

Not so bright but an early start this morning! Met at our friends house at 4:30am to make our 7:30 flight to Orlando.

Flight ran ahead if schedule and we landed at 9:30cst / 10:30est! Grabbed our bags and called for our limo.

Made a quick Walgreens stop for supplies and headed to the ship!

More to follow...

Baby...

Baby's doing okay. Her energy level is good and we are back to taking more walks. She's still hungry at times but nothing like she was.

I took this pic tonight after our walk with Ivy.

Her prescription refill is due tomorrow...she's just about through her 1st 30 days on Trilostane (Vetoryl) and so far so good!

Packed!

World's largest suitcase (in our world anyhow) is packed!!! *Yes, that's a quarter balanced on "Big Bart"!

Update on Baby

Baby had her ACTH Stim test on May 3rd.

ACTH stim results:
Pre 2.7. (8 hours post Trilostane)
Post 5.6

No change in dosage at this time. Vet says Baby is just where we want her!

We will retest at 30 day treatment mark, including a panel to recheck liver enzymes and see if those numbers are getting closer to normal.

Gonna board her and Ivy while we are on vacation so I gotta type up instructions and contact numbers for the kennel staff! I'm a little anxious about leaving her but she seems very stable at this point so it will be fine. Ivy will be just fine too!

Baby (and Ivy) Steps

Took BOTH my girls on a walk tonight! They were so well behaved. No fighting!

Bark For Life - 4/30/2011

Ivy enjoyed the Bark for Life event this morning! She bobbed for kitties (toy), tried out the obstacle course (fail), met other dogs (fun), watched the frisbee dogs, competed in the treat eating contest, got lots of pets from strangers, and rode in the car. Best day ever!!!

Update on Baby-Day 8

Appetite:
Baby appears to have a better appetite in the evening versus the morning. She does eat her food very slowly and she tends to leave a little in the bowl. This morning I had to wet it down for her and get her interested. She seems to prefer her treats to actual dog food and has no hesitation in eating them. Maybe she’s being temperamental?

Activity Level:
We walked around the block last night with no problem; she seems to have the best energy level in the early evening. In the morning she seems lethargic. She readily gets up to go outside and eliminate, but after eating she lies down and somewhat hesitates to rise when called. As I said, evenings are much better.

Other:
I have also noticed she has some weakness in her hindquarters. She’s having some minor issues when jumping up onto furniture. She also has some intermittent trembling. Drinking and elimination are normal, although she has been having 2 BMs in the evening.

Wondering...
Should we skip an evening dose and see if that improves her morning appetite?

All things considered, we’re happy with her progress. She seems so much more at ease now.


-- Post From My iPhone

Hmmmm...

This morning brought a significant change in Baby's appetite. She did not immediately eat her food when it was presented, it took a minute or so for her to get started and when she did it was slowly and she only ate half of it.

Last night LacubriousToo took her out in the yard and she wandered around actively. She's still playing with her toys when prompted.

Stools are normal.

Water input/output is reduced as well.

The ACTH stim is scheduled for May 3rd.

-- Post From My iPhone


***Vet's response***

"This could be potentially worrisome, meaning that the medicine does not usually have that dramatic of an effest that quickly, however it is posssible that Baby's Trilostane dose is too high. I would like you to monitor Baby for 24-36 hours. If her appetite and water intake do not improve or continue to decrease, then give us a call tomorrow and we will reschedule her stim for this Friday to make sure that her Trilostane dose is not too high."

4 Doses and all is well...

Another update...Baby has had 4 doses. She had one loose stool but all others are ok. Appetite and water intake seem closer to normal, still excessive but not as intense as before. The panting is completely gone! I'm hopeful she continues to progress on this treatment.

-- Post From My iPhone

Medicated

Baby got her first dose tonight of the Trilostane! Fingers & paws crossed!


-- Post From My iPhone

The results are...

LDDS Test Results on Baby confirm that she has Cushing's. Most likely PDH, Pituitary Dependent Hyperandrenalcorticism. Meds are on order from Roadrunner Pharmacy and should be arriving tomorrow!

Dex Suppression (3 Samples)
Time 815
Time 1215
Time 415
Cortisol Sample 1 5.6 Range: 1.0-5.0 μg/dL HIGH
Cortisol Sample 2 Dex 4.3 Range: 0.0-1.4 μg/dL HIGH
Cortisol Sample 3 Dex 5.2 Range: 0.0-1.4 μg/dL HIGH
INTERPRETATION OF THE DEXAMETHASONE SUPPRESSION TESTS:
*
Low-dose dexamethasone suppression test:
Normal: Cortisol level less than 1.4 ug/dl 8hrs post-dex.
Hyperadrenocorticism: Cortisol level greater than 1.4 ug/dl 8hrs
post-dex.
...
If the 8hr post dex. cortisol level is greater than 1.4 ug/dl,
the following can be used to differentiate pituitary dependent
hyperadrenocorticism (PDH) from an adrenal tumor:
1. Cortisol level less than 1.4 ug/dl 4hrs post-dex is
consistent with PDH.
2. Cortisol level less than half the baseline level at either 4 or 8
hours post-dex is consistent with PDH.(Samples taken at 2 or 6hrs are interpreted the same way as a 4hr
sample)
...
If neither of these criteria is met, further testing is needed to
differentiate PDH from adrenal tumor Cushings.
...
NOTE: Approx. 5% of dogs with PDH have normal results.
False positives may occur with stress/nonadrenal illness.

Article on

Still waiting to hear back on Baby's LDDS Test!

In the meantime, I found this short article about spending trends for pet medical expenses.

Appointment & Info

Baby's LDDS Test is scheduled for Friday, April 15th.

I also found this link to some miraculous before and after pictures of a Cushing Dog.

http://www.io.com/~lolawson/cushings/cleo-alison.html

Trilostane AKA: Vetoryl

The drug recommended by our Vet for the treatment of Baby's Hyperadrenocorticism is called Trilostane, AKA: Vetoryl.

I found a detailed article that discusses how the drug works, how to monitor its effectiveness, and possible adverse reactions.

We are still trying to work out the appointment for the LDDS, Low Dose Dexamethasone Test for next week. It's a busy work week and fitting in a full day at the vet is challenging but I really feel that the sooner we get Baby oon the treatment the better she will feel.

Today she's a bit lethargic again and her belly appears bloated. It seems like these symptoms wax and wane every few days and I'm not sure why. I also wonder if she is having any pain. I understand that cortisol is a steroid and as such should mitigate any inflammatory response, but does that mean the dog is not in any discomfort? Also in my research, the added cortisol can affect the GI tract and so giving NSAIDS to an untreated cushingoid dog can cause GI bleeding.

Do they have doggy narcotics? Those are probably metabolized by the liver which is not a good option either.

I guess she's just going to have feel better from having a good meal and maybe a full body massage...doggy spa style!

Mutt Census...

Just read this interesting article on a national mutt census.

If you go to the referenced Mutt Census site, you can click on your state and view detailed information, including Most Popular Breed and Most Unique Breed.

Cushing's Anyone?

jl-0178_NI
Originally uploaded by dehmystic

Well, I just got the call from the Vet Specialist. Baby's test results were as follows:

ALP: 2800
Cholesterol: High
Platelets: High
Thyroid: Normal
Urine: Dilute
Blood Pressure: High
Liver Aspiration: VH - Vascular Hepatopathy (typical in cushings, NOT CANCER!)
Spleen: EMH - extramedullary hematopoiesis (not typically treated, NOT CANCER!)

So the Vet (as was I) is leaning towards Cushings. Next step is a Low Dose Dex test, probably next week sometime. It's an 8 hour test where they will do 3 blood draws after they administer Dexamethasone. They will be testing for cortisol suppression, if there is any, then no Cushiings, most likely there will be none and she'll be diagnosed Cushingoid. Their recommended treatment is with a drug called Trilostane. On going follow-up by ACTH testing every 3 months for monitoring dosage.

So, as always, we're keeping it real...real interesting!

Dog Obedience Class #2

sa-0458
Originally uploaded by dehmystic

As usual, I was in a rush to get home and get to my evening commitment! Doggy Obedience / Owner Training class!

I gave Ivy just a tidbit for dinner so she'd be hungry for treats in class. Then we loaded up our doggy bag, water, treats, etc. and headed to city hall.

As expected, it was a bit trying but the new pinch collar makes her so much more controllable. She was the noisy one in class, barking and whining. She did eventually calm down and since the class was small (only 4 dogs/handlers, plus the instructor and her 2 dogs) Ivy got on with the training pretty quickly.

We basically, worked on heeling, turns, and leash pressure work.

It went by fairly quickly and I think Ivy enjoyed the stimulation!

We played in the backyard when we got home...that dog LOVES to retrieve!

Basic Obedience Class

Went to orientation for Basic Dog Obedience class tonight! Me and Ivy are gonna go on Tuesday's. She has so much potential I just need some guidance.

The class is thru the Union Parks Department but the company is Poochy Smooches. Http://www.PoochySmooches.com

Tonight was dog free and just covered the class do's and don'ts. I've got to get some treats for training Ivy and probably a different collar, but I think it will be really good for the whole pack!



When are we going?????

Vet Specialists

Well, gotta have some testing done on aspirations from nodules in her liver and spleen, Vet says nodules could be normal due to aging or could be something else. Plus her adrenals are both enlarged by about 2mm beyond normal...so more blood work (senior profile) for an accurate liver enzyme number and a week waiting on the cytology reports. The rest of her looks good though! And she's pretty peppy!

Never a dull moment...

dogs0104_n
Originally uploaded by dehmystic

We had to take "Baby" to the vet for 6 stitches (2 wounds) after a dog fight...with Ivy!!! Food is such an issue with these two, it's crazy. We are managing it with some additional vigilance and more pack leaderism. It's been fine since then.

I was planning Baby's Geriatric Dog checkup for next month but took this opportunity to ask the Vet about her little pot belly and he said it was probably fluid but would do xrays and bloodwork while she was sedated. The Xrays showed an enlarged liver but all other organs looked good. She also has a sewing needle in her stomach!!! I'm no seamstress so I can't figure that out. He was not too concerned with that because the liver problem needs top priority. He also diagnosed an ear infection, so she's on otic antibiotic for a few days.

Abnormal Blood Tests were as follows:

WBC:
NE K/ul 14.76 (mildly elevated) Range: 2.0 - 12.8
LY K/ul 0.36 (moderately low) Range 0.6 - 5.8

NE% 94.14 H Range 50.0 - 80.0
LY% 2.29 L Range 12.0 - 30.0

ALB 4.5 Range 2.5-4.4
ALP>2400 Range 20-150 (OMG!!!!)
ALT 268 Range 10-118
GLU 126 Range 60-110

She also appears very thin, hip bones and spine are visible, but has actually gained 4 lbs over the last 5 months. She weighs 44 lbs. We weren't sure if we were just comparing her to Ivy (chunky monkey) or if there has been actual muscle loss.

We estimate that she drinks about 60-70 ounces of water per day which is somewhat excessive, plus on walks she urinates multiple times, this started about 2 years ago. She also had accidents in the house beginning 2 years ago, so we went thru urine testing, treated with antibiotics whihc resolved the bacteria but there was no real change in her urination. Also treated with DES thinking it was female bladder issues. No change, so we stopped hormones. Using puppy pads while we are gone and confining her to the kitchen!

Her urine also tested high for PH (10) and I was advised to alternate between vitamin C and another product (can't remember the name). I bought test strips and it appears that her urine is in the normal ph range. So treatment was discontinued. She's also developed a really dry, rough nose that I have treated with vitamin E.

I am taking her to a specialist next week for a review of the liver findings. Ultrasound for sure. I am wondering if Cushing's fits, though I know they would have to do extensive testing.

My GP Vet basically just handed me a pamplet for the specialists and I've been combing the web for answers until her appointment.

Poor Baby, she's had a rough patch here lately. Hope we can resolve the liver issues with not too much aggravation for her. All she wants is a cuddle buddy!