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!