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barney's mom
04-24-2009, 06:59 AM
Just got back from the vet. Barney's corneal ulcer still isn't healing. No better, no worse. The ulcer has been there for two months now. We are going to refer out to a specialist. He is due for a stim test, so we are going to do that wednesday, just to make sure that his numbers are good and it isn't high cortisol levels preventing him from healing.

It is so hard to watch him squint all the time. :(

stardeb55
04-24-2009, 07:15 AM
Just to let you know, Harley fought an non-healing corneal ulcer for nearly a year. My IM did say the repeated infections were definitely because of the immune suppression from the Cushing's. We finally ended up at a vet eye Dr., who diagnosed the real culprit as untreated dry eye. I still find this strange to this day as my GP vet had tested Harley for dry eye, either 2 or 3 times, & got normal results. I was standing there when they did the test a the specialist, & it was definitely abnormal in the left eye. We ended up on 2 different antibiotic ointments, & cyclosporin drops for the dry eye. One of the ointments did have just a tiny amount of steroid in it to help clear the residual corneal scaring. The specialist felt the amount was so small that it shouldn't affect the Cushing's. Harley's left eye seems to be fine after doing all this over about a 4-5 month period, but he will be on cyclo eye drops for the rest of his life.

Debbie

barney's mom
04-24-2009, 08:49 AM
Thanks Deb,
It does make me feel a lot better knowing that its not that uncommon to see ulcers take this long to heal. Once you got the cyclosporin drops did the eye heal quickly? I hate seeing him uncomfortable. I bet it was horrible fighting this for an entire year. Poor Harley :(

stardeb55
04-24-2009, 11:31 AM
Harley would be on a round of antibiotic for a couple of weeks to a month, everything would look ok, so we would stop. In a couple of more months, I would happen to look at his eye & see it oozing "crud", off to the vet's, back on antibiotic ointment, & so forth. After the 3rd re-ulceration, we got sent the eye vet who said at that point it was about 90% healed, but with a lot of scar tissue. We started on a different antibiotic ointment + steroid in the AM, same antibiotic/no steroid in the PM, cyclosporin drops 3x daily, & in between all of the above, artificial tears as frequently as possible. I think it took around 5-6 months for things to totally heal up, & the scar tissue to subside.

Debbie

Harley PoMMom
04-24-2009, 01:24 PM
Hi Cheryl,
Sorry to hear about Barney and his eye, I'm sure the specialist will be able to help you. Who are you taking Barney to see?
How is Beth doing?
UGH, yes this waiting game for the test results does get on the one last nerve that I have left:eek::D but I guess anyone with a cushpup/sick pup feels that way don't they?! So I may as well get used to it!!
Good luck with the stim test and I'll be waiting and watching for Barney's results.

Take care, Harley and Lori

barney's mom
04-24-2009, 04:09 PM
Right now he's on Tobramycin drops 4-6 times daily.
The eye doctor is Dr. Glick, I believe he is from Philadelphia, but he travels around and is in Harrisburg on Tuesdays. He may need another 3rd eyelid flap and debridement. The vet never tested Barney for dry eye. Hopefully the eye specialist will.

BestBuddy
04-24-2009, 04:29 PM
Hi Cheryl,
I am sorry Barney's eye is still causing problems. Now this is my interpretation but the eye protects itself but putting a film/skin over the ulcer and that then stops the ulcer from healing. Buddy was on the cyclopoirin ointment and the specialist said she though it was the best treatment to heal the ulcer before the skin covered it again. After the initial surgery treatment I had to continue using the cyclosporin ointment every morning and we used Acular (small amount of steroid I think) drops every night. This was a forever thing but it worked. Hoping you get something that sorts our Barney's eye.
Jenny

LuvMyMunchie
04-24-2009, 04:30 PM
Hi Cheryl,

Sorry to read that the Barnster is still having problems with his eye.

The vet never tested Barney for dry eye. Hopefully the eye specialist will.

I'd for sure be adding that to my list of "must do's" for the eye specialist. Munchie is also being treated for dry eye in his one and only good eye. These furkids!!!

Louise

stardeb55
04-24-2009, 05:55 PM
Cheryl, I don't want to criticize your vet, but I don't understand why Barney wasn't tested for dry eye early on. Every time Harley's eye would re-ulcerate, my GP would do the dry eye test, Schrimer's tear test, but it would always come up normal. The specialist repeated the test, & that's when it came up abnormal. You can "google" the name of the test, & see that it's pretty simple to do. They put a small piece of litmus paper, (I think), in the corner of the eye. The paper is graduated in millimeters. They time the migration of tears up the paper strip for a set amount of time, then read how far the tears have traveled. I don't remember what normal range is but on the first abnormal test at the eye vets, Harley's bad eye read something like 5 which is grossly abnormal. She said that it was probably more like 3, but the treatment he had been on had helped a little.

Debbie

forscooter
04-24-2009, 06:32 PM
We need a healing kissy icon...

here Barney....kissy kissy kissy kissy kissy kissy kissy kissy kissy...

I have no advice bc I know nothing about eyes so I'll do what mommies do...

kissy kissy kissy kissy kissy kissy kissy kissy kissy...

Beth, Bailey, always Scoobie and Allo

barney's mom
04-24-2009, 06:36 PM
Cheryl, I don't want to criticize your vet, but I don't understand why Barney wasn't tested for dry eye early on. Every time Harley's eye would re-ulcerate, my GP would do the dry eye test, Schrimer's tear test, but it would always come up normal. The specialist repeated the test, & that's when it came up abnormal. You can "google" the name of the test, & see that it's pretty simple to do. They put a small piece of litmus paper, (I think), in the corner of the eye. The paper is graduated in millimeters. They time the migration of tears up the paper strip for a set amount of time, then read how far the tears have traveled. I don't remember what normal range is but on the first abnormal test at the eye vets, Harley's bad eye read something like 5 which is grossly abnormal. She said that it was probably more like 3, but the treatment he had been on had helped a little.

Debbie

Sigh........I know :(

stardeb55
04-24-2009, 06:52 PM
I must give all credit to Cushy. She PM'd me some links that will give you further information about dry eye. Unfortunately, 2 of the links don't seem to want to work when I cut/paste them. I know the Marvista link should work. Maybe Cushiy will send them to you directly.


Dry Eye:
http://www.marvistavet.com/html/body_kcs__dry_eye_.html


Debbie

I'm going to try to put in the other 2 links after Cushy suggested a "fix".

http://www.peteducation.com/article.cfm?c=0+1302+1473&aid=1186

http://www.peteducation.com/article.cfm?c=2+2092&aid=451

Spiceysmum
04-25-2009, 12:23 AM
Hi,

Sorry to hear about Barney's eye problems. My other dog, Brin suffered from KCS, dry eye, when he was 4 years old. It started as an infection that didn't heal. His nostril on the same side dried up too as there was no lubrication to it and he couldn't breathe through that side of it. The tears didn't even register on the test. He was on Optimmune for months which wasn't working and so we found a specialist Opthamologist on our own as our vet (at that time, no longer though!) said nothing more could be done. We carried on with the Optimmune as well as artificial tears and steroid drops, I can't remember the name, and after a month or so we could see his nose gradually getting wetter and his eye too. The doses were gradually reduced over the next year and then stopped altogether. He is now 12 and has had no problems since. I think it must have been an immune problem as I was told they usually have to continue the treatment for the rest of their lives.

It is terrible to see them so uncomfortable, I hope Barney gets some relief soon. Did you say he has had steroid drops? I am sure it was those that 'kick-started' Brin's eye into getting better.

Linda and Spicey

barney's mom
04-25-2009, 07:10 AM
Thank you Debbie and cushy! I was able to get all of the links open! I am going to get him some artificial tears for him in the interim until he sees the specialist. From the articles the tears are very soothing to the dog, and I am hoping the provide some relief.


Hi Linda,
My vet said no steroid drops until the eye ulcer has healed. It really does sound like dry eye could be the culprit! Thanks so much for the information and I am glad that your dog is problem free now :)


CHeryl

stardeb55
04-25-2009, 02:11 PM
Cheryl, you have to be very careful what artificial tears you buy. I use "Refresh". The eye vet gave me a list of acceptable brands which I am looking for as we speak. If I can find it, I will post the rest of what was on the list besides the "Refresh".

Debbie

barney's mom
04-26-2009, 04:28 AM
Debbie, its funny you should say that. I was at the store I started combing through the MANY different varieties of artificial tears. There are several kinds .............who knew?:D
I ended buying "artificial tears" (the ingredients seemed the most inert)
but when I got home I was so confused I was afraid to give them :D
Will head back out today for refresh.

Thanks so much!

BestBuddy
04-26-2009, 04:43 AM
I used the optimmune (cyclosporin) ointment on Buddy for many months after the ulcers. I then started to use lacrilube ointment instead for the dry eye and it worked really well. I think it was Natalie that recommended this as Buddy was diabetic and I had to be careful with a lot of medications. The lacrilube seemed to be the simplest with the least ingredients/preservatives and it did work really well.
Jenny

barney's mom
04-26-2009, 08:08 AM
I used the optimmune (cyclosporin) ointment on Buddy for many months after the ulcers. I then started to use lacrilube ointment instead for the dry eye and it worked really well. I think it was Natalie that recommended this as Buddy was diabetic and I had to be careful with a lot of medications. The lacrilube seemed to be the simplest with the least ingredients/preservatives and it did work really well.
Jenny

Hey Jenny!
Lacrilube is some pretty good stuff. We use it at work all the time on patients who are unable to blink and moisten their eyes. Thanks for the tip

LuvMyMunchie
04-26-2009, 09:51 AM
Hi Cheryl,

Here's another suggestion to add to your list. Munchie's Opthamologist first gave me an expensive drop for his dry eye, which I purchased from them (can't remember the name at the moment). He also gave me the name of a reasonably priced over-the-counter alternative I could use for him, which I have been doing since July '07. Seems to do the trick and works as well as the pricey one I first used as far as I'm concerned. It is GenTeal Lubricant Eye Gel (the Severe Dry Eye Formula). Seems like the different specialists must have their own preferences. This was the only alternative I was given for Mr. Munch.

We need a healing kissy icon...


Yeah.....and we could use a "margarita cheers" icon for all us frazzled parents too!!!

Louise

gpgscott
04-27-2009, 06:21 AM
Hi Cheryl,

Sorry to be so tardy in checking in.

I hate eye issues we have only had a few and they were all injuries not some systemic issue so I have no real advice, although it looks like you have had lots of good advice from others.

I can send well wishes though as you and Barney deal with it.

Scott

barney's mom
04-27-2009, 08:05 AM
Ok.....I did an ingredient search as well as a lot of reading on corneal ulcers.
The eyedrops that Debbie and Louise use, the active ingredient is carboxymethylcellulose. I think that the lacrilube is awesome and lasts a lot longer than the eyedrops because it is an ointment, but I think this would be good for after the ulcer is healed, to prevent a recurrence.

So......I have been cleansing his eye with sterile normal saline, and I bought the refresh drops with the carboxymethylcellulose. (that was one overwhelming decision, lol! Do you know what's available in eyedrops now?)
I have been doing the saline rinses for a few days now, his eye was beginning to look infected with a discharge. I just started the lubricating eye drops last night, but they appear to sooth his eye.

I have been doing the saline rinses for several days now. His eye isn't red like it was and there is no discharge, so I think if it was becoming infected, we nipped that in the bud. He also is on antibiotic eye drops prescribed by the vet.

He is holding his eye open more yesterday and today. Not all the time, but definitely more than he was. I have a vet appointment on Wed. Pray we've made headway!

When I ask Barney, "how's your eye?" He squints his eye :( Poor boy.

Thanks everyone for checking on us :)

Loves,
Cheryl

Harley PoMMom
04-27-2009, 04:11 PM
We've all got our paws up and praying for you and Barney :D:D
Harley and Lori

BestBuddy
04-27-2009, 04:22 PM
Good luck with Barney and his new eye regime. My sister has a very smart dog that had hurt her paw and got so much sympathy that every time you said poor girl have you got a sore paw she lifted it up and limped around. This went on for weeks until we realized she wasn't limping on the same leg each time. She was smart enough to know it got her attention and now several years later those same words make her lift one paw and start limping.

Jenny

barney's mom
04-27-2009, 04:24 PM
Good luck with Barney and his new eye regime. My sister has a very smart dog that had hurt her paw and got so much sympathy that every time you said poor girl have you got a sore paw she lifted it up and limped around. This went on for weeks until we realized she wasn't limping on the same leg each time. She was smart enough to know it got her attention and now several years later those same words make her lift one paw and start limping.

Jenny

:D:D:D You can't blame a gal for trying!

forscooter
04-27-2009, 05:25 PM
Oooo....we could have "Doggie Oscars"!

I hope the drops help Barney....I ouch all over thinking about it. I can related too much and am feeling his pain! How is he getting drops? Does he cooperate?

Thinking of you!!! Sending soothing healing thoughts....Beth

barney's mom
04-28-2009, 07:17 AM
Oooo....we could have "Doggie Oscars"!

I hope the drops help Barney....I ouch all over thinking about it. I can related too much and am feeling his pain! How is he getting drops? Does he cooperate?
Thinking of you!!! Sending soothing healing thoughts....Beth

Actually, he cooperates very well. He knows he gets cheese after the drops. Barney will tolerate nearly anything for a piece of cheese. :D
I tell him "come on Barney, lets get your eyedrops" and he and Beth both come running. (Beth always gets cheese too, ya can't feed one and not the other :rolleyes: )

Truffa's Mom
04-29-2009, 03:51 PM
Barney!!! you little cheese bandit; or should I say Cheese pirate? You would look kind of "bow-wow hunky wow" with a patch over your sore eye .

When Truffa had her eye ulcer, I made apparently a very "usual" mistake. I applied extra drops of her anti-inflammatory drops. Her ophthalmologist told me that THIS INFLAMMATION was a good one, the anti-inflammatories on this case delay the healing process. And poof 20 days under his instructions and it healed. But I also know that probably Truffa's case was more superficial.

What he did was : under topical anesthesia he debrided (shaved, and I almost fainted watching that)corneal epithelium and performed a grid keratotomy; he prescribed 20 tablets of Tramadol 50 mg (2 tablets twice a day) for pain and an Ulcer Mix Solution -(He made it, I don't know what it contained) 1 drop 3 times a day. By the second day she wasn't squinting as much as before.

Here are two links that helped me a lot. Hope you get well soon and we will keep praying for good results.

http://www.2ndchance.info/cornealulcer.htm
http://www.pethealth101.com/eye/corneal_treatment.shtml (this one describes an ophthalmic solution with Adequan!!! very interesting)

Marcela & The Choco Labs

barney's mom
04-29-2009, 09:44 PM
Barney!!! you little cheese bandit; or should I say Cheese pirate? You would look kind of "bow-wow hunky wow" with a patch over your sore eye .

When Truffa had her eye ulcer, I made apparently a very "usual" mistake. I applied extra drops of her anti-inflammatory drops. Her ophthalmologist told me that THIS INFLAMMATION was a good one, the anti-inflammatories on this case delay the healing process. And poof 20 days under his instructions and it healed. But I also know that probably Truffa's case was more superficial.

What he did was : under topical anesthesia he debrided (shaved, and I almost fainted watching that)corneal epithelium and performed a grid keratotomy; he prescribed 20 tablets of Tramadol 50 mg (2 tablets twice a day) for pain and an Ulcer Mix Solution -(He made it, I don't know what it contained) 1 drop 3 times a day. By the second day she wasn't squinting as much as before.

Here are two links that helped me a lot. Hope you get well soon and we will keep praying for good results.

http://www.2ndchance.info/cornealulcer.htm
http://www.pethealth101.com/eye/corneal_treatment.shtml (this one describes an ophthalmic solution with Adequan!!! very interesting)
Marcela & The Choco Labs

I saw this a few days ago and immediately thought of Scott. I KNEW Truffa had a corneal ulcer. When Barney was first diagnosed, I did a search for
"corneal ulcer" over at cc.net but it turned up nothing. Thought I had imagined it.
Glad to hear that all healed well.
Cautiously I am thinking that we are definitely making headway. He is holding his eye open much more the past few days, and there is definitely less corneal edema.
He went for a stim test today. It was scheduled at 1130. I fed him last about 2am. Boy am I glad I did, he got home a little before 5pm and he was so hungry and thirsty.
He won't go with the vet tech. I have to walk with him and as he barrels in front of us I sneak back and out the door. I hate to trick him :(
He was soo funny tonight. He loves me and John to both pet him and make over him, kinda like his own love fest.
John was on the couch petting him and I was on the loveseat watching tv. Barney starts barking and barking and barking, looking at ME..........
He wanted a lovefest, lol! I went over there and started petting him too and he just writhes around making this loud "purring" kinda noise, its so cute!!!!!!

Truffa's Mom
04-29-2009, 10:05 PM
I am envious of the "Purring" noise!!!! and the lovefest!!!! How can one live without this amazing creatures?

Last week while I was looking where to post about our temporary home here at K9diabetes, I found a forum and one of the members question was "how can I stop my dog from licking my face ?" And then a few seconds later I re-read and asked myself "what?????..... who in the world would like that?" And here I am begging Truffa to give me kisses, and totally envious of some purring and lovefest. I can't remember which web site it was and obviously never posted there.

Glad to hear we are making some progress with the eye.

Happy lovefest

Marcela & The Choco Labs

Harley PoMMom
04-30-2009, 06:35 AM
Hey Cheryl!
Glad to hear things are going better for Barney.:D It seems the eye takes so long to heal, but you and Barney are doing an amazing job. Here's to a puuurrrrrfect recovery:D:D

Take care, Harley and Lori

barney's mom
04-30-2009, 11:45 AM
I am envious of the "Purring" noise!!!! and the lovefest!!!! How can one live without this amazing creatures?

"how can I stop my dog from licking my face ?" And then a few seconds later I re-read and asked myself "what?????..... who in the world would like that?" And here I am begging Truffa to give me kisses, and totally envious of some purring and lovefest. I can't remember which web site it was and obviously never posted there.

Glad to hear we are making some progress with the eye.

Happy lovefest

Marcela & The Choco Labs

Me too Marcela! I am always bribing my dogs for kisses. You know what's funny? We had a dog Kelly that was a "daddy's girl." She was John's dog all the way. But she would NOT kiss him.........ever! He would say "give daddy kiss".......she would turn her head! ROFL! I got kisses from her all the time! Weird eh?

Hey Cheryl!
Glad to hear things are going better for Barney.:D It seems the eye takes so long to heal, but you and Barney are doing an amazing job. Here's to a puuurrrrrfect recovery:D:D

Take care, Harley and Lori

Haha! Thanks Lori!

barney's mom
05-04-2009, 03:02 PM
Well I finally got Barney's stim results back
Pre: 1.9
Post: 10.2

Not where he needs to be :(
He is having problems with his back pain. I don't see any symptoms of cushings, his eating and drinking are fine and his doc doesn't want to adjust his meds based on the numbers alone. I am afraid if he is hurting now with his back, I will make it worse by trying to get his numbers "text book perfect"
I am inclined to agree with him, but how high exactly is 10.2?
Our symptoms are well controlled, but what about end organ damage?
Barney will be 12 in June.

Any thoughts????????

Cheryl

AlisonandMia
05-04-2009, 03:20 PM
Hi Cheryl,

Just off the top of my head first thing in the morning here:p - I wonder if the back problems couldn't be a result of subtle muscle weakness creeping in because his cortisol is too high?

Maybe a few days of cage rest would help with the back - just to settle things down again. Then you'd be able to get him back where he needs to be cortisol wise without worrying about him ending up in agony towards the end of a mini-load.

Alison

Lulusmom
05-04-2009, 04:57 PM
Hi Cheryl,

Just how high is a post stim of 10.2 ug/dl? I think Alison and I are on the same page. In my opinion, it's high enough to be concerned about. If Barney's last post stim number was within range (1 - 5), then it would be pretty obvious to me that you've lost some ground and the adrenals are regenerating. Without a minload or an increase in maintenance, I suspect that cortisol will continue to climb and you will see a return of symptoms at some point. Can you post the results of Barney's prior stim so we have a frame of reference?

I hate to parrot Dr. Feldman all of the time but he's been treating cushdogs with Lysodren for more than 35 years and has seen it all. He is emphatic with his students that "for a dog to be considered normal, you must get the post stim below 5." Now I just have to figure out what his definition of normal is. :D

Glynda

labblab
05-04-2009, 05:17 PM
Cheryl, what would be the normal lifespan for a dog of Barney's size and type? If he is approaching the last couple of years of an expected lifespan, I guess I am taking a bit of a different tack here in that I would be more concerned about his outward comfort than his "inward" numbers. That is to say, I would not be as worried about chronic organ damage as I would be about his mobility and current quality of life.

Not having been a Lysodren parent, the piece that I don't know is whether you would be making life a whole lot more difficult for him by perhaps necessitating a full load in the future if you don't make an attempt to rein in his cortisol again now (e.g., I don't know how a full load compares to a mini-load in terms of stress for the dog). But at Barney's age (and from his pictures, I am presuming him to be a "big dog"), if it were me, I'd be making the treatment judgement largely on the basis of his visible comfort and the status of his symptoms.

Marianne

forscooter
05-04-2009, 05:39 PM
Cheryl,

Just checking in. I have to agree with everything Marianne said here. As you know, I battled arthritis issues with Scooter, and Bailey has the hip dysplasia on top of it all. For bassetts, the average lifespan is 8-12. Scooter made 8. Bailey, God willing, will be 10 in July.

Bailey's last ACTH (which I admit was some time ago) was around 9. The thing is, he was more comfortable there. I don't see since then that we are back to Cushing's symptoms at all. I was thinking of re-stimming him but then I thought, why???? It won't matter bc whatever he is now, he is comfortable.

I am not a believer in treating by the numbers. I mean, after all, to make the diagnosis you don't just treat on numbers alone. You treat based on numbers AND symptoms. So, in the absence of symptoms, if Barney seems otherwise happy and with good quality, isn't that the end goal after all? :) Treating by some piece of paper is not, in my opinion, the determining factor.

Also, high cortisol levels do damage over a period of time. Not overnight. Not in 2 weeks. So with Marianne's thoughts on what his lifespan would be otherwise, I would keep that in mind as well.

All this rainy weather has me hurting. Bailey has been limping around and I thought twisted an ankle before so I am keeping an eye on him. I am wondering if the back pain can't be somehow related to this unrelenting weather around here???

I just thought I'd chime in....you, of course, know what's best....but a very wise woman once posted on the old board when I first joined, "I don't believe in treating by numbers alone"....and to this day I keep that in mind.

My two cents...which in today's economy probably means I owe you money...

Love ya! Beth, et al.

gpgscott
05-04-2009, 05:51 PM
Hi Cheryl,

I am more concerned with Barney's behavior than I am this post number.

10, is not considered bad for a non-cushpup and if he feels well, me; I would't push it.

And you have other issues going on which interestingly enough have not raised his resting cortisol.

As to the Dr. Feldman qoute from Glynda, I really don't think Barney is one of those pups with no control whatsoever of cortisol, based on his history.

If I am remembering right he is on a maintenence only Lysodren rgimen, is that right?

Scott

barney's mom
05-04-2009, 06:37 PM
I am so confused!!!! LOL
His last stim was post 5.5, I don't remember what his pre was. That was 6 months ago. He is definitely trending upwards. I do fear his symptoms may return, at some point down the road, and I also fear that his leg weakness may be because of the higher cortisol? He hasn't been his playful self, but then again, he has been battling this eye ulcer, so he has been mopey at times over that plus back has been bothering him and he limps from time to time ......again, I am not sure if this is related to his elevated cortisol. ?????
Average life span of a border collie is 12 to 13 years. But maybe he will live years on borrowed time :)

I guess I am going to get the eye taken care of first. Likely he will have a repeated surgery to debride the eye and hopefully the tissue will take, and he will heal.

Then I will tackle the cushings. The vet doesn't feel that the cortisol is high enough to cause his leg weakness, but I just don't know. Right now he is on 375mg of Lysodren a week. That about 16mg/kg/wk.

He would prob require a mini load, but how much do you think? He loaded initially on 500mg daily and loaded in 7 days. His post stim was 1.5.



Cheryl

barney's mom
05-04-2009, 06:43 PM
OH......and thanks guys! :D:D
We love you and couldn't do this without all of you!!!!!!
XOXOXOXOXOX
Cheryl

AlisonandMia
05-04-2009, 07:00 PM
It does sound, if nothing else, that his cortisol is on the rise and that his present maintenance dose is not adequate to hold it even where it is. A compromise could be to up the maintenance dose a tad to at least keep him where he is now especially if eye surgery is in the offing - you don't want him becoming raging symptomatic two days before scheduled surgery! You could discuss that option with the vet. I wonder what (if any) effect elevated cortisol could be having on his eye ulcer? Debbie may have some useful input in that regard.

Humans with Cushing's just about universally report horrible, unremitting muscular-skeletal pain presumably as a result of soft-tissue weakness. I know people and dogs are different and humans are much bigger and heavier which is probably a factor when it comes to muscular-skeletal pain - and cushingoid humans are almost always grossly overweight but I do wonder if some cushingoid dogs aren't in similar discomfort - especially the larger ones. I have read at least one account of a woman who had her cortisol lowered by pituitary surgery and interestingly she began to feel much better almost immediately - rather like a lot of cushdogs responding to successful treatment.

If you do reload at some point and it causes problems with pain when the cortisol lowers there are always other pain meds and if the worst comes to the very worst there is always a little dose of pred. I wouldn't be so sure that he isn't suffering some muscle weakness as a result of the high-ish cortisol already - what symptom is the most bothersome seems to be an individual thing and maybe, for Barney (particularly with his history of a back injury) muscle weakness is first and worst symptom. When Mia was put on pred briefly during her final illness I saw absolutely no cush symptoms at all - except she started wetting her bed again almost immediately. Her water consumption didn't go up appreciably though.:confused::p

Alison

barney's mom
05-04-2009, 07:15 PM
Thanks Alison!
It was hind leg weakness that had me test him for cushings in the first place.
I am calling his IMS in Maryland. She was a bit overbearing and definitely not a people person, and we did clash, but she loaded Barney perfectly........she did an amazing job. I am going to call her tommorow. She is now two hours away from me, but I wonder if she won't do a phone consult and maybe be in charge of reloading Barney and I can have him tested here in PA. He gets car sick and that is one long ride.

I talked with my husband when he got home and he thinks he is drinking more, and he has awakened him to pee in the early morning twice in the past month or so....That is something he never does.

Elevated cortisol does interefere with the eye healing. They won't give steroid eye drops with an active eye ulcer for that reason.

I guess I can't say for certain that he isn't symptomatic, this may be sequelae from elevated cortisol??????

stardeb55
05-04-2009, 07:42 PM
I guess I peeked in at the right time. Harley's eye kept re-ulcerating, partially due to the elevated cortisol, & the immune system suppression that we all know comes with Cushing's. If I remember the sequence of events correctly, the eye infections/ulcer started prior to the Cushing's diagnosis. We had actually had it cleared up at one point which was either right before or right after the first time he was loaded in the Spring of '08. His first post numbers were horrible, I had argued with the IMS for 3 weeks about this before they finally agreed I needed to bring him in. I remember sitting in the exam room, looked at Harley, & went, "Damn, your eye is all goopy, again." I re-started all of the eye meds, called the GP for a 2 week follow-up. Things looked ok, so we started decreasing the eye meds. Follow-up in another month, & his eye looked like it had never been treated. At this point, we got sent to the vet eye Dr. which I believe was early last fall. Now, to get to the point, the vet eye dr. put him on an antibiotic ointment with a very tiny amount of steroid in it which she felt would not be detrimental to his Cushing's. She did explain that due to the amount of corneal scaring, the steroid was an absolute necessity to try to thin & clear out some of that scaring. This ointment was given in the morning. Same antibiotic ointment, no steroid was given at night. Cyclosporin eye drops 2-3x per day, & in between all of this the "Refresh" drops. This has actually all worked since Harley has not had a re-ulceration in about 10 months. His tear test is still not ideal, but better. We are due for a recheck at the eye Dr. in the next week or so, & I will know more then. I never saw any issue with the steroid containing eye ointment aggravating his Cushing's or increasing his stim results that I can recall.

The only other thing I can say is Mom, here, hasn't been as diligent as I should be with the cyclosporin eye drops, but I'm trying to change that. Unfortunately, I, now, have found out that my other boy, Chewbacca, is "allergy boy", so I'm having to manage a huge round of medication for him, along with Harley's regular meds. I have my day job to make money which is to pay for my night job which is taking care of 2 "medically needy" pups!:eek::D

Debbie

Lulusmom
05-04-2009, 09:28 PM
Hi Cheryl,

I think calling the IM is a great idea and we'll have fingers and paws crossed that she can get your boy back on track. I am going through a similar ordeal with Lulu at the moment. About three months ago, her post stim was 11.4. Because she is so tiny, her IM did not want to do a full blown reload so we did a half load for four days. She originally loaded with 50mg twice daily but this time we loaded with 50mg once daily for four days and then upped her maintenance dose the following week from 50mg twice a week to 50mg three times a week. We stimmed her four or five weeks ago and her post was 6.4. Because she has multiple issues, including a continuing unknown skin problem, her IM felt that we need to get the post down below 5 so we upped her maintenance a bit to 60mg three times a week. I had my doubts about whether we would be successful with the half load routine so I was pleasantly surprised to see the 5 point drop. I'm not convinced that the 30mg increase was enough but we'll find out in a few weeks. I am so tired of stim tests!

Jojo has chronic keratoconjunctivitis requiring optimmune twice daily. If his cortisol is too high, like Harley, the condition worsens big time. His eyes have been really runny and redder in the last week so I am wondering if he may be running high too. I guess I better take him in with Lulu. I am so tired of stim tests!

Glynda

barney's mom
05-05-2009, 08:14 AM
So I called his IMS in MD and she won't treat him, she told me to find an IMS in PA. :rolleyes:

So I have an appointment tommorow in Towson for an IMS. It is an hour drive for my poor carsick dog. I am truly growing weary from the fight and constantly finding vets, only to find a new vet again and again. :(

Squirt's Mom
05-05-2009, 11:01 AM
Hi Cheryl,

I've been following along even tho I haven't posted. I certainly hope the IMS can help him. Are you sure we can't trace Barney's problems back to that hair cut? :p

Hugs and prayers,
Leslie and the girls

barney's mom
05-05-2009, 11:50 AM
Hi Cheryl,

I've been following along even tho I haven't posted. I certainly hope the IMS can help him. Are you sure we can't trace Barney's problems back to that hair cut? :p
Hugs and prayers,
Leslie and the girls

ROFL! I wish we could! Poor John will never be allowed to live that down.
He is seeing Dr Martinez tommorow. It's an hour drive, so I guess it could be a lot worse.
Here is a blurb about her from the vets website:
"She conducted research on the pathophysiology of hypertension in canine hyperadrenocorticism as part of her graduate studies. During her residency, she was awarded the Bente Flatland Memorial Award in recognition of her clinical abilities and compassion toward pets and owners."

Lets see, a compassionate vet who is up to date on hyperadrenocorticism....
well that is the best offer that I have had yet :)

LuvMyMunchie
05-05-2009, 03:17 PM
I am truly growing weary from the fight and constantly finding vets, only to find a new vet again and again.

From one weary Mom to another...boy, do I ever hear ya' Cheryl! The search (in Munchie's case anyway) seems to go on, and on, and on.....

Dr. Martinez sounds wonderful. Hope she lives up to the "blurb" and you're able to get things sorted out for Barney.

Louise

Truffa's Mom
05-05-2009, 10:25 PM
Here will be crossing paws and fingers, not just for a fast recovery (eye, back pain, high cortisol, car sickness), but also for a good doctor for real and not just on paper....

Lets see, a compassionate vet who is up to date on hyperadrenocorticism....
well that is the best offer that I have had yet .

Barney we will be sending you tons of GOOD ENERGY. And to mom Cheryl another ton probably topped with choco-kisses

Marcela & The Choco Labs

barney's mom
05-06-2009, 07:30 AM
I had to cancel todays appointment with the IMS. There was no way I could get his medical records from the vets that quickly. Actually I am feeling pretty positive about this IMS. (I know, I always say that.........rofl) Actually I still think Dr/uncle Rick still has a place in Barney's care, just not managing his cushings or his eye.


Cheryl

Harley PoMMom
05-06-2009, 08:47 AM
Hi Cheryl,

Was just catching up on the forum, I was sick, I am so sorry to hear about Barney and having to find a new IMS. Hopefully, Dr Martinez will be the one for Barney.
I'll be praying for you and Barney, and watching for your post.

Take care,
Harley and Lori

ladysmom06
05-06-2009, 10:28 AM
Hi Cheryl,

Just checked in to see how your appt. with the IMS went and saw that you had to cancel it. Hoping you can get there soon and she can help him. Hugs to you and Barney.

barney's mom
05-06-2009, 12:05 PM
Thanks guys :)
I need to get his chart from his former IMS. I thought I had enough of a paper trail here from prior vet visits to pull it together, until I started searching for my paper work.
The old CC.net site was almost Barney's diary. I used his thread to look up lab values I had posted, etc.....
I am so lost with out it. My fault entirely, I should have kept the numbers on my computer as well. I had very little documentation, everything was phone calls.

I will get the chart and THEN make the appointment.

Cheryl

barney's mom
05-07-2009, 02:45 PM
Barney's eye is looking MUCH better. And the improvement seems to be sustained, overall. He still squints quite a bit, but the eye is opened probably more that it is closed. I am sooo hoping that he is finally healing!

Happy day here!

Cheryl

Harley PoMMom
05-07-2009, 03:20 PM
Cheryl, that's great news, so happy to hear Barney's eye is healing. :D
Harley and I are over here doing our Happy Dance!!:D:):D:)

Truffa's Mom
05-07-2009, 06:37 PM
La, la,la,la,la
Happy, happy,happy.

Marcela & The Choco Labs

Harley PoMMom
05-12-2009, 09:40 AM
Hi Cheryl,

Just checking in to see how things are going, how is everything?

barney's mom
05-17-2009, 11:58 AM
Hey guys, sorry I haven't been here much the past few days. Crazy busy schedule this week. Our little community hospital is going to computerized charting and I have been in computer class all week.

Barney had an eye appt with Dr Rick. Maybe a slight change for the better, he said before he could see a "lip" or and edge where the cells were building up and not sticking to the membrane. He doesn't see the lip any more.
I see the eye specialist this Tuesday.

Funny thing is I got disgusted with the eye drops. 4 times a day for just the antibiotic eye drop and then the tears, and it seemed all for nothing. This has gone on for months. He and I are both tired. I didn't put his eyedrops in for two days........and his eye looks fantastic! I am talking a HUGE improvement. Not sure if it is coincidence or if maybe the drops were irritating him???? Anyway since our eye appt is only a day away I am going to continue like I have been and see what happens.

Now my other problem. I shampooed my carpets upstairs a few days ago. My dogs are very very good about going potty outside. It can be months or years between accidents. As soon as I shampooed, I am finding pee and poop everywhere!!!!!!!!!!!!!:mad::mad::mad::mad::mad:
Carpet is beige :rolleyes:
This didn't start until after I shampooed the carpets, and ironically I just bought a new steam cleaner! I am pretty sure it's Beth. I went upstairs to go to bed yesterday morning and she was hiding beside my dresser.
The former owners of this house had cats. Think I may have stirred something up? I don't see any old spots, but there sure are a lot of new ones :mad:

Any suggestions?

forscooter
05-17-2009, 01:05 PM
Oh sure, it's always Beth's fault!!! Beth Beth Beth....sure blame poor Beth...we can take it!

Weird with the eye....but you may be right! Sometimes I think we can overdo (not that you weren't following instructions....just that sometimes I think after a while Mother Nature does better.....my opinion....and it's trial and error...)....I'll be interested to hear what the doc thinks!

As for the carpet, I was once told by a carpet guy that steam cleaners can do just what you are seeing. They make the smell come up but don't get rid of the underlying problem. Kind of like when it's humid and you can smell accidents worse. What I have done in the past, and it has helped, is "shampooed" the carpet with Nature's Miracle. If the area is too large to douse with it straight from the bottle, I have gone over the area letting the carpet cleaner spray it on and then I leave it, put towels down until it dries. Sometimes this has taken a few times....

Now, you go give Beth kissies and tell it's OK, bc the other Beth said so....she's just trying to mark what's her's....not that I have peed on the carpet myself! But surely there is just no way it is her fault....:rolleyes:

Love ya! The Other Beth

barney's mom
05-17-2009, 01:43 PM
Oh sure, it's always Beth's fault!!! Beth Beth Beth....sure blame poor Beth...we can take it!

Weird with the eye....but you may be right! Sometimes I think we can overdo (not that you weren't following instructions....just that sometimes I think after a while Mother Nature does better.....my opinion....and it's trial and error...)....I'll be interested to hear what the doc thinks!

As for the carpet, I was once told by a carpet guy that steam cleaners can do just what you are seeing. They make the smell come up but don't get rid of the underlying problem. Kind of like when it's humid and you can smell accidents worse. What I have done in the past, and it has helped, is "shampooed" the carpet with Nature's Miracle. If the area is too large to douse with it straight from the bottle, I have gone over the area letting the carpet cleaner spray it on and then I leave it, put towels down until it dries. Sometimes this has taken a few times....

Now, you go give Beth kissies and tell it's OK, bc the other Beth said so....she's just trying to mark what's her's....not that I have peed on the carpet myself! But surely there is just no way it is her fault....:rolleyes:

Love ya! The Other Beth

lol, I was thinking of you as I was typing about Beth's unsavory behavior. :D

LuvMyMunchie
05-17-2009, 02:37 PM
Right along with "BB", I will also be interested in what Barney's eye doc has to say. Munchie's eye doc certainly had an entirely different opinion from the GP vets he saw.

I've also used Beth's (the human) technique for kitty urine in the carpet. I put the solution into the carpet cleaner, saturate the area and then blow dry with a box fan. Have used Natures Miracle in the past but switched to Simple Solution. Munchie never has had accidents in the house but my senior kitty was a repeat offender. :mad: I have a birch carpet and either brand of the cleaning solution leaves a yellowish residue that I have to wipe off with a damp sponge. With a beige carpet you may end up with the residue too but other than that the stuff seems to work.

Louise

gpgscott
05-17-2009, 04:46 PM
Hi Cheryl,

Glad Barn is looking better and hoping the specialist gives you the high sign.

Can't recommend a product on the carpet issue but what Beth and Louse have said makes sense.

Scott

LuvMyMunchie
05-19-2009, 06:29 PM
Hey Cheryl,

How did Barney's eye appointment go????

Louise

barney's mom
05-19-2009, 06:48 PM
Hey!
The ulcer is healing, the vet said there are new blood vessels forming to bring blood to the eye and that a clot is forming over the affected area. (thats a good thing) He also said the blood vessels would dissipate after the area has healed over. He said ulcers with no vessels have a 30% chance of healing while cases like Barney where the vessels have formed have a 70% chance of healing. He feels that Barneys will heal within the next 2 weeks to a month. He wants to see him after the scab or clot dissipates.
He also said Barney has a corneal membrane defect. He showed me how the new cells just move loosely over the eye instead of adhering. He said he has a 99% chance of a new ulcer forming in that eye or in the other eye.

There is a procedure where they "burn" little holes into the cornea (100 in each eye) He never gave me the name of the procedure! I want to read up on it. But he has performed over 2200 of them and has never had a failure and has never lost a dog. He wants to do both eyes because with Barney's kidney issues and his age he may not be a candidate for anesthesia in the future and with an almost certain chance of recurrence he feels we should do this in a month or so. It would be 845.00 for one eye and 1275.00 plus medications for both eyes. I was expecting worse :)
What do you all think?

BestBuddy
05-19-2009, 07:20 PM
Good news about the ulcer. Surgery is always something that has to be carefully considered but the fact that there will be more ulcers and they could be even more difficult to treat and heal that I would (my opinion only) go ahead with the surgery. I haven't heard of the "burn" procedure so I will have to google it so I understand what it all means.
Jenny

LuvMyMunchie
05-19-2009, 08:35 PM
I second Jenny's opinion, I'd opt for the surgery. I have no idea what the procedure is but if the eye doc has performed over 2,200 of them and has never had a failure, that sounds pretty darned good IMO!

Louise

Lucygoo
05-19-2009, 09:16 PM
Hi Cheryl....That sounds good to me. I would DEFINATELY do the surgery..

Gina and Lucy

Harley PoMMom
05-20-2009, 03:35 PM
Hi Cheryl,

Hey there girl :D I know how busy your schedule is, so I had some time to surf on the internet and I typed in: a procedure where they "burn" little holes into the cornea (100 in each eye) for a dog and found this: multiple punctate keratotomy, do you think this might be the procedure? I found this link,http://www.furrycritter.com/health/dogs/Corneal_ulcer.htm kinda interesting, doesn't tell you alot, tho.

Just tryin to help ya out. Give Barney a big hug from Harley and me and I'm so happy his eye is doing better.

gpgscott
05-20-2009, 03:54 PM
Hi Cheryl,

I am guessing that the holes anchor the cornea. I am sorry that Barney has this condition but it sounds like its either the surgery or continuing issues that may be even more threatening.

I know you will make the right descision.

Scott

AlisonandMia
05-20-2009, 04:39 PM
Here's something on the procedure: http://dspace.library.cornell.edu:8080/bitstream/1813/2898/1/2004%20Plant.pdf

If you google "thermokeratoplasty ulcer dog" there is quite a lot of info out there.

Alison