Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

[LuvMyMunchie]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

John,

I, for one, am glad you shared your thoughts about Roxee.

As you all know, this is such a difficult and confusing experience for both the cush pup and the cush parent.

I certainly agree with you here!! I personally don't think you're being too impatient, just a concerned parent. Roxee has had a number of things going on and all any of us want is to see our babies feeling well.

I definitely relate to your concerns and thoughts when it comes to the possibility of some unknown ??? going on. That's how I feel about Munchie, my all to frequently misdiagnosed mystery dog. He's managed to keep all his hair...it's my hair that's falling out at this point!

I'm glad that your Roxee is better today than she was before you started the meds and hope she continues to improve.

Louise

[nikkismom]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi, John, I certainly understand your frustration.I have been very uncertain since I started Nikki's treatment in November. Other than symptoms going away, she seems to feel worse since she's been on lysodren. She seems to have a hard time walking, so mostly sleeps. When she is up she feels pretty good, but that's not often. She is just now recovering from the stress of us leaving her for 6 days.When I had her stimmed right before leaving her post number was 8.7.When we got back she was so weak. I gave her a pred and she perked up, even though I know her number is now alot higher. She still isn't starving and doesn't finish her dinner. I need to have her stimmed but know my vet wants to get her number to 5, which I know will make her feel terrible.I wonder if this may be because when we started her post number was a high 50. My goal was always to have her as comfortable as possible, and when she's where she is supposed to be with cortisol level, she is not comfortable.This is just so hard! It always helps to have company in this battle for answers. Sharon

[Roxee'sDad]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi All,

And then you have days like today.... Roxee woke up a little earlier this morning. Gave me the little yipes and moans to let me know she was up and needed to go outside. (Roxee and Rozee have always slept in bed with us) Took her out and she was trucking around so much stronger than the last couple of days. No falling over today and just all around a stronger day.

Be nice if I could find some consistency in her strong and weak days.

John II

I read, that is to say, I think I read that you were considering changing Roxeee's meds (in another thread) is that the case?

Just thinking outloud - Check my earlier post, it is on my mind but too early, need to give it a chance. Once a day, twice a day???? If I could see a difference between am and pm, I would consider twice a day but with Roxee it more like a few good days then a few not so good days.

Louise -I so am Looking forward to making this Friday night a margarita night.

Sharron- yes it is difficult, if it was easy, we wouldn't be here. Wouldn't it have been nice if we all here became friends due to just our love for our healthy pups and not because of cushings. BTW - From the many threads I have read, some cushparents find there pups do better on cortisol a little higher than the preferred range. How many times have I read that "My cush pup hasn't read the manual on cushings"

BTW - For those of you that know LittleBit, She was spayed yesterday and of course when I picked her up I felt terrible. Poor little girl was just out of it, drooling and whimpering. Gave me that look like "what did you do to me?" I felt so bad I feel like I betrayed her trust in me.

All the best to you and your pups.
John (Roxee's Dad)

[Squirt's Mom]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi John,

Crys was spayed a few weeks back and I got the same look. She was back on her feet in no time, but I still felt like a heel, especially when she couldn't eat that morning! I never want her to face the fear of no food ever again. Crys got extra, extra lovings that nite and for the next few days, but the surgery didn't slow her down a bit except for that first nite. She was back in full out form the next day!

It's good to hear that Roxee is doing good today. I guess we just have to be happy for the good days and remember them on the bad ones. Easier said than done for a cush parent!

You're such a good dad, John, and Roxee, Rozee, Lil'Bits and Mic are all lucky to have you, and Patty, on their side. You have done an amazing job to learn as much as you have in the short time you've been around. Keep up the good work!

Hugs,
Leslie and the girls

[Truffa's Mom]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Just checking on you.

You have such a wonderful heart!!!!. A good day is something EXTRAORDINARY for a cush parent and a cush pup. We will cross our paws for more good days to come for sweet Roxee.

LittleBit will be up and running in a flash. Just one of those sleep overs on mom's and dad bed, and everything will be forgotten.

Please have a wonderful weekend, with or without margaritas.

Marcela & The Choco Labs

[Roxee'sDad]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi All,
Well it's time for a Roxee update:

ACTH Stim Test:
Yesterday May 14, 2009
40mg Trilo
Pre: 0.7
Post 1.7 (within range, not sure a celebration is in order)

March 12, 2009
40mg Trilo
Pre: 0.7
Post: 5.2

Feb 12, 2009
30mg Trilo
Pre: 0.9
Post: 10.2

They also ran a short bloodpanel, Can't believe her improvement in ALK and ALP

ALK 213 (23-212)
ALT 57 (10-100)

In 2006:
ALK 705 (10-150)

You can check all Roxee's records and history in an updated excel file at http://spreadsheets.google.com/pub?k...tafT0A0-ejnkOg
At the bottom of the excel page are tabs for acth, urine, bloodtest, weight and so one. Records go back to 2005.

Yesterday was stim day and it was rough with the panting and all. She recovered nicely by evening. She was very strong last night and very strong today

So is the cortisol going to continue to drop or stablize? I guess we have to continue to watch her for symptoms of too low cortisol I guess I'll keep my twitcher turned on

Bad news: Roxee is down a half pound to 12.2 She is eating 3 to 4 meals a day, get's little to no exercise Are the sex hormones involved

It looks like all her bio chemistry is lookin good but I am lacking the sex hormone information. Wish I had gotten the UTK in the begining still may have to consider doing it. Will discuss with our vet next week.

That's it for now. Maybe I will have a margarita tonight

Belly Rubs to all your furBabies.
John (Roxee's Dad)

[BestBuddy]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi John,
I would be a little concerned that Roxee's stim was too low......
In the Vetoryl flowchart it says for a post less than 50 nmo/l (1.8) to stop treatment for 7 days and restart at a lower dose.
I would be keeping a close watch on her like you already are doing. Was your vet concerned about the low number?
Jenny

[John II]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi John & Roxee,

There's always something, isn't there?
Hope Roxee's doing OK.

Best wishes,

Uncle John and Cousin Angelina

[Roxee'sDad]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi Jenny and Brother John,
Yes I am concerned and will watch her very closely. Vet said it looks good and to keep her on the 40 mg per day. Will talk to him early next week.

But the weirdist thing, Roxee is stronger, today and tonight than she has been in months. Just truckin along in the yard. and to think, two days ago I was begining to give up hope as she could barely stand. We think she may have hurt her front leg sliding on the very few bare spots on the floor. We've pretty much put throw rugs everywhere she walks but somehow she manages to find a bare spot.

Well, nighty night time.
Belly rubs to all your pups
John (Roxee's Dad)

[Roxee'sDad]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi All,
Sent my vet a fax yesterday, thought I would document my concerns and questions in writing giving him a chance to read it and prepare for our coversation. I expressed my concerns about weight loss, continued lowering stim results, UTK and a few other items. He called me this evening, thought the fax thing was a great idea and he agreed to contact Dr. Oliver to discuss Roxee's case and his opinion's on the next steps if any we should take with Roxee.

In the Vetoryl flowchart it says for a post less than 50 nmo/l (1.8) to stop treatment for 7 days and restart at a lower dose.
I would be keeping a close watch on her like you already are doing. Was your vet concerned about the low number?

Hi Jenny, I read that the number was 1.45 So now I'm confused.

Belly rubs to all your furr babies.
John (Roxee's Dad)

[BestBuddy]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hey John,
There are so many numbers out there but the one I was talking about was in the Dechra product info for Vetoryl. The conversion is 27.59 so 50nmo/l comes to 1.8.(I hope my figures are right). Many dogs go below this number and are fine but if you have some strange symptoms at this or lower number then I would seriously consider the 7 day break.
Jenny

[labblab]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi Jenny, I read that the number was 1.45 So now I'm confused.

Belly rubs to all your furr babies.
John (Roxee's Dad)

I think I can solve the mystery...

Up until just the last few months, we had been depending upon Dechra's UK published guidelines in making trilostane treatment and monitoring recommendations. In fact, Jenny was instrumental in obtaining and scanning a hard-to-find, detailed informational brochure for us (thank you again, Jenny!). That 2007 U.K. brochure and flowchart did list a "lower" limit of 50 nmol/l (or 1.8 ug/dl).

However, the newly released 2009 U.S. monitoring flowchart has shifted the "lower" limit down to 40 nmol/l (or 1.45 ug/dl). So I guess we must assume that is Dechra's most current recommendation.

http://www.dechra-us.com/File/vetory..._Flowchart.pdf

Hope that clears up the confusion!

Marianne

[BestBuddy]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Yep that's me, always behind the times.
John, I hope I haven't confused you. I don't like reading off the computer so I have been using the hard copy of the 2007 brochure. I guess I had better get with the program and get myself updated.
Jenny

[labblab]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Regardless of the slight modification of the numbers, your observation was still "right on," Jen -- Roxee's test result is down there at the low end. So your advice remains well taken, to be watching her closely. And you are still very much with the program!

Marianne

[Roxee'sDad]

Re: Roxee, 13 1/2 y.o. Shih-Tzu/Lhasa mix on Trilostane

Hi Marianne and Jenny,
It's really good that you are keeping me on my toes. Either way, it's a reference number and it is low, and as has been said, every pup is different.

Roxee is being pretty steady on her feet lately but her weight loss is worrisome. She has been very, very picky about what she wants to eat. I can't believe she gave up soft food for kibble. So now she will eat some "Taste of the Wild" Salmon formula. We'll see how long that last

She is still sleeping thru the night, I actually had to wake her up this morning. So we decided to not give her any Trilo today and see how she does thruogh the day and evening. Might skip a 2nd day too and see how it goes from there.

Hope the vet gets to discuss Roxee case with Dr. Oliver at the UTK.

I really rely on your inputs and opinions, that is why I post, so keep it up.

Belly rubs to your pups.
John (Roxee's Dad)