Barney

[barney's mom]

Re: Barney

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. It seems the eye takes so long to heal, but you and Barney are doing an amazing job. Here's to a puuurrrrrfect recovery

Take care, Harley and Lori

Haha! Thanks Lori!

[barney's mom]

Re: Barney

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]

Re: Barney

Hi Cheryl,

Just off the top of my head first thing in the morning here - 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]

Re: Barney

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.

Glynda

[labblab]

Re: Barney

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]

Re: Barney

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]

Re: Barney

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]

Re: Barney

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]

Re: Barney

OH......and thanks guys!
We love you and couldn't do this without all of you!!!!!!
XOXOXOXOXOX
Cheryl

[AlisonandMia]

Re: Barney

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.

Alison

[barney's mom]

Re: Barney

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]

Re: Barney

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!

Debbie

[Lulusmom]

Re: Barney

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]

Re: Barney

So I called his IMS in MD and she won't treat him, she told me to find an IMS in PA.

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]

Re: Barney

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?

Hugs and prayers,
Leslie and the girls