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  • #46
    Re: Coolidge...

    Hi Becky,

    Another PDH/Atypical parent here.

    Based on Coolidge's reaction to the Lyso and the UTK panel, I think you are dealing with Atypical only! YEAH! If I were you, I would not let the vet use any Lyso for now. Try the melatonin and lignans first for a good while, then if it seems the signs are not controlled, check the cortisol again. But I feel you may have just lucked out and Coolidge is simply Atypical! Just another "non vet" opinion!

    Leslie and the girls
    "May you know that absence is full of tender presence
    and that nothing is ever lost or forgotten." Anne, a Corgi mom


    • #47
      Re: Coolidge...

      I think it's still questionable whether the flaxseed lignans are necessary... he doesn't have elevated estradiol levels - I'm not absolutely positive, but I thought the lignans were more for controlling the estradiol levels.



      • #48
        Re: Coolidge...

        Susy, I believe you are 100% correct about the purpose of the lignans.



        • #49
          Re: Coolidge...

          On the Treatment Option Considerations Paper I got back for Harley it has under option # 3:

          Note: Melatonin and flaxseed oil with lignans are used together when estradiol is increased.

          I seen from older sheets that it used to say may be used together, so, I guess Dr. Oliver changed it?


          • #50
            Re: Coolidge...

            Just thought I would post the results of the ACTH stim test done at the end of December, when my new vet said I should start Coolidge on maintenance.
            Of course one test lab does it in ng/ml and this one did it in ug/dl. (Math has never been a strong suit).

            December Results:

            Pre-ACTH: 5.5 ug/dl (norm: 2-6)
            Post- 8.8 ug/dl (norm: 6-18)

            However, I noticed that the notes in the reference range (from Idexx) says 1-5 is the desired pre and post cortisol on lysodren therapy (which I assume means that's the numbers you want to keep it at during maintenance.

            Perhaps that one pill put her over again.

            The endocrinology report on her thyroid (done also at the end of Dec) has everything in the normal range except for:

            Free Thyroxine (FT4) 7 pmol/l (8-26 norm)
            Free Triidothyronine (FT3) 1.5 pmol/l (4.5-12 norm)
            T4: 2% (Norm 0-20%)
            T3: 3% (Norm 0-10%)

            The thryrogobulin antibody results were:
            <20% Negative
            20-35% inconclusive
            >35% positive

            The endo guy at Michigan State said "The free fractions are borderline to low, but total fractions look good. TSH is not elevated and the specific TgAA is negative. Hence, not real indication of primary thyroid disease."

            I don't know about all of you, but I'm getting pretty tired of "we will treat it as if" and "not real indication". It's like it's purely a guessing game at the expense of our animals. One would think this guy on this test would have said, hmmm, that FT3 number is really low, I wonder what is causing that... and do a Dr. House on Coolidge. Where is Dr. House when you need him?

            Coolidge's panting, drinking, hunger, and urination is getting worse by the day. Her cough is getting huskier and more frequent.

            I'd like to think that one day we will have this all resolved. And a final determination made. I'd like to think it's just Atypical, and we do the melatonin routine. I will keep the lysodren just in case we do need to go there. But I will tell Hope Safehouse, a rescue in our area, that I have pills in the event a pup needs some. I will be able to share.
            Last edited by Coolidge; 05-16-2009, 11:10 AM. Reason: Added T3 and T4 Counts for clarity


            • #51
              Re: Coolidge...

              In theory, with a post of 8.8, on dose of lyso should not have caused an Addisonian crisis. I still think the real problem is that Coolidge never had PDH to begin with, & that's why there have been so many problems with the lyso.