Just want to start off by saying that I have tremendous respect for Vets and all they do. I so appreciate the care my Vet gives my furkids...
Anyone that knows me or that has read my blog knows I have a dog (Raider) with Addison's disease (hypoadrenocorticism). I volunteer on the Yahoo Group Addison Dogs helping people with their newly diagnosed dogs.. Yes I am one of those dreaded online people who give suggestions on Canine Addison's ..
I am not a Vet and I make sure to tell people that, and I also tell people not to make changes to their dogs medications without talking to their Vets.
But I do know how to manage a dog with Addison's disease.
We have vets who join our list to get information or who have their own Addison's dogs and want help. We generally have the latest treatment info, and often more up to date than many GP Vets have.
We see everything from people who will do everything they can for their dogs to ones who put their dogs down when they get the diagnosis.
We see people who have great Vets and the dogs get the best care. We also see people who have Vets that either don't care or slept through Veterinary school or at least endocrinology. Now I realize that Addison's in not a common disease and it is often misdiagnosed, it is called "The Great Pretender" as it mimics lots of other things including Kidney disease. Vets certainly don't see this everyday. But can't they look it up... for crying out loud.
One of the best drugs out there to treat Addison's is Percorten V (desoxycorticosterone pivalate). But it is not available everywhere so many parts of the world they must use Florinef. I have used that drug as well but hope to never have to go back to it for my boy.
As I said we see the good and the bad in both owners and Vets..
My rant today is on the Vets who could use some education on Addison's disease, so if anyone has suggestions on how to get the message out I would appreciate it because educating one Vet at a time is slow..
For example today we get a Vet who tells us that he is fine with reducing the percorten dose but he does it by reducing 25% at a time but he doesn't test the lytes ( electrolytes, specifically the sodium, potassium and chloride )because and I quote, " I am not a fan of testing the lytes because they are inaccurate and questionable" ... I'm sorry but WTF... so instead he reduces the dose and if the dog is fine in a month he reduces it again.. great way to put the dog in Addison's crisis I'd say. The lytes test/BUN are the most important tools when dosing to effect..
Or the vet who reruns the ACTH test monthly to see how much pred to give the dog... another WTF ... The ACTH test if done correctly the first time is a diagnostic test for Addison's, not a management tool, there is no reason with Addison's disease to do it again unless this was a Cushing's dog turned Addisonian and you want to be sure it is not returning to a Cushing's state.
Then there is the Vet who reruns the ACTH test to make sure the dog is getting enough Percorten V... again WTF.. it measures cortisol not Aldosterone. So again a waste of money.
Or the vet who refuses to lower the percorten dose even though the dogs K is 3.8 ( 3.4 - 5.8 ) at day 28 and just gives another full dose of percorten or increases the dose because the dog gained 3 lbs... another WTF, that's like giving more insulin to a diabetic dog whose blood sugar is already too low.
Don't these vets know anything about 'dosing to effect" or using the lowest effective dose..???
Then there are the vets who have the dogs on prednisone for a week before they run the ACTH test. Prednisone interferes with the test and can cause a false positive for Addison's. Dexamethazone can be used in the short term and it doesn't have any real effect on the ACTH test other than to sometimes reduce the pre stim result a bit. But the post stim test is the biggie anyway and it has no effect on that.
We see on average a couple of dogs a month who are misdiagnosed with Addison's because of a false postive on the ACTH test because of pred being used before the ACTH test. When they are taken off of it and supported on dex until the pred clears their system they pass the test.
Or the dog who fails the ACTH test but has perfectly normal lytes but the Vet puts them on either percorten or florinef anyway. These dogs only need a steroid replacement.. They don't need the other meds.
Now I realize they can transition to Typical Addison's but that happens in less than 20% of cases.. so no need to put them on it until they actually do need it.
I don't expect a Vet to know everything but I do expect that if they don't know something that they would try and find it out..
So any advice or suggestions on how you would talk to a Vet who does some of these things?
Thursday, April 22, 2010
Tuesday, April 20, 2010
We had a fine needle aspirate done of the lump and vet feels sure it is a fatty tumor. It however is located in a bad spot that can grow into the muscle and interfere with walking etc so if it grows much bigger that thing is coming out. It is in the same place Buddy's was ( his was huge ) and he had surgery several times and it took months to heal.. So I will keep a close eye on it and if that thing gets any bigger out it comes..
Monday, April 19, 2010
Sunday, April 18, 2010
It has been raining all day here so I went out with Emma and we picked out new stuffy's for the furkids. We got them for 25 cents a piece at frenchies. They loved them, you can just see Tramp staying out of the way on the chest.. smart cat.. Caley and Raider tugged and tugged..
and tugged some more
Opps we lost one...
I think I am starting to see a pattern here... But they had so much fun.. One stuffy survived to be tugged another day.. hmm two arms are missing now, I hope Chauncy did not devour them....how soon does the vet clinic open.. now I need to go look for those arms.
Sunday, April 11, 2010
This is Cooper and "HE" owned Velma and Howard..
Cooper came to them as a rescue that no one else wanted. He however, was very much wanted by Velma and Howard. Cooper and Howard were together "all the time." Coop went everywhere with Howard, including to work every day.. He loved his Tim bits and he always got his share..
Late last fall Cooper was diagnosed with cancer and he had his front leg amputated. I want you to know that this NEVER slowed Cooper down for a minute, he chased a ball with the best of them including my dogs. He and Raider were pretty good friends.
Cooper out on one of his daily runs with the other dogs.
Cooper you lived life the way we all should, enjoying every moment!!
We, who choose to surround ourselves with lives even more
temporary than our own, live within a fragile circle,
easily and often breached.
Unable to accept it's awful gap we still would live no other way.
We cherish memory as the only certain immortality,
never fully understanding the necessary plan.
- Irving Townsend
Saturday, April 10, 2010
I have 3 grandchildren, Emma the oldest at 10, Aselin 2 1/2 and Desmond 2 yrs 3 mos. I get to see the girls pretty much every day as we are lucky enough to live very close. Emma travels to school with me most days as she takes french immersion at one of my schools and where I just happen to have my office. How cool is that... Desmond I don't get to see as much as he lives in Ontario but I did get to be there when he was born and that was one of the greatest moments of my life. I even got to cut the cord. His Daddy got a little weak in the knees at that point. Now the BEST news is now Maddie is expecting again and so in November Desmond will be getting a little brother or sister. It's too soon to tell yet as Maddie is just 9 weeks so stay tuned to find out if it will be a boy or girl!! We are totally overjoyed and we are now going to plan a trip to Ontario for the birth of our next grandchild.. Mom and Dad have asked us to be there this time as well, we did not get pushy and ask...we waited and they asked us... So now I am so excited again.. My lap is not going to be big enough for all four!
Thursday, April 8, 2010
Now for all my friends who know Chauncy, they know he is very vocal, he is a loverboy.. No one has ever exclaimed that is a smart lab.... trust me no one. But he is smart like a fox.. He can figure things out that the other two would never think about. Like how to get the lid up on the dog proof garbage can, 30 seconds flat! Then how to get the lid up on the little compost bin under the sink... 10 seconds and that includes opening the cupboard door. But it took us humans 3 years to figure out how to keep him out of it without a lock on the cupboard. Get this we turned the bin around backwards.. sad it took us that long to figure that out.. But I want to show you Chauncy's GREATEST trick ... well it's his only trick really but never mind you will love it...