9 January 2010

Update on The Bean

I have been lax on posting an update on Simon since my last post. Since then, the following has occurred:
  • Simon had a Bile Acid Test done. This is done to determine if the liver is functioning normally. The results of the test indicate that Simon's liver is healthy. ---> *So, that's one in the Wahoo! column*
  • Simon had a Cushing's Disease Test done. This determines if he has excessive cortisol (a naturally occurring steroid that, in high quantities can be detrimental) circulating in his system. The results of the test showed that Simon had levels that are borderline for Cushing's Disease. My vet, wanting to clarify the results, contacted the lab that did the blood work. The pathologist he spoke to said that she believed that Simon did not have Cushing's based on the lab work. Still not satisfied, my vet called back to further discuss the results and once again was told by the pathologist that Cushing's was unlikely. So, if it isn't Cushing's, then what was making Simon drink and urinate so excessively? ---> *One in the Huh? column*
  • Next, Simon went for an abdominal ultrasound at an emergency vet (the only local clinic that has the equipment) to check the size of his kidneys and adrenal glands. Since we had hit two dead ends, my vet thought that maybe there was a tumour or some other abnormality. The ultrasound required that Simon's belly be shaved and then he was held immobile on his back by a vet tech while the emerg vet did the testing. Simon was not happy - we could hear his howls of indignation in the waiting room. It took every thing in me to refrain from going to his rescue. The ultrasound showed nothing of concern, just healthy organs. ---> *One in the Yippee! column*
  • At this point, my vet, admittedly at a loss for answers, posted Simon's case history on a website that is frequented by vet specialists in the field of internal medicine. The diagnosis came back as Cushing's disease. ---> *One in the Aw, Shit! column*
  • My vet then called back the lab where the original Cushing's test was performed and asked to speak to a supervisor. The supervisor confirmed, based on the lab results, that he would diagnose Simon with Cushing's disease - he said that the other pathologist was foolish to have dismissed it. Now my vet was understandably livid and demanded that I be reimbursed for the cost of the testing and the ultrasound. So, I should be getting a cheque in the mail. ---> *One in the Unexpected Windfall column, followed by one in the This Fuckin' Sucks, My Dog Has Cushing's Disease column*
As of Friday, my vet is suggesting we treat Simon with Vetoryl (trilostane). It is a drug that blocks the overabundant production of cortisol. In my research, it appears to be the safest form of pharmaceutical treatment out there, as long as an appropriate dosage can be determined. I have an appointment to talk to my vet on Monday about the drug, so I'll post what I learn then.

Once again, thank you so much to all the people that have left kind comments or emailed to inquire about Simon & I. The last few weeks (months?) have been a stomach-twisting, insomnia-filled roller coaster ride (that doesn't look like it's going to end any time soon) and the support I have been given has helped to keep me going.

Lastly, I would be remiss if I didn't send out a special thank-you to Leslie for providing me with the benefit of her knowledge and sharing her story with me at a time I needed it most.


*"The Bean" is my knickname for Simon. I always thought this In Living Color skit was funny, especially the "Lazy lima bean" comment. And, as you can see in the photo above, Simon is definitely a lazy lima bean.

41 comments:

Lilian said...

So sorry to hear it didn't turn out as you hoped. I hope there will be a way to let Simon live the rest of his life as comfortable as possible. And one BIG HOORAY for your vet to be so thorough, persisting and helpful.

gwensews said...

Poor Simon, and poor Simon's mother. I hope he is able to get better. Wishing him well.

wendy said...

Awww. Poor guy- lots of hugs for him. What a bummer that you had to just about go through a doggie House MD episode to get him diagnosed!!

Nancy K said...

Poor Simon and poor you. I am so sorry that it isn't better news. Good luck to Simon.

KID, MD said...

I'm so glad that your vet was persistent and got an answer! That's the first step to a healthier life for Simon. I hope y'all can find a therapy that works for all.

Lisa said...

Shannon,
Sorry to hear about Simon. It may have not been what you wanted to hear, but there is some relief in knowing what is wrong.

I love the photo of him. He looks so....so.... unconcerned! Aren't dogs just the best!

Heather said...

Here's hoping you find the best possible treatment for Simon. It sounds like you have a very good vet.

JodieK said...

I've been checking regularly to get a "Simon update". As a dog owner (well, I'm sure Dinah would day she owns me), I can't even imagine the concern and stress you've been under. I hope a diagnosis is a relief and that adequate treatment can be found.
Best wishes

Anonymous said...

Shannon, I don't know how similar equine Cushings is to canine but I have three horses with Cushings who are doing well. Apparently there is a large number of false negatives in the testing of equine Cushings and some vets are now beginning to recommend treatment based entirely on the symptoms. Hope Simon feels better soon!
VtMartha

Trudy Callan said...

I'm so sorry to hear about Simon's bad news. I hope he responds well to the treatment and is comfortable.

She Says said...

I hope Simon lives a long and happy life. Our Lab Magnolia lived for many years after a top vet college told us cancer would claim her quickly. We fought and so did she, and I know you and Simon will, too.

EmilyKate said...

Poor lil' Simon! It's so horrible when your pet is ill, and how much more upsetting not to have known why! I hope Simon is feeling better very soon now that you know what he has and what his treatment should be.

Chris said...

Glad to know that you finally have a diagnoses on Simon. May not be the best news but at least now the little guy can get the proper treatment and you will feel better knowing you have done everything you can for him.
Give him a belly rub from me!

Uta said...

I'm sorry about Simon's disease - lucky for him that he has you taking such good care of him. Maybe it's a comfort to finally know what's wrong and be able to take action.

Michelle said...

So sorry to hear about Simon. He is a lucky pup to have someone to take such good care of him.

Mountain Thyme said...

A few years ago, our Border Collie was finally diagnosed with Addison's Disease when she was about 2 hours from death. Could not walk, was disoriented, had not eaten much but a little cat food for weeks. She was started on the meds and I gave her the $50 injection once a month and she lived for another 4 years.

There is hope that they can still have a good life even when faced with these dreaded diseases. Good luck and Happy New Year, Simon.

lsaspacey said...

Sorry for the diagnosis, but at least you have confirmation that if anyone will get Simon right, it will be your vet. He should be commended for being excellent at his job! If there's an award he can get, nominate him.

Rose said...

Thanks for the update on Simon. It sounds like you have an excellent vet which is good for "the bean" and you. The news isn't great but at least you have a treatment path to explore. Since I'm waiting for a new computer and don't want to download Outlook Express until I get it, I am not able to e-mail you through the blogger link. I do want to thank you for your encouraging and funny comment on my blog. It's amazing that you did such a kind thing with everything else going on in your life. What a woman!

Jules said...

As someone who has had to listen to their pet cry during a necessary (but unpleasant) procedure, I know exactly what you mean about that natural urge to go protect them. It's so hard to stay put.
I don't know much about Cushing's disease but I hope for both you and Simon that he can live many more years happily with you.
I only wish your wonderful vet was around the corner instead of in another country.

lorenakitty said...

Poor 'ol bean, but at least a few minutes of indignities have led towards a solution. My pet filled home is headed by a 19 year platinum plated pussy cat (that's what he's cost me) who in one episode not the ongoing kidney episode or the other episodes but the punctured cranium episode, required twice daily flushing of his sub dural cavity - gross. We do what we must for the ones we love.

ACorgiHouse said...

So sorry! Keep in mind this is treatable. My dog Maggie bit me during an ultrasound, but after diagnoses of melanoma, and years later lymphoma, she lived to the ripe old age of nineteen and was happy till the end. They are sooo wonderful! K

Summerset said...

Well, at least you have some answers and that is so much better than the uncertainty of not knowing what is wrong or how to help your dear pooch. Good luck to you both and happy thoughts!

Sue said...

Phew, a diagnosis at last. This will make it easier to live with I hope. The right medication will work wonders. I wish you all the best.

A Sewn Wardrobe said...

I hope your little bean starts to feel better. Try to keep your chin up!

Mary Beth said...

Love to you and Simon and thanks for the update. I'm so impressed that you're getting a windfall and didn't I just ask for one? but not for a 4 legged critter. Never heard of Cushings, am off to research. I'll tell Patch, Gaely and Martini that the Bean has a diagnosis; they'll be relieved.

JenSA said...

You're lucky to have such a dedicated vet and at least now you know the diagnosis, I can imagine the uncertainty was worrying. Good luck to you, Simon & your vet in finding the the best way forward.

Carol said...

At least you know how to proceed from here. The only thing you can do is get the best medical advice and spend as much time loving Simon as you can. Molly and I send our love and good thoughts.

Claire S. said...

oh, it's hard to know a good response. I'm glad (& I'm sure you are too) that there is a diagnosis, finally, but sorry it's not a better one. Hugs to you & Bean.

meredithp said...

I'm glad you have a diagnosis, and have a med to try. I feel like it's good to *know* what you're dealing with, so you can start dealing with it! AND you know a lot of other bad things it isn't! Hope he is feeling better soon, and his parents too!

Linda T said...

I, too, am sorry to hear of Simon's diagnosis. We had a Rottie that had Addisons disease--opposite of Cushings. She did very well on her meds. I know that Cushings is more difficult to treat, but I also know that medicine is improving greatly in Veterinary practice. Sad that you are having to deal with this. Good thoughts are still coming your way for you and Simon!

Sharon said...

Oh drat - I'm sorry to hear the diagnosis for Simon. But I am glad to know that you at least know what you're dealing with. Thanks for updating us. Abby and Sophia send big wet doggy kisses to Simon.

gaylen said...

Yea for having a vet in your corner. I'm sorry Simon has been diagnosed with Cushings - but it sounds like you have a treatment plan. We will keep you in our thoughs. g

jacquiJB said...

That is good news! And your vet ROCKS, taking the lab to task over wasting your money. Continuing good thoughts from DK, for all of you.

Anonymous said...

Vetoryl is what my 13 yr old Beagle, Calli is on and it really does work well. She takes a lot, 90mg, every day but since it is hid in turkey or some other meat, she loves the treat. Finding the right level amount takes patience and testing but once you know, they really do respond quickly. Best of luck!....Tina in Virginia

Jan from England said...

glad to hear simon that the problem's been found and hope you are soon fit and well and 'woofing' around. Hugs to you all and hope its only a minor case. x x Jan & Co.

Cisa said...

I'm so sorry to hear about Simon's diagnosis, but at the same time so very glad to know that you finally have a diagnosis. Keep your chin up and love that little bean for all he's worth! He sure is a lucky bean to have a momma like you! :)

amber said...

I'm glad you finally have a diagnosis and hopefully he (and you!) will start feeling better and be back to a normal routine soon. {{hugs}}

Coco, not as in Chanel :) said...

Oh poor Simon. I hope you can get the right medication and he feels better. I do not know anything about Cushings, so I will have to read up on it.

Teddylyn said...

Awww--special ear scratches and a back rub for Simon. I hope the meds help your pup and that giving him the meds will help you to feel better about his condition. One more back rub...

Lynda in LV

Cindy May said...

Hi Shannon,
i'm so sorry about Simon. This is definitely a challenging diagnosis. It is obvious how much you love Simon.
I just wanted to say by implicating your pathologist, your veterinarian has seemingly brushed aside his own ignorance and part to play in the diagnosis. Cushings is really hard to diagnose. Many animals have all normal results with the cortisol test being inconclusive. Pathologists are not clinicians. It is the clinicians job to take the tests along with the patient's clinical symptoms, history(which was clear as day here), breed, and physical exam and make the diagnosis, not the pathologist who is a million miles away and doesn't have "his hands on Simon" so to speak. I went to Davis and was taught by Feldman/Nelson....and bottom line is, for this particular disease, the patient tells you in the end, because the lab tests are not always reliable. I also treated my own pet as a veterinarian so if you have any questions, please feel free to email me. And this is not to impart blame on your vet either, it is a challenging diagnosis to make if you weren't taught well, I just don't agree with "blaming the pathologist" for missing the diagnosis. What the pathologist did do wrong was pretend to be the "diagnostican" so to speak, fo this particular disease.

Karen said...

Awww, poor Simon! Although I'm glad that at least you have a diagnosis now so that Simon can begin to get treatment for what ails his cute little self.

And his shaved belly. Don't tell me you're not kissing the shaved puppy belly to add to his indignity; I did it to my cat and it's hard to resist.

Take care of Simon, take care of yourself.