Jack's medicine for Cushing's

Jack was prescribed Mitotane. It's a drug used to treat cancer of the adrenal glands. He doesn't have cancer, they're looking to destroy some cells in the adrenal glands so they aren't able to produce as much cortisol. Tricky part is if you kill off too many, it could be fatal. So we have to watch for warning signs - stomach upset (acting sick), vomiting and diarrhea are the top common. Those symptoms are the same that he has with his Pancreatitis episodes. This is so scary. They prescribed him Presnisolone 5mg and we are to give him 2 tablets if he begins showing these signs then call the vet immediately. The drug is pretty much a chemotherapy drug. It's so toxic that you have to wear gloves to give him the capsule. Knowing that I'm putting this in my man's body is so difficult. His first dose was yesterday evening. This mmorning he threw up his undigested breakfast. I don't want to freak out because it was one dose and his first. I'm going to hope and pray that this is one of the Pancreatitis episodes.

Facials and dates ❤️

Me and Phoebe had a lunch date at Fuddruckers. Now we are getting facials at Hand and Stone. 

Then Damian is taking me out to dinner and walking around Waterway. 

Update on Jack - Cushing's and Diabetes

Jack had his ultrasound yesterday. They did not see a tumor on the adrenal glands, there wouldn't have been concern of cancer, they're just narrowing down the reasons for high cortisol levels. After the ultrasound they completed a cortisol blood test, which did confirm the Cushing's diagnosis. His blood sugars during fasting were 565. We're going to increase his insulin from 5 units twice a day to 8 units twice a day. We are going to start on a medication called Mitotane. This is the scary part. The Mitotane will help reduce his cortisol levels by destroying parts of the adrenal glands. But it can be life threatening if it gets too low. And the symptoms of that are pretty much the same as his Pancreatitis episodes. It's all so overwhelming.

Below is some info that I found on the Mitotane research I've done so far. I don't have all of the answers yet, but I'm compiling a list of questions to discuss next week with the Dr. My comments are in italic.

Mitotane and trilostane therapy are effective and relatively safe in dogs with adrenal-dependent hyperadrenocorticism. Dogs with adrenal tumors however, tend to be more resistant to mitotane and trilostane than dogs with pituitary-dependent hyperadrenocorticism. This is why we didn't want a tumor!

Dogs with Cushing's disease have elevated levels of cortisol, which increases triglycerides and cholesterol. To help combat these increases, a food that's lower in fat (less than 12 percent on a dry matter basis, or DM) and moderate in crude fiber (8-17 percent DM) is reasonable. But as you'll see below, it's preferred that you give the Mitotane with a food that is high in fat.

The basis for increased panting in dog's with Cushing's disease is multifactorial. First, Cushing's disease results in increased fat deposits in the abdominal cavity and around the chest. This might explain the fatty deposits he began getting a few years back. I'll have to reach out to his prior vet and request his records.

Second, an increase in liver size impedes the diaphragm from being able to expand with ease. Mitotane, also known as o,p’-DDD (brand names: Lysodren®, Lisodren®) is an anticancer medication that is toxic to the adrenal gland cells and is used to treat hyperadrenocorticism (Cushing’s disease) or adrenal gland carcinoma. Its use in dogs and ferrets to treat adrenal disorders is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

Mitotane is given by mouth in the form of a tablet. It should be given with food, preferably one high in fat. Your veterinarian may provide you with a high fat pet food, or you can give the medication with a little corn oil, butter, or cheese. Wear gloves when administering this medication and do not allow the medication to come into contact with your skin, eyes, or mouth. Wear gloves when handling your pet’s urine, feces, or vomit, as the drug may be present.

The following medications should be used with caution when given with mitotane: central nervous system (CNS) depressant drugs, fentanyl, insulin, midazolam, phenobarbital, selegiline, spironolactone, or warfarin. Your veterinarian will monitor your pet to be sure that the medication is working by monitoring clinical effects and performing regular ACTH response tests. Your veterinarian may also monitor liver and kidney values, blood cell counts, blood sugar levels, and blood electrolytes. Regular monitoring at home for adverse/serious side effects is very important in addition to regular monitoring by your veterinarian.


Recommended Facebook Groups: Support group for owners of dogs with Cushing’s disease Dogs with Cushing’s support and information Canine diabetes support and information

Cheer Competitions

So far the Strykers have only competed in one competition this season. BUT they did get a Summit Bid, so we're going to Disney World at the end of April! (subject to change due to COVID of course) The New Orleans competition had switched to virtual, so we had to cancel our flights and hotel. NCA in Dallas (the big comp) was changed to virtual, so we cancelled that hotel reservation (which was going to be the day after we get married in Austin). Woodlands Elite decided to attend CheerSport in Atlanta Feb 12th-14th after finding out about NCA, so the girls have a chance to compete in person (fingers crossed). I just booked our hotel room and flights for that one. So far we have a virtual competition this Sunday and Monday evening. And the competition in Tulsa, OK is still in person, which is Feb 5th-7th. So that flight and hotel are still good to go! Whew, COVID is giving me another full time job with these reservations! And one that I don't get paid for! :) No, but in all seriousness, I must give a shout out to everyone at Woodlands Elite. I know that it can't be an easy job to manage all of this and break the news each time. :-/ And another shout out to the parents, coaches, athletes and team moms for being understanding and support with everything.

Jack's lab results...

We took Jack to the vet yesterday because he just hasn’t seemed like himself lately. He’s been drinking a ton of water, going outside like once an hour and then heads straight back to the water bowl. It’s just a vicious cycle and had us concerned. The vet said they can run the labs in house but it would just be negative vs positive and if they send them off, they’ll get actual numbers back to help us with his diagnosis. So I got the call on my way home today. The doctor was on the phone with me for my 30 minute drive. Jack’s glucose shouldn’t be higher than 114, his was 630. Then he said “I wish this was as simple as me saying ok, that’s it, come in and I’ll show you how to administer the insulin shots, but that’s just the first thing we found.” Then my heart sank. • Sodium is low (signs of kidney disease) • Potassium is high (can indicate kidney failure • Protein is high (relates to liver, kidneys and infectious diseases) • ALP, which should be no higher than 160 was 2017 (indicating Cushing disease) • Triglycerides were 379 (norm is high of 150) • Lipase was 544 (normal high is 250) indicating pancreatitis • cPL was 627 (shouldn’t be higher than 200) indicating pancreatic inflammation • T4 was low (indicating hypothyroidism) • They mentioned that his kidneys appeared to be stressed They are definitely diagnosing him with Type II diabetes which will require 2 shots of insulin per day and possibly Cushing disease. He was already diagnosed with a heart murmur and Pancreatitis. Our next step is to have an ultrasound done this week to look for an adrenal tumor. If one is present, he said we may consider declining treatment for any of the conditions as the expectancy is 2-3 months. If a tumor is not found, we’ll begin aggressive treatment of diabetes and Cushing. My poor little guy. :( Phoebe saw that I was upset when I got home and she made sure to work her magic and cheer me up in addition to lots of hugs. I love that kid. Update 1/14: Ultrasound is now scheduled for Jan 22nd so we're going to start him on insulin today to try and get his glucose levels down.