This morning, we dropped Bartles off at Town and County Animal Hospital so that he can get his ACTH Stimulation test for his Cushing's Disease. The tests are performed to adjust dosage levels for Cushing's medications so that symptoms can be under control. Some symptoms of Cushing's Disease in dogs include increased thirst, urination, accidents in the house, pot bellied look, hunger, weak back legs and loss of fur.
Bartles was diagnosed with Cushing's Disease while he was under the care of the group that rescued him -- OBG Cocker Spaniel Rescue. They, and his foster, did an amazing job of spotting it, getting him tested and putting him on medication to get his symptoms under control.
When he came home to us in December, he was on 30mg of Trilostane which he got half (15 mg) in the morning and the other half at night. He had his ACTH test done before coming home with us and had his dosage increased to 30mg. His foster mom gifted us with 3 months worth of his Cushing's medicine and even told us about Wedgewood Pharmacy where we can get the medication compounded with great prices. Everything was great - he didn't show any Cushing's symptoms and the only thing I was really worried about throughout the months of December and January were getting him house trained (we're still working on it and Bartles has gotten so much better, but we also decided that getting him fully house trained is not on the high priority list right now).
In January, I wanted to see if I can get Bartles more comfortable with his mobility as he has arthritis and because of his Cushing's his weak legs give out. I looked into acupuncture for dogs and we went in for a consultation session late January and he had his first full acupuncture session, that lasted 50 minutes, in early February. It was very promising and I saw an immediate improvement in his mobility. He was jumping off of our deck on to our grass without hesitation, without any wobbling, his posture was straighter, he was "saving" himself from potential falls and splats by using his hind legs to give himself support and he was walking with more strut.
Then a few hours after his first full acupuncture session I noticed that his drinking increased and he began to urinate almost every hour. I keep a diary of when Bartles does everything (pee, poop, eats, etc.) and he logged in jaw dropping numbers that day -- peeing 9 times and drinking 16 times. The days that followed didn't improve --
The next day - peed 7 times ; drank 16 times
2 days after - peed 7 times ; drank 10 times
3 days after - peed 7 times ; drank 16 times
4 days after - peed 7 times ; drank 10 times
5 days after - peed 6 times ; drank 16 times
I emailed Bartles's acupuncturist to let him know the first day back how Bartles was doing. I read that some dogs (and people) can feel worse after treatment. It was the body trying to heal itself (healing crisis) and that it can last up to 72 hours for them to start feeling better again. I asked him if this might be the case with Bartles. He replied that healing crisis is uncommon but not unheard of and said in a couple of days Bartles will start to feel better.
We decided to ride it out.
I sent him another update after 5 days letting him know that his drinking hasn't decreased although his mobility continues to be great. I didn't get a response back.
6 days after - peed 5 times ; drank 10 times
7 days after - peed 6 times ; drank 11 times
8 days after - peed 5 times ; drank 12 times
9 days after - peed 8 times ; drank 15 times
10 days after - peed 7 times ; drank 11 times
From days 6-10, Bartles's drinking decreased somewhat but the issue still was that Bartles's while drinking more times was also drinking a bowlful each time he was drinking - literally just drinking and drinking and drinking until his bowl was nearly empty. Like he just couldn't quench his thirst. He has never done this before.
Bartles's is also on Enalapril Maleate because there is protein leaking in his urine. I never really considered this to be harmful. Piri was also on it for his high blood pressure and he never showed any side effects to it. But then I began to suspect that maybe it was different with Bartles.
I promptly took him off of it to see how he did. This was days 8, 9 and 10. When he didn't show signs of letting down in the amount he was drinking I put him back on it on day 11.
11 days after - peed 8 times ; drank 14 times
12 days after - peed 6 times ; drank 7 times13 days after - peed 5 times ; drank 9 times
By day 12, I began to get frantically worried, feeling at times exasperated.
What was I doing wrong?
I belong to a Cushing's support group on Facebook and shared my story in hopes that someone may be able to help or give insight. Was it the Enalapril? Was it the acupuncture? Or is it something else?
After a string of messages with group members who took a look at Bartles's previous ACTH test results, they suspected that his Cushing's dosage wasn't working for him and that perhaps another ACTH test was needed. They said getting the dosage right is the most tricky part (and can take multiple tests, which can be expensive, but worth every penny). People suspected that Bartles's would need an increase in his Trilostane.
I ended up canceling Bartles's follow up acupuncture session which he was supposed to have today and instead he went in for his ACTH test. I am still not ruling out acupuncture, but perhaps it is not the time right now.
I was an emotional wreck the morning. After feeding him his breakfast and giving him his medicine (and logging the times because the vet needs to know before performing the tests), we all got in the car to head to Town and Country. I began to get worried if Bartles was thinking that he was being let go. That we no longer wanted him and that was why he was being caged in an unfamiliar place. That thought broke my heart and I began to sob in the car (meanwhile, Bartles was soundly asleep - snoring even).
Then I got reminded of all the familiar car rides to Town and Country. It was the hospital Piri went to and they all know him there. Piri, like Bartles, always had a stoic face. I could never really know when he was scared or in pain. We put him through a lot -- surgeries, shots, visits, treatments, prodding and poking. I began to wonder if he was really terribly scared inside and wasn't showing it. And I got emotional recalling back to all the times he came back to us, high spirited, brave.
Right up until the moment the vet tech came to take Bartles I kept petting his head and telling him, "We'll be back, Bartles, I promise. We'll come back for you. Stay strong." I left a little bag of his male wraps and two treat bags and asked the vet tech if they could give him some when he is allowed to eat them. She picked him up and they went to the back. And I was left with a worried look, teary eyes and someone who just looked like she has some major attachment issues.
We're waiting for the vet to call us so that we can go pick Bartles up. As if he doesn't have enough treats already, we stopped by Petco to pick up another bag. It's waiting for him on the dining table.
I'm upstairs writing this blog almost expecting to hear Bartles's jingle collar - a signal that he is up and most likely will want to pee.
I am nervous about his test results. But I hope we are on the right track of getting him feeling better again.
When his drinking increased, I began to doubt myself and was wondering if maybe I was the wrong person to adopt Bartles. Perhaps he needed someone stronger, more knowledgable, better at taking care of elderly dogs, who wasn't so panicky and a worrywart. But I hope that's not true.
We'll see you soon, Bartles.
Hang in there.