Hannah's progress, week of July 23

This week we have seen few changes in Hannah's health. For the most part Hananh is a good mood and is still, well, Hannah. The main change that I have noted is that Hannah has not wanted to go up and down the half dozen or so steps on the deck so we are having her go out a different door.

She seemed a bit uneven over the weekend so we changed her Tramadol from twice daily to three times daily per previous instructions from her vet. That seemed to even her out some. We talked to her medical team about this ans asked what we could do further even this out. Her vet suggested that we give 2.5 tablets at breakfast time and 2.5 tablets as soon as we get home from work and then 2 tablets at bedtime instead of two pills per dose.

Hannah has had some nausea and vomiting issues at night time -- well early morning is more accurate since it's at about 3:00 a. m. We were advised to hold back some of her dinner and give her a Pepcid A/C (Famotidine) tablet with the remainder of her food at bedtime. Hannah is continuing to eat Purina EN canned .

Finally, we discussed her treatment plan moving forward. We are opting for Lysodren treatment and were again advised that

• Lysodren is a derivative of DDT and is a very potent drug
• There is the possibility that treatment will make her worse since each patient may react somewhat differently
  
• However not treating Cushings will ultimately lead to her demise
  

The week of July 7 we will do a blood panel and possibly a liver function test. Depending on those results, we will decide if Lysodren is likely to be beneficial. Additionally, starting Lysodren just before a holiday is not advisable. If we decide to move forward at that time, we will begin the Lysodren the following week. In the meantime, I am to call around and get prices for 25 pills of the 500 mg Lysodren.

Dr. S. feels that Hannah's kidney issues are age related or possibly related to her history of urinary tract infections. While this is not exactly good news, at least Dr. S. doesn't feel that Hannah has a malignant adrenal tumor that is affecting her kidneys. That is not to say that the adrenal tumor is either malignant or benign, just that the kidney issue is more likely age related than Cushings related.

	Lysodren 500 mg
Target	$120.49 for 25 (4.82 ea)
Costco	$146.92 for 30 ($4.90 ea)
WalMart	$125.78 for 25 ($5.03 ea)
Rite Aid	$140.99 for 25 (5.64 ea)
CVS	$152.99 for 25 ($6.12 ea)
Walgreens	$145.99 for 25 ($5.94 ea)
Walgreens Prescription Savings Club	$135.74 for 30 ($4.52 ea)

Hannah's current medications: osteoarthritis (Tramadol, Zubrin), urinary tract infection (Amoxicillin, FortiFlora probiotic), Denamarin, Actigall, Famotidine (10mg); Purina Veterinary Diets EN GastroENteric Canine Formula dog food

June 30 update: Hannah is in good spirits but she is not eating all of her food. She is currently getting two cans per day. She eats about half of her breakfast and stops. We let her out and she comes back in, eats a few more bites and stops. This means that 2/3 or 3/4 of the food is eaten at that time. I called the vet to see if that is enough nutrition for her. I hesitate to add more pills to her routine since she hates them so.

Dr. S. said that Hannah needs to stay on the Denamarin and that the food issue is not so bad that she is concerned about it. She suggests not worrying so much about the food itself but to instead add carbs such as mashed potatoes with butter, rice, bread with flax oil, etc.