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Speaker 1: You're listening to Petlifradio dot com.

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Speaker 2: Well, good morning, good afternoon, depending on where you are

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residing at this point.

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Speaker 3: Here in the good old USFA, I am your host,

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Doctor Jeff Over.

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Speaker 2: We're here with you for the next thirty minutes on

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Ask the Vets with Doctor Jeff here on pet Life Radio.

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We are the only live call in show here on

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pet Life Radio, and live call in means that you're

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supposed to call in. I'm sitting here here in Los

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Angeles at.

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Speaker 3: My home studio waiting to hear from you.

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Speaker 2: I'm here to help you out with your pets, answer

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your questions, help solve some problems if you have any,

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and the best news of all, it's free. You don't

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have to make an appoint with your doctor and go

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in and pay an office call. All you have to

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do is pick the phone and give us a call

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at eight seven seven three eight five eight eight eight two.

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Speaker 2: You can also just join in on the conversation if

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you log on to pet Life Radio, click on the

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send me a quick email. You'll be forwarded to me

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live as we speak.

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Speaker 3: To Dr Jeff.

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Speaker 2: That's doctor Jeff at petlifradio dot com. So you have

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no excuses, none whatsoever. And as I said, not only

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not only is it free, but by calling in, joining

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us on the conversation, letting us hear your voice or

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your print on the computer, and we will actually send

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you out a pro sense pet product and a contoy.

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Speaker 3: These are our sponsors.

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Speaker 2: Without them, we wouldn't be here to help you. You know,

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it's funny I'm giving this away. You know, I have

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clients that come in, we'll make the office call, make

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an appointment, and we'll talk. And you know, oftentimes, and

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this is what you've learning from me here on the show,

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is that we don't have to panic. You get a

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really thorough history, you do a thorough exam, and oftentimes

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is that you don't even have to do a single test.

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And I'll talk to a client about some of the possibilities.

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Let's try this, and that try this usually means that

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we don't have to panic, we don't have to do

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anything now.

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Speaker 3: And clients actually love it. It's great.

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Speaker 2: But here I am giving advice and it's free without

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even have to make the office call. And even then,

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my clients complain they say, They say, well, you just

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talked to me for fifteen twenty minutes and now you're

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to charge Well, yeah, because I saved you on hundreds

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of dollars, had to go on someplace else.

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Speaker 3: So anyway, give us a call here.

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Speaker 2: At eight seven seven three eight five eight eight eight

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two once again eight seven seven three eight five eight

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eight A two. And as I mentioned, I always have

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a game plan, my lesson plan for the day if

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you will, and if you don't call, I have to

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talk to you about something. And we've been doing a

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series first of some common ailments that the gamut of

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work up of treatment really ranges. And we've talked about vomiting.

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I mean they're vomiting cases. I probably most that we

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see are not serious at all limping. So we've gone

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through all the different things that you might bring your

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pet in four and try to help you sift through

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the diagnostic procedures that your veterinarian may or may not

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want to do based on the history and the physical exam.

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Then we moved on to some of our metabolic diseases,

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and we had spoken about cushings disease last week, and

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just as a refresher Cushing's disease is an over secretion

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of either the adrenal gland itself as in Cushing's disease,

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or the petuitary gland, which signals the adrenal gland to

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fire and release the cortisol hormones. And that is the

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case of Cushing's syndrome very common. You know. We used

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to think that the Cushing's syndrome, in other words, the

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petuitary problem was the more common condition in the small breeds,

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and the actual Cushings disease, which is the problem of

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the adrenal gland itself, was a problem in the larger breeds.

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And we have since learned many believe that you really

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can't tell. We've see both of them in both the tests.

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Speaker 3: That we do.

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Speaker 2: We talked about last week the low dose dex methisone

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suppression test will help us often determine which is which

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and we have to treat accordingly. We talked about the

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different treatments in the case of adrenal disease. Adrenal tumor

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surgery is an option. In the case of the pituitary

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problem or non surgical disease, there is a medication that

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we are sort of been using lately called trilif stain

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under the trade name Veteral, that has replaced the might

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attain or OPDDD lysodron, which was the drug and still

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often is the drug that we often use. But now

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I just wanted to switch gears a bit to Addison's disease.

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And Addison's disease is a real interesting disease because it's

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very difficult, unlike cushings that has.

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Speaker 3: I mean such clear clinical signs.

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Speaker 2: I mean it's that dog using dogs that are drinking

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water like it's going out of style, peeing therefore, like

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it's going out of style. Their skin that gets very

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thin and greasy, and they kind of get this appearance

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of a rounded appearance, which is very similar to dogs

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that are getting too much cortisome. And that's exactly what's

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going on in the body. The doctor's not giving too

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much rtisol as in case what we call iatrogenic cushings.

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This is the body giving itself too much cortisol, and

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therefore the history of the clinical the signs that we're

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going to see are very similar to that of the

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dog who's receiving too much cortisome, too much prednisone. So

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with Addison's it's the exact opposite, and it's much harder

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to diagnose it. Well, that's much harder to diagnose. This

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is much harder to tell because the signs are much

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more subtle. Maybe and oh one thing about Adison's. These

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all of the signs that we're going to discuss are

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maybe's like you don't even see it all the time,

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and not every dog is going to present the same way.

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But some of the things we look at are going

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to be vomiting, excessive water drinking. So as we mentioned this,

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you're going to stay to yourself, Oh my god. But

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we talked about vomiting for all these other conditions. So

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that's why it's such a puzzle. This is one that

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is sort of a lot of what we call a

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dr ain't doing right, just a little bit off. You

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can't really pinpoint it. They just don't have the energy

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they used to, maybe a less of ability to respond

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to trauma, slower healing, episodic shivering and shaking where you

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don't notice your dog just going through these fits where

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there's like a little muscle weakness and or maybe a

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shivering trembling episodes almost looks like maybe the minor little

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pettit mal seizures and that's it. I mean, they're very subtle.

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So they're brought into your veterinarian because of problems that

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just you can't really pinpoint, but it's just there.

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Speaker 3: We do see this more.

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Speaker 2: Frequently in the females than males. It's usually the middle

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age female where we see it the most. And the symptoms,

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as I said, are very difficult to really to pinpoint exactly.

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Speaker 3: And then we get our blood tests back.

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Speaker 2: And one value that we clearly see abnormal in most

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of these cases. And you know, I've learned over the years,

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there's no such thing as the absolutes. It's not all,

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it's not none, it's not always, it's not never. But

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because that's going to get you to trouble because, as

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they always joke, we read the books we went to school.

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Apparently your pets have not, so they don't always know

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how they are supposed to react to something, how they

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are supposed to behave under certain conditions, how are they

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supposed to present when they have a certain disease. So

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all this data is based on the averages, the norms,

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the mosts, but never the allls. So again most of

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the cases we have, we look at the sodium potassium

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ratio and we see it low. Now there's a low

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normal typically of twenty seven, and we will see this low,

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sometimes as low as twenty three twenty four. I used

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to use twenty four as my quote unquote low, and

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now they're even saying twenty five, meaning that if you

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have a sodium potassum ratio of twenty five or less

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and any semblance of the clinical symptoms of addisons, you

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should go ahead and have your dog tested for addisons.

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And the test we use for addisons is obviously similar.

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It is one of the two tests that are often

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used for cushions. Now, if you were twoed in last week,

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and of course paying attention with the test that we

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used to use a lot and names do for cushings

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is called the ACTCH response test, the adrena cordicotropic hormone

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response test, where we give the adrenochotropic hormone that's the

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hormone that typically comes from the tuitary gland to stimulate

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the adrenal glant of fire. And when we give ACTCH

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to a dog with cushings, that same amount of stimulus

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with cushions stimulates that adrenal way more so, the post

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actch cortisol levels are much higher than they would be

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if this for a normal dog. What we see with

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Addison's disease is a low pre cortisol level, and then

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even after we go ahead and stimulate the adrenal to fire,

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the post ACTCH value is also low, and often it

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doesn't even change at all. I mean sometimes it will

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go as low as point one before you stimulate them

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with the act hormone value is point one.

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Speaker 3: That is classic classic Addison's disease.

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Speaker 2: So now also the reason why the amt of potential

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symptoms are so different with addisons with the hypo or

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low secretion of the adrenal gland, it's because there are

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the different zones of the adrenal and when with Addison's disease,

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it's not just the zone glamory looso, which actually will

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control the secretion of the cortisol, but it also is

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a zone that is responsible for the minerali corticoids, thus

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your sodin and potassium ratios. So when we have these imbalances,

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there is more symptomology that we see in the body

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and often, as I mentioned, it's very subtle. So once

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Addison's is diagnosed, the treatments vary.

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Speaker 3: Again.

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Speaker 2: We have the old standard, which if many of you

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have had Pat's dogs with Addison's disease years ago, you

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probably remember giving a pill every day called fluorine F

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and you probably result. We're also giving a little bit

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of and I mean a very small amount of daily

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prednosome smaller dose by the way then you would use

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if you were using it to treat an anti inflammatory condition,

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and way smaller than that even if you were using

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it to treat an immunosuppressive im mean mediated condition where

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you were.

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Speaker 3: Using the cortisone.

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Speaker 2: As an aminosuppressive agent, because as we know, that dose

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is four times the dose of anti inflammatory and with

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using it to supplement the very very small amount of

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the hormone that we need four cases of addisons, we

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just give a I mean it might be for a

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fifty pound dog that you might get one milligram. I mean,

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it's very small. It's just to give the body that

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small amount that it needs to offer to provide the

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necessary steroid for the day to day function.

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Speaker 3: And the key is a floor n F.

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Speaker 2: Now we actually have another medication that has gained a

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lot of favor, certainly for the pet parent. It's a

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lot easier. And that is an injection. The medication is

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called per Corton. It is given well, here's another one.

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We used to give it a based on weight, a

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weighted dose and given every twenty five days, and then

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we've noticed again not every dog is the same. So

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we are now finding out that some dogs could use

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it every forty or forty one days. And there is

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a veterinary internist, university internist, and I forget what school

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she's at, but she's been writing a lot of really

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really cool papers that almost like a homeopathic type of

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medication that you can give a tenth of the dose

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of the per courdant and it would actually do the

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same job.

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Speaker 3: And she is an advocate of using the.

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Speaker 2: Smallest amount of per courton that will satisfy the needs

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of the patient and giving them as long as it

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takes in between, if you can get up to thirty

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to thirty five forty days, do it. And that's also

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gaining a lot of favor. It's something you need to

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talk to your veterinan aaron about, but it is it's

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a very very treatable condition.

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Speaker 3: It's not for break.

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Speaker 2: When we come back, we're going to talk about some

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of the other reasons that dogs can get madisons, and

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we're also going to talk about a pretty funky treatment

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for Cushing's disease to actually turn them into an addisonian, which,

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as I mentioned.

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Speaker 3: Is a lot easier to treat.

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Speaker 2: So when we come back, don't go away. Stay tuned

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here at pet Life Radios ascivest with doctor Jeff.

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Speaker 3: We'll be back with you in just a minute.

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Speaker 1: On demand only on petlife Radio dot Com. Let's Talk Past,

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Let's Talk Pet, Talk About Life Radio HETLFE Radio.

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Speaker 6: Pet life Radio dot com.

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Speaker 2: And welcome back, And if you're joining me just now

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here on pet Life Radio, I'm your host, doctor Jeff Warber.

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That's the best with doctor Jeff Orer, I am here

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for you to answer your questions, discuss doggingcat issues, just

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kind of help make that bond even better, right, you know,

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obviously it's the best thing in the world. I'm having

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thirteen pets at home. I can only tell you that

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it is the best thing in the world. I wish

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they made a bed bigger than a California king. I

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think I can get more dogs that way, because right

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now it's pricky full. And before the break, we were

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talking about continuing with our endocrine related conditions. We were

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talking about Addison's disease, having spoken about Cushing's disease last week,

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and now we're onto Addison's disease. And we were by

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the way, they join in the conversation box here and

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my computer is blank, as is our email to doctor

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Jeff at Petlife Radio dot com. That's not good. You know, guys,

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I'm getting a complex here. I want somebody. You don't

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have to ask me a question, you just have to

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log on and in those one of those boxes, just

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say hey, doctor Jeff, then I'll at least know you're

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alive and somewhat paying attention.

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Speaker 3: Maybe then if you do that, you'll.

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Speaker 2: Have the courage to actually ask me a question about

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your pets. You know, if I'm using my small microcosm

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of my own clients as any indication, I know that

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you guys are loaded with questions because I get them

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all the time, and I just have a smallimal practice.

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So I can only imagine multiplying the numbers of people

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here on pet Life Radio with the number of dogs

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and cats out there that are listening to us. Then

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I know you have more questions than that, So give

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us a call. So back to Addison's disease. So, one

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of the other conditions that we see with addisons, and

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one of the other causes of addisons, is that when

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we have animals that are being given pregnisone cortisomes inappropriately,

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and by that I mean they're either giving too high

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a dose for too long a period or for too

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frequently administered. In other words, one of the important things

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about using corticosteroids is that we know this adrenal gland

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is on board and what does this adrenal gland do.

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One of its jobs is to secrete cortisol. Well, what

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happens is if we are giving and as I mentioned,

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when it comes to testing, it's all about the feedback mechanism,

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Meaning when the body senses that there's enough cortisol on board,

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it kicks back and says, hey, I don't got to

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work because there's plenty there. So this poor adrenal gland

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is functioning based on feedback mechanisms from the body. So

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the pituitary is not going to fire if it really

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senses through the feedback enough steroid on board, nor will

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the adrenal gland.

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Speaker 3: Ah. So what happens in.

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Speaker 2: Cases where cortisone is given inappropriately, where the drug itself

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is not being respected if you will that we can

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create an addisonian. So first we have a what we

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call iatrogenic cushings. We are creating cushings because we're giving

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too much steroid to our pets or your veterinarian or

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somebody's not paying attention. And then the poor adrenal gland

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who's sitting back and how hasn't had to function in

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weeks and weeks and weeks from months and months, and

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in a sense it atrophies. In a sense when you

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need it to turn back on, it's not working anymore.

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We've actually blown out the adrenal gland and so we

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now have created an addisonian because of our use of cortosome.

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One of the things I say about prednisone, it is

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one of the most used drugs in veterinary medicine, but

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it's also one of the most abused drugs in veterinary medicine.

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It is being used, as I said, it's not being respected.

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It is a fantastic medication, and anyone of the clients

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come into oh no, no, we can't use thee We heard

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so many horror stories. No it's not the drug itself.

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The drug itself has amazing implications. We could use it

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all the time. The applications are just are endless. But

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we have to be careful how we use it. We

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have to make sure that we are not using it daily.

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We have to make sure we are not going to

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suppress the adrenal gland too much. And we have to

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you know, if we realize that we have to use

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the longer drum, we need to may need to bring

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in some other medications for example, as immunosuppressive agents. If

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you have a dog with immune mediated hemolytic anemia, it

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needs to be on steroids. We're limited as to how

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much cortisome we want to use, so we may bring

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in azothiopren and amorant. We may bring in CycL fossil vide,

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which is site toxin. We may bring in another drug

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to using conjunction with to suppress that immune systems so

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the body doesn't continue to attack its own red blood cells.

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But we have to be careful with using cortisols. Sometimes

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cortizomes as our only medication. So that brings me then

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to another treatment of cushings. As we mentioned last week,

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in certain countries, the whole method of treating the cushings

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dog is completely different. The old drug we used to

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use was called OPDDD or lysogren or mightatain different names

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for the same medication, and it would actually destroy the

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various zones as needed, especially the zone secreting the cortisol,

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but it also would have effect on some of the

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other zones, and the goal was to titrate this medication

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so it would just give enough zonar destruction to normalize

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the pet okay, and we would monitor this via the

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actch response test. Well, it is very difficult to do.

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Every dog is different and to just get it just

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right and to have to do the actate response frequently.

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So what would have hap and is there would be frustration.

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And again this is before the tryal this stand came out,

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which is a bit of a different drug. So what

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was done in some places in some countries, it is

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so difficult to treat these cushions dogs. Let's use this drug,

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the OPDDD, and to heck with it, let's just zone out,

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blow out that adrenal gland because we know that it's

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much easier to treat addisons. And they would literally just

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use it to high dose destroy the adrenal gland altogether

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and then go ahead. And now you've created through your

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treatment of cushions, you've created an addisonian a condition that

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is a low or non secretion of the adrenal gland,

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the exact opposite of cushings. And you treat that accordingly.

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You treat it with your either your fluorine f or

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or per cordon. You treat it with your very very

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small amount of cortisoon on an everyday basis, you don't

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have to worry anymore about the ruining the adrenal event.

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It's already shot and it's an easier way according to

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many to treat these dogs. You know, it just shows

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you that throughout the world there are many, many ways,

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different ways to treat these cases. But I think some

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of the take home lessons are starting to recognize your

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dog's norm And we talk about it all the time.

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Speaker 3: Back when I started the show, we.

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Speaker 2: Had a whole day on just unreally understanding your dog

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or cat's normal behavior, normal activity, normal appetite, just everything

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about them, because sometimes the changes that we see are

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so subtle that if you really don't have a handle

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of grass on what their normal is, you may not

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recognize their abnormal. So therefore it's very important to do that.

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And then what will happen is once you do, you'll

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start noticing some of these subtle changes, as I said,

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especially with Addison's disease, where unlike cushings, where you know

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they're going to present typically with that pupd excessive peeing,

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excessive water drinking, you'll notice it. You're going to notice

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their their appetite change, You're going to notice their skin

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00:21:52,039 --> 00:21:55,319
you're going to notice their roly poly round appearance, that

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00:21:55,519 --> 00:21:57,839
redistribution of fat. I mean, there are so many things

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that you'll pick up on a dog with cushings, but

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you don't see the same with Addisons. And sometimes it's

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just gonna be that shivering, shaking, of those episodic weakness.

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You're gonna notice, maybe some vomiting. You're gonna notice, maybe

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some excessive water drinking. But again, some of these symptoms.

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Speaker 3: Are so similar to many other diseases.

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Speaker 2: It's not going to really just point to Addison's disease.

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But again, having that female, young to middle aged, you know,

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00:22:21,880 --> 00:22:23,720
you have a four to three year old dog, five

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00:22:23,799 --> 00:22:26,440
year old dog, You don't think many things can happen Addison's.

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Addison's gonna happen. So next week what we're gonna do

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is we're gonna continue our endocrine series. We're going to

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talk about hypo and hyper thyroidism. I don't know if

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I can get him all into one day. The hypo

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00:22:38,759 --> 00:22:41,440
thyroid is that which we're gonna see in dogs, and

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the hyper thyroid is what we're going to see in cats.

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As a matter of fact, my own cat just finished

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00:22:47,000 --> 00:22:51,680
his treatment. My almost seventeen year old Magnificent Oreo. He's

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00:22:51,720 --> 00:22:54,119
obviously a black and white. He's like a main coon

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Norwegian forest cat crossed. He is huge, a cat that

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I'll tell you a story about next week how we

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got him. But he dropped almost eight pounds. I mean

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00:23:02,880 --> 00:23:04,759
that's a lot of weight for a big guy like that.

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00:23:05,160 --> 00:23:09,240
And anyway, he's getting back to normal. He did amazingly well,

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00:23:09,519 --> 00:23:12,039
so we'll talk about that. Also, once again want to

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00:23:12,079 --> 00:23:16,160
thank our sponsors pro Sens pet products, which are over

443
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the counterproducts available to you and basically better rank quality.

444
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And of course Calm now giving you the hint next week.

445
00:23:24,839 --> 00:23:28,200
Hype pots, irodism mostly in dogs, hyper and cat. If

446
00:23:28,240 --> 00:23:30,720
you have any questions about cushings or Addison's I want

447
00:23:30,720 --> 00:23:33,359
to hear from you. You can send me an email

448
00:23:33,640 --> 00:23:37,119
to DRGF at Petliferadio dot com, or just be prepared

449
00:23:37,160 --> 00:23:39,200
to log in next week and join us here at

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00:23:39,240 --> 00:23:41,920
pet Life Radio eight seven seven three eight five eight

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00:23:42,039 --> 00:23:43,799
eight eight two. I want you to have a wonderful

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00:23:43,799 --> 00:23:46,559
week and we'll see you here next Sunday.

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Speaker 3: Thanks for joining me.

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Speaker 1: Let's talk Pets every week on demand only on Petlife

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00:23:52,519 --> 00:24:01,960
Radio dot com. It doesn't any