[zowiandnikasmom]

hello all.
my dear zowi has been doing great for the past 4 months and her cushing's has been controlled to "exactly where we want to be" according to her dogtor. march 1st she went in for her 6 month checkup. she had a full senior workup, bloodwork, including checking her thyroid, etc. her dr said that zowi looks great and all of her labs show that she is "strong and stable." zowi was 10.9 pounds back in spetember. after a diet change and addition of new meds she is down to a healthy 9.2 pounds! all great news!!! but now this...

last sunday night i noticed zowi scratching her right ear and rubbing her head on the floor and furniture. she allowed me to look at the left but wasn't too happy when i checked her right ear. i couldn't see any problems but took her to the dr on monday. problem was that her regular dr is not in on monday or tuesday so we had to see someone else which had me very concerned with all of my girl's conditions.

microscopic cytology revealed a yeast infection. they did a thorough ear cleaning which left her shaking her head like crazy for a few hours. poor baby. she got an antibiotic/antihistamine injection and i'm giving her 1/4 of a 25mg benadryl to calm the itching per dr instructions. she was prescribed illini ear drops, a med that usually has the steroid dexamethasone in it but the pharmacy made zowi some without the dex mixed in, as a cushing's patient should not be given meds containing steroids. she has been getting the drops once a day. the part that has me so worried is that she was also prescribed ketoconazole! it is an anti-fungal med but can also be used for the treatment of cushing's. it is a last resort med for cushing's as it is known to frequently cause liver damage. I AM VERY CONCERNED WITH THE COMBO OF THIS ALONG WITH HER TRILOSTANE. the dr assured me that it should not be a problem but agreed that i need to closely monitor her as is it possible that her cortisol could get dangerously low using both meds concurrently. i was honestly so concerned that i waited until i could speak with zowi's regular dr yesterday (wednesday) morning before giving the keto. she explained there's not an alternative unfortunately and has given both concurrently to other patients with no problems. i told her i hadn't started it yet and she said that was fine but for lack of a better solution, to start the med so that's what i did. i am certainly not one to agrue with the vets or not listen but i was worried because this dr was not familiar with my girl and wanted to take the better safe than sorry approach. zowi will get her 2nd dose today although i do not feel totally comfortable with this protocol. i want my baby girl better but certainly don't want to cause any further harm to her. i also posted on the cushing's site i am a member of and did receive a response from a lady who went through the same situation with her mini poodle and she did not have any problems with the combo. i also double checked with a human pharmacy asking about interactions and was told that as long as the keto is only given temporarily it should be ok. there would be great concern if it was permanent. so zowi is on a very low dose of ketoconazole (25mg once a day) for 8 days and will have her infection rechecked march 26th. i am watching zowi constantly and so concerned right now, i hardly slept at all last night. i know you guys understand completely!

does anyone have any advice or alternative ideas that i could discuss with zowi's dr? or opinions on this protocol? i sure hope this clears up quickly. zowi has pretty much stopped the scratching and rubbing, so i am very happy that she is comfortable right now. sorry this is so long as usual lol. thank you so very much!