New diagnosis - Feeling overwhelmed and hopeless (Blue has passed)

[Bluester]

Hello my name is Laura and I have a 12 year old female Beagle named Blue. Blue is my everything. She was diagnosed with Cushings on July 14th and was prescribed Vetoryl 10mg after the ACTH test. She weighs 21lbs.

Background:
About 3-4 years ago I noticed she started drinking more water and had to go outside more frequently and during the night. I immediately made her an appointment thinking it was a UTI. All tests were negative but it continued. I continued to bring it up but was told was probably due to her age. Around this time she also started getting skin lumps, her vet said were age warts.

In the last year she started showing additional symptoms. Increased hunger (eating everything including trash), shaking limbs, trouble jumping, insomnia, boney appearance and pot-belly.

Last month she started panting nonstop and started losing patches of hair. I took her to the animal hospital and was told it was most likely cancer and they ran some tests. After a week of crying thinking the worse, tests came back negative. A couple weeks later I took her for a bath and the next day her tail was completly bald from the bottom. I did some research and found oout about cushings disease. She had almost all the symptoms. I took her back to the vet and asked about Cushings. After the ACTH response test the next morning it was confirmed.

After Vetoryl:
She has been on the medication for almost 30 days now. The panting has stopped and she now sleeps through the night but everything else is the same or worse. She has several bald spots around her neck, back and chest now. Her skin looks very spotty. She continues to drink a lot of water then inflates like a balloon after for about an hour. The scary part is her eyes. I'm not sure what is wrong but sometimes after waking up it looks like she has lazy eye or had a seizure. Not sure how to explain but doesn't look at me the same.

I am not sure if we waited too long to get a diagnosis or I just need to give it more time. I have also purchased and started her on HMR Lignans and K9 Melatonin.

Any advice is appreciated. Sorry so long.

[Harley PoMMom]

Hi Laura,

I have manually approved your membership so now all your posts will be seen right away. Also, please just disregard the validation email that was sent to you from k9cushings.

Welcome to you and Blue! I am sorry for the reasons that brought you here but sure glad you found us and we will help in any way we can.

If you would get copies of all tests that were done on Blue and post those abnormal values along with their normal ranges it will enable us to provide you with better feedback, ok? With respect to the blood chemistry and complete blood count (CBC), you need only post the highs and lows. For the ACTH stimulation tests there will be two set of numbers: a pre value and a post value. Does your girl have any underlying illness that she is taking medication for? And if so, what is it and what is the medication? Is she taking any supplements, medications or herbs? Was an urinalysis done and if so could you post those findings too? Does she still have those skin lumps and was a skin scraping or biopsy performed to identify what they are? Did the vet perform any tests to differentiate between the adrenal or pituitary form of Cushing's?

Usually improvements in the drinking/urinating are seen within 2 weeks of starting treatment. The recommended starting dose for Vetoryl is 1mg per pound of a dog's weight which means that a 20 mg of Vetoryl would of been an appropriate dose for Blue's weight of 21 lbs, so it could be that the 10 mg may need to be increased. But I am glad to see that the vet did start her out at a lower dose because you just never know how a dog will react. And the go slow and start low is our motto here. Now, a couple important questions I have; is Blue getting her Vetoryl with a meal so that it is properly absorbed? And is an ACTH stimulation test scheduled to see where her cortisol level is? Also, those monitoring ACTH stimulation tests have to be performed 4-6 hours post pill.

And just so ya know we love details so never feel like you are posting too much information.

Hugs, Lori

[DoxieMama]

Hi Laura,

Lori covered all my questions and ideas so I'll just say welcome to you and Blue! I look forward to learning more about your girl.

Shana

[judymaggie]

Hi, Laura and welcome to you and Blue! My beagle, Abbie, sends a big ar-o-o-o to Blue.

Is the issue with her eyes a constant thing or something that you notice occasionally? You mentioned the possibility of a seizure and, as you probably know, beagles are a breed that is prone to seizure activity. Have you discussed what you have seen with your vet? If this is an occasional thing, it is very difficult for a vet to determine a cause if he/she does not actually see it happening.

Hopefully, we can alleviate some of your feeling overwhelmed and hopeless. Abbie is my second beagle Cush pup and I found that reading and learning as much as I could about Cushing's helped immensely. Take some time to browse in our Resources forum. Here is the link:

http://www.k9cushings.com/forum/forumdisplay.php?f=10

[Bluester]

Thank you everyone! I am already feeling better knowing I have some support.

Lori, here are the lab results. She had a full blood, urine and fecal analysis done.

Lab Test Lab Result
Cortisol Sample 1 4.4
Cortisol Sample 2 53.9

For the urine it says WBC negative, color and appearance abnormal, RBC positive, specific gravity 1.006, protein 300.0, glucose 0.0, and pH 6.0.

I don't see anything regarding checking between adrenal or pituitary but I will ask this weekend when she has her next ACTH stimulation.

She has never been ill before this and continues to act like a happy/hungry dog. The only supplement she took before the diagnosis was Cosequin which I started giving her when she started shaking and having problems jumping and Clavamox twice this year when I took her in for the balding/masses on her skin.

Yes she had a biopsy back in March and it was negative. No neoplastic cells identified. No evidence of malignancy.

Should I continue the Lignans and Melatonin? If so do I give her all 3 meds together? I have been giving her the Vetoryl and Lignans in the late afternoon and the Melatonin before bed.

Judy, I have only noticed it a few times and no other indications. Thanks for the nice welcome!

[labblab]

Hello and welcome from me, too! I'm afraid I have only a moment to post, but I want to caution you about dosing Blue with her Vetoryl in the late afternoon. In order to obtain useful results, monitoring ACTH tests should be administered 4-6 hours after the Vetoryl is administered along with a full meal. In order to be metabolized properly, Vetoryl should always be given with a meal. So there are two issues here: is Blue getting her Vetoryl with food, and on your current dosing schedule, can the test be run 4-6 hours later?

From what you've written above, it's not clear to me whether or not this will be Blue's first or second monitoring test. But either way, I'm hoping you will be able to adjust her dosing appropriately for any future tests. As Lori had suggested, it may be that she needs a larger dose of Vetoryl to control her symptoms, and accurate testing will be an important tool in figuring that out.

Also, if you want to continue giving the lignans and melatonin, there is probably no problem with that, although I'm not sure how much they are benefiting her. Lowering her cortisol would seem to be the top priority right now, and the Vetoryl has far more of a powerful effect in that regard. Also, I'd probably not give the lignans directly alongside the Vetoryl unless you can verify that there's no risk of the lignans interacting in some way. You might contact Dechra, the manufacturer of Vetoryl, in order to see whether there is any interactive effect.

Marianne

[Bluester]

Hello and welcome from me, too! I'm afraid I have only a moment to post, but I want to caution you about dosing Blue with her Vetoryl in the late afternoon. In order to obtain useful results, monitoring ACTH tests should be administered 4-6 hours after the Vetoryl is administered along with a full meal. In order to be metabolized properly, Vetoryl should always be given with a meal. So there are two issues here: is Blue getting her Vetoryl with food, and on your current dosing schedule, can the test be run 4-6 hours later?

From what you've written above, it's not clear to me whether or not this will be Blue's first or second monitoring test. But either way, I'm hoping you will be able to adjust her dosing appropriately for any future tests. As Lori had suggested, it may be that she needs a larger dose of Vetoryl to control her symptoms, and accurate testing will be an important tool in figuring that out.

Also, if you want to continue giving the lignans and melatonin, there is probably no problem with that, although I'm not sure how much they are benefiting her. Lowering her cortisol would seem to be the top priority right now, and the Vetoryl has far more of a powerful effect in that regard. Also, I'd probably not give the lignans directly alongside the Vetoryl unless you can verify that there's no risk of the lignans interacting in some way. You might contact Dechra, the manufacturer of Vetoryl, in order to see whether there is any interactive effect.

Marianne

Thank you so much, I will start giving it to her in the morning now. She does take it with food.

She has only had the initial test the next one is in a few days.

[molly muffin]

Hi and welcome from me too. Lets see how things go on the medication and see if some of this can't be turned around.

When is the next test? You said a couple days. And what are the results of that and how is dear Blue doing now?

[Bluester]

Hello! Sorry, it has been a while since I shared anything.

Blue was diagnosed July 2016. Her levels were at 53.9 at the time. She had ALL the symptoms and had been misdiagnosed a couple times. Her vet started her at 10mg of Vetoryl. There were no noticeable changes to her levels but some of her symptoms did get better.

She was on 30mg for about 3 1/2 months but after her last test her levels were at 30 so we changed her to 30mg twice a day instead of once a day. She also lost weight but still eating like normal.

She is not reacting well to the higher dosage. Started losing hair within days and other skin issues. I started her on Melatonin again and that seemed to get better but she has a lot of stomach issues so vet changed her to 30mg in the morning and 10mg at night starting tomorrow.

I also feel like she is a bit sad. She is still always hungry and she still drinks a lot. She still shakes a lot (limbs).

[labblab]

Welcome back to you and Blue! I'm sorry I have only a moment to post right now, but I will come back later in order to add a more complete reply. However, in the meantime, I wanted you to know that I've merged your new post into your original thread about Blue. This way, it'll be easier to keep Blue's history as well as everyone's thoughts and suggestions all consolidated in one place.

Once again, glad to have you back!
Marianne