Dealing with Cushings in a third world country

[M&Inu]

The hydrotherapy sounds like a great way to help with that muscle loss, I believe some members have tried cold laser therapy and acupuncture too. The wheelchair looks like it could help too and that's awesome that you could build it!!

My Harley's body temperature seemed to run hot too and I would spritz his feet with water to try to keep him cooler. Cush dogs do have an insatiable appetite and some members give their dog frozen green beans and carrots to help in satisfying that hunger.

Hugs, Lori

Hi Lori, thank you for your reply! I will try the pool idea then, but when its a bit warmer, since I am a big wuss and current "low" temperatures are too cold for me to get into the pool with her.
Ihave bought her cooling mats with some sort of cooling gel in it, that when applied pressure to, it gets cooler than the floor, of course she is like a cat with the shipping box, instead of using her bed, I can buy her ten beds and the floor is stils the best. But thats why she has elbow protectors on, because a year ago she developed a hygroma on her left elbow. Veterinarians wanted to operate, but I got it down and completely healed just with cleaning and olive oil with honey and the elbow pads now on all the time, so that the trauma doesn't repeats itself.
Inu avoids her vegetables but then eats them when nothing else is coming along, thank you, I will give her more, so she fills up with that and can take a break of feeling so hungry all the time.
I hope you are having a good week! Hugs!

[M&Inu]

I also wanted to give an update regarding the online pharmacy PetCareRx, they were very helpful with my order. When I found out it was out of stock and contacted them with my discomfort of how that all was going to make Inu's Anipryl arrive so late, they assured me they would have it as fast as possible and made it an overnight shipment without charge. It has arrived at the "real US address" I provided, and they will be forwarding it to me now! I am very happy.

Also, tomorrow the lignans and the Chinese herbal medicine is arriving here in my country! I look forward to start using them.

[molly muffin]

Oh good, it does seem that you have a system worked out now for receiving medications. I wish there was a solution for easier testing too.

[M&Inu]

Hi Sharlene, hi everybody!

Thank you for your answer Sharlene, sorry that it took me so long to answer.

As they say here: no news, good news.

We are going through each day at a time. I would love to know if the Anipryl is having effect or not. Some days she is panting more than other days, but also these last weeks are getting warmer and warmer over here in the tropics. So I don't know is she just "normal" hot or is it the cortisol coursing through her body?

Polyphagia is still going strong, food is the only thing she cares about! But maybe her eyes are less red. Her hair is somewhat growing? I don't know what is wishful thinking anymore. On MY bad days I see only declining symptoms in her. Its so subjective, without being able to test.

As for Anipryl - yes, it does have a low rate of success in controlling cortisol for MOST pups. However, Squirt was on it for over 9 months and it helped her a great deal.

Leslie could you tell me what symptoms were an indicative with Squirt, that the Anipryl was working?

We are now officially on one month of Anipryl, Selegiline. And aprox three weeks into melatonin with lignans. Also the Ophipogon formula.

I don't know should I up her Anipryl dose to 2mg/kg (she currently is on 1mg/kg=40mg Anipryl)? Is it dangerous to do this? I ask, since it is stated in the insert that you are allowed to up the dosage.

I am trying to get in touch with Dr Castillo in Argentina to try out Cabergoline or 9-Cis Retinoic Acid. Until now no answer from him. I will keep trying.


We are trying to heal a hard to heal sore on her hind leg. Almost any medicated cream has corticosteroids, so I am trying the "natural" way with cleaning it and using honey and stuff, but its going so slow.

I hope everyone here is doing well!

[Squirt's Mom]

Squirt's initial signs that I recall (it has been a decade and my memory ain't what it used to be! ) were withdrawing from her family and the activities she used to enjoy; she would do what I called hiding - she would crawl under furniture and stay. She was drinking a bit more and peeing a bit more but her appetite was normal for her, which was always strong to start with. She did have some minor hair loss but nothing major and her hair did regrow after shaving but it was slow to do so. Bear in mind - her cortisol was NORMAL at this point. Once the cortisol began to rise then the voracious appetite and excessive peeing and drinking really kicked in. At that point, we added the Lysodren.

[Harley PoMMom]

We are trying to heal a hard to heal sore on her hind leg. Almost any medicated cream has corticosteroids, so I am trying the "natural" way with cleaning it and using honey and stuff, but its going so slow.

The two skin medications that I've seen on the forum that have worked and contain no steroid ingredient are; Hibiclens and Vetericyn Animal Wound & Skin. I think you can purchase both of these online; Hibiclens in also sold in pharmacies and I see that target has it too and Vetericyn can be bought in a pet store.

Hugs, Lori

[M&Inu]

Hi Leslie and Lori, thank you for answering my post. I have been busy, but good busy. I wanted to let you all know that we are right now doing the 8-hour LDDS test. I will be posting the results when I get them!
Leslie, thank you for your information. I was asking because in other threads you also mentioned Squirt having a spleen tumor that made symptoms like Cushing's and that it was resolved by removing the tumor. I am intrigued because in the ultrasound last year the vet mentioned Inus spleen being small, almost non existing? But he told me not to worry and now I worry. Maybe I will have another ultrasound with another doctor. Also my question was more towards how do I evaluate objectively if the Anipryl is working. I feel her hunger (she still gains more weight, even if I reduce food) and panting and hind leg weakness is the same or bit worse in the hind leg weakness. �� ��
Thanks Lori, I am curing her sore or higroma with a biofilm my current vet advised. It's a membrane made out of honey and it's made for curing deep burn wounds. It's working really well and has cero corticosteroids or antibiotics.

I hope you all are doing well! I will be back with results when I get them.

[Squirt's Mom]

Yes, the tumor causes stress which can cause the cortisol to rise naturally in response to the stressor. Since the tumor had been there for a while apparently her cortisol was elevated long enough to cause cush signs. The elevate cortisol was found during routing lab work for a dental and the tumor found a few months later when we had an ultrasound as part of the testing for Cushing's.

[M&Inu]

Hi!

Thank you Leslie for explaining how Squirts tumor was affecting her cortisol.

I have the LDDS results:

LDDS (Low Dose Dexamethasone Supression)
Cortisol 0 hours: 1.94 ug/dL
Cortisol 4 hours: 0.26 ug/dL
Cortisol 8 hours: 0.83ug/dL

Using this table (https://www.cliniciansbrief.com/site...iles/COC_2.pdf)
4-hour Cortisol 8-hour Cortisol Diagnosis
<1.4 mcg/dL < 50% basal PDH

So now I know its PDH. I still don't know what to do with this now. I am considering using Cabergoline as in the Argentinian study, since Cabergoline I can buy here in my country since its a human medicine.

But I am also at a super low point again, because her liver values just skyrocketed...

Triglycerides 245.1mg/dL
TGP/ALAT (alanine aminotransferase) 258.6 U/L
Alkaline phosphatase 1226.7 U/L

I have been giving her SAMe and Milk Thistle every day in the mornings on empty stomach. I had hoped this was protecting her liver. I am so sad right now. Again back to feeling hopeless.

Thanks as always for listening to me. I hope you all are doing well.

[labblab]

Hmmmm...actually, these results are negative for Cushing’s. The very first thing you need to evaluate is the 8-hour result in order to see whether or not the overall diagnosis of Cushing’s is confirmed. You did not include the lab’s normal range, but typically it is 1.4 or 1.5. This means that the dog’s 8-hour result must be higher than that cut-off point in order to be considered positive for Cushing’s. Since your girl’s 8-hour result was only 0.83, I’m confident that was within the normal range. Here’s the explanatory info from that article you cited:

Within 2 to 3 hours after administration of dexamethasone, plasma cortisol levels in dogs with a normal response will decrease to less than 1.4 mcg/dL (reference value dependent on the laboratory) and persist longer than 8 hours...

Eight-hour plasma cortisol levels greater than 1.4 mcg/dL are consistent with a diagnosis of hyperadrenocorticism.

If the 8-hour result is higher than 1.4, it is only then that you go back to further evaluate the 4 and 8-hour results in order to see whether a pituitary tumor is the likely cause. In your case, that further analysis is unnecessary since Cushing’s was not confirmed in the first place. Your results were consistent with those of a normal dog who suppressed her cortisol level throughout the entire testing period (per the top “normal” line of the table in the article).

I hope this explanation makes sense, and I’m not really sure where this leaves you in terms of treatment steps. As the article states, 10-15% of dogs who truly have Cushing’s do not test positive on the LDDS. Typically, though, those few dogs who don’t test positive are in the early stages of the disease. Here in the U.S., in this situation a vet might choose to perform an ACTH stimulation test as an alternative diagnostic option. But, unfortunately, I know the ACTH is not available to you. So right for the moment, I guess we have to assume that something other than Cushing’s is responsible for Inu’s problems.

Marianne