Hi all, foster girl with Cushing's

[medusa]

Hi and sorry for my english I am from Greece and I found this forum while searching for Cushing's syndrome, never thought there will be a specific forum! Glad I found it!

I have 2 mixed breed dogs of my own and i often foster strays, we really have a problem here.
Last 20 days I have a new foster girl, sweet Lucy . She is small, only 8 kgrs, around 10-11 years old, and was abandoned at the streets of Athens about a month ago so I don't know anything about her past.
From the first day I noticed the bad skin condition, the alopecia, the large belly, the excessive drinking and urination and how hungry she was, she was licking the floor for hours ! She had many of the symptoms, we did the blood work and she was officially diagnosed some days ago. I believe she was abandoned cause they found out she was ill and the cost of the exams and meds is quite big here.

I already found a lot of interesting and helpful information in the forum, thank you!
Hope the best for your fur babies

[labblab]

Hello and welcome to you and Lucy! I’m so glad you’ve found us, and your English is excellent — there is no problem at all with that! I’m afraid it will be tomorrow before I can write more to you, but I did not want to wait to welcome you and to let you know that your membership has now been fully approved and anything you post from now on can be seen by all our members. You do not need to reply to an email request for membership confirmation if you should receive one — you’ve now already been fully approved.

You are a wonderful person to take care of all your dogs, and we’ll do everything we can to help you make decisions about Lucy. As I say, I’ll write more tomorrow, and once again — welcome to you!!

Marianne

[medusa]

Thank you mery much

I ll do my best to "study" as much as possible, its quite a new and complicated thing for me.
So nice to find people that can understand and have a knowledge, I want to do the best for this poor girl someone left.

[labblab]

Alright, I’ve made it back once again! As I said yesterday, we’re so grateful to you for taking care of the stray dogs who have been abandoned — you are truly their guardian angel. Sadly, we know how overwhelming and expensive Cushing’s treatment can be in all countries. I’m sure Greece is no exception. If you could share Lucy’s numerical test results with us, that will help give us a clearer picture of her current situation. I’m not sure what diagnostic testing is done in Greece, or what medication options may be available. If you can tell us more about that, we’ll then do our best to help you find the best solutions for her care.

So please feel free to ask us any questions you may have. We’ll be so anxious to learn more about sweet Lucy!

Again, welcome to you both.
Marianne

[medusa]

Marianne, thanks again for your nice and encouraging words

From previous posts I read, I noticed things are quite the same. Except from the symptoms which she had most of them, she also had some anomalies in her check up blood test, like high ALT. So she did the LDDS test. I do not have the numbers etc of the LDDS test ( it was done by the towns shelter vets and its somehow complicated to have them in hand) . Vetoryl is also used here, as i understand its the only medicine suggested for Cushing's by greek vets.

Vet prescribed to start 30 mg vetoryl every morning, cause he said her cortisol is very high and her symptoms advanced. It seems so big dose for a such small girl (she is around 8 kgs.) and i am scared (in general overprescribing its usual here). An animal welfare organization donated her first box of medicine but i did not started yet, I am trying to get the papers/exams so I can take an opinion from a vet clinic I trust ,asap.

I hope i ll take the second opinion fast, cause her skin condition is worse in comparison with the first day she came here. Her panting is somehow better cause she is all day in a room with air condition and i take her small walks only late at night (Greek summers are very hot). I also think she has lost some weight and the belly looks smaller. She probably had a poor diet before, now i feed her 3 small meals, only cooked low fat meat with vegs and also grain free kibbles. I also started her milk thist , turmeric and probiotics to prepare her body as best as possible for all these meds.

My main concern at this time is the 30 mg dose, seems very high. I noticed dogs with the same weight in the forum usual started with 10 or maybe 15 mg.

Thank you, Matina

[labblab]

Dear Matina,

Thank you so much for all this additional information. I think you are doing all the right things in the way in which you are taking care of Lucy -- the air conditioner, the short walks, the meals, the supplements. Everything you are doing is so good, and such a gift to her after her life in the street.

I understand that it can be difficult to personally get test results from some vets, especially if they are working directly with shelters. We do know that conditions other than Cushing's can give "positive" results on the LDDS test, but from all the symptoms you've described, it does sound as though Cushing's is the likely cause of Lucy's problems. I'm especially sorry to hear that her skin condition is getting worse, because there is a particular kind of skin ailment called "Calcinosis Cutis" that can make life miserable for Cushing's dogs. If you do an internet search on that term, you can find some pictures that you can compare to what you're seeing with Lucy. If it looks the same, then it's true that you'll want to start Vetoryl treatment as soon as you can in order to try to keep it from getting even worse. It it's only the case that she is losing hair and having bald spots, it's not so important to be be speedy in starting treatment. In that case, it's mainly just her appearance. But if she is developing sores that look like the pictures of Calcinosis Cutis, then the problem is more serious.

It's so good of the welfare organization to have donated a first box of medication. However, like you, I wish so very much that the shelter vet had prescribed a lower dose to begin with. I'm afraid many vets make the same mistake of thinking that, if the symptoms are bad and the case seems advanced, the dog should be given a higher dose. But everything we've been told by researchers and even the company that makes Vetoryl is that initial dosing should be based solely on weight and not severity of symptoms. So you're right, a safer starting dose for Lucy would be 10-15 mg. Every dog metabolizes the drug differently, and it may well be the case that she might end up needing to take a larger dose such as the 30 mg. daily. But in order to avoid risky side effects, you want to start with a lower dose, and see how the dog does both in terms of symptom relief and bloodwork results. After you see how the dog handles the medication, then it is safer to increase the dose at that later time if it seems necessary.

In Lucy's case, though, especially if it looks as though she has Calcinosis Cutis, I really don't know what I'd do if she were mine and it looks as though it will take a long time to be able to get a smaller dose. I might risk going ahead and starting the medication, while watching her very closely for any ill effects and stopping the medicine if anything worries you. You can see that I am placing a lot of importance on her skin, though. So if you can describe her skin in more detail, that can help us make some decisions about whether or not to wait to start treatment.

Marianne

[medusa]

I searched about calcinosis cutis, I think she is not so bad, seems an awful thing.

Lucy has some sores in her back legs and tail and her belly seems to have some kind of mild infection, the skin is very thin i can see her veins and not so elastic, i can also see 2 large round spots that seem infected and she has some small bumps . She also has some darkened spots that seem a little dry. Her nose is crusty and dry also and her ears seem a little dirty.

The main skin problem is around her throat, when she came here she had already lost her hair and had some dark patches but now it seems like some kind of dermatitis or bad infection, has sores, its greasy and has developed a weird odor.

I expect to have the exams tomorrow and get her to another vet for a second opinion , especially about the dose. I ll try to talk again to first vet also , maybe he will agree to a smaller dose.

Thank you.

PS. I send the vet the Dechra protocol about Cushing's treatment , where is is clearly suggested to start with the smaller dose of 2 mg/kgr and i am waiting an answer.

[labblab]

You are doing such a great job for Lucy! I know I keep repeating this, but it is *so* true! Good for you that you sent the Dechra info to the first vet, and that you've set up the new exam as well. Thanks also for the thorough description of Lucy's skin problems. I agree with you -- it sounds more like she may be suffering from skin infections rather than the Calcinosis Cutis. Skin infections of all kinds are pretty common in untreated Cushing's dogs because their immune systems are weakened by the disease. Low thyroid levels can also be associated with Cushing's, and that can also make dogs more vulnerable to skin problems. If Cushing's is causing low thyroid, the thyroid levels should improve on their own once the Cushing's is treated. However, sometimes dogs end up needing thyroid supplementation if their levels are low and Cushing's is not the cause. I just mention the thyroid because that may be a blood level that you'd want to have checked by the new vet if it wasn't already done by the shelter vet.

No matter what, we'll be anxious to hear how the new exam goes tomorrow.

[labblab]

Me again! I had one more thought to add. After posting a similar reply to another member, it occurs to me to also suggest to you to request a “rescue” dose of prednisone from one of your vets in the event that you do decide to start her off with that higher 30 mg. dose of Vetoryl. Having prednisone on hand could give you some extra peace of mind, because you would be able to quickly supplement Lucy’s corticosteroid level in the event that the medication were to drive her natural cortisol level too low. Hopefully you will be able to start off with a lower dose of Vetoryl to begin with. But I just wanted to suggest the prednisone as a backup if the lower dose is not available. The necessary dose of prednisone would be very small for a dog of Lucy’s size — I’m very annoyed with myself that I can’t remember the exact formula! But it is just one more thought that I had before your vet visit tomorrow.

[medusa]

Its a good thought, I have always predinasone at home, saved my dog once when he had a bad allergic reaction, so that will not be a problem. I ll ask the vet about the dosage.

Tomorrow Ill probably have the numbers of the LDDS test and her blood work so I can ask a more experienced with Cushing's vet about the 30 mg dose.
I hope I ll get an answer until Monday and can finally start with the treatment.

Lucy is now enjoying her new cooling mat, seems to work for her.