My girl pug (confirmed Cushings & confirmed calcinosis cutis) / Tobey has passed

[goldengirl88]

Renee:
I guess all dogs are different and show their clinical signs at a different rate. Tipper's are so bad you can tell within hours of her not having Vetoryl. Hope you got the meds and all is well. Blessings
Patti

[Renee]

Hey everyone. I haven't check in on Tobey's thread, because not much has been happening. I definitely feel that her CC is improving somewhat, especially one of the first lesions is looking much better. They are all very dried up now, and rarely bleed. None are fully gone though.

What has come up in the past few weeks is a lot of hair loss. Her skin is very dry and flaky and the hair is coming out in clumps, with little dandruff / skin flakes attached to it. Her fur in general is much drier. The hair loss is mostly on her sides, stomach, legs and stomach.

I have her on a fish oil supplement, probiotics, and a good quality food. I stopped cooking for her, as she has been tolerating The Honest Kitchen very well the past 6 weeks.

It's almost like she needs lotion rubbed into her skin? I don't understand the hair loss though.

As for her cortisol levels, we have an ACTH scheduled for Wednesday, and we will see where she is at. Her pu/pd is virtually gone, with a small peak mid-afternoon/evening. The panting is gone. She still has a pot belly, but I feel like she may always have that.

[molly muffin]

Hi Renee,

What about that spray lotion that University of Davis recommended for Butters CC? That might help. trizchlor spray

hugs,
Sharlene and Molly Muffin

[addy]

Renee, that is how I describe Zoe's skin problems last Spring when she had yeast, dandruff and bacteria on her skin. I had to use ketochlor shampoo and the hair loss got worse before getting better because the hair follicles have to go through a cycle so they die off and then regrow and that can take maybe 3 months to cycle. But the hair follicle had white dandruff attached to the base. It was when all that started, I had the skin scraping done.

I would have to recheck on DVM 360 but I thought the case study I read they used a medicated shampoo with calcinoisis cutis. In Zoe's case, I had to start at smaller increments and work my way up, so the first time I used it, I did not use as much, only allowed to stay on for 3-4 minutes, we did that twice a week for a few weeks, then built up to eight minutes twice a week for a few weeks and then cut back to once a week for a few weeks, then continued to cut back.

So it would be a matter of treating the secondary skin issues besides the calcinosis cutis. Could you discuss with your vet?

[Renee]

Addy, thanks for the suggestion on the skip scrape and shampoo. Tobey sees the vet on Wednesday of this week, so I'll have the vet check it out. I am taking her today to be groomed by a very good friend of mine. We are going to hopefully just pull out all these clumps of hair, because everywhere she goes, hair clumps are just falling off her.

Her hunger is getting more pronounced again. She woke me up last night twice to eat. I gave her a small treat, but I can tell she wanted a lot more.

I feel so confused, because a lot of her symptoms are manageable, but at the same time, I feel like she could still go lower on her cortisol, because she's still not as happy as she used to be. I guess cushings is like this. I think she's fine overall, but then there are moments where I think it's not fine and I wonder what it must be like for her.

[Dawn Anderson]

Morning, dry clumps are really a good thing, its a sign that the underside is calming down and slowly entering a new growth stage, as frustrating as it is this process, as long as you are seeing fewer and fewer new spot , you are both heading in the right direction. Cycling is a good discription, the damage to the folicals started long before we could see it. Butter has now lost almost all of her fur on her top side, the fur that she left is mostly in bedded into the cc plaque.
As long as you can control the hormone and it sounds like you are getting it in check, then the CC will slowly subside, it just seems to take forever to really see any major changes in that area. The spray is helping the condition of her skin, cleans and conditions it.
We just entered the medication faze & keeping my fingers crossed that we have minimal issues. If we do I will be asking for advice.

[Renee]

Thanks Dawn, for the pep talk. Yes, we are seeing fewer spots for sure, just her hair growth has thinned out so much. We are back from her grooming, and it's sad to see how thinned out her hair is. This is my girl that has a double coat. But, I am hopeful on the progress of the CC.

[Renee]

I have a question for the experts:

Tobey's pre number has continued to drop (last ACTH was 2.1), while the post number has continued to creep back up.

Is there an explanation for why the pre would drop, but the post would not?

Her next ACTH is this Wednesday, and while I feel she could do with a dose increase, I worry about her pre number getting too low, without being able to get that post number into therapeutic range.

[Dawn Anderson]

Yes that is a good ??, would like to see what our forum experts have to say. I will be keeping a close eye on your posts, butters is on day 3 of Vetyrol, will have first acth post meds on 02-22.. Little nerves here.

Dawn & Butters

[addy]

Renee, I know you are hoping one of the administrators stop by to discuss your question about why would the pre go down and the post go up on an ACTH test.

When I first found this forum four years ago, we didnt really pay much attention to the pre number on an acth test. We usuall saw stress show up on the pre number and really concentrated on the post. Lately, the pre number has become more of a discussion with Dechra not wanting the pre or post below 1.45 ug/dl. I cant find much written about the "pre" number on an ACTH test.

When debating whether or not to change a dose for your dog, my opin ion is to take everything into account. I dont have time right now to go back through your thread so maybe could you post all ther ACTH stim results on your thread? That would help the discussion as history and symptoms play a huge role in deciding whether to change a dose, it cant just be about chasing numbers.

Thanks