Unsure of what to do

[Charlie Browns Mom]

Hi,
When I recently had blood work done prior to Charlie's teeth cleaning the vet found that his blood levels were off. She suspects it might be Cushings disease. Further tests to be done. Charlie is 11 years old and is a rescue dog that I have had since 2005. Due to his allergies he was on Prednisone for a several years. Long story behind the allergies at this point no need to discuss. The vet told me that if it is Cushings that it can be controlled with meds for around $60 per month. I have been reading as much as possible and have noticed that with meds his blood levels will need to be monitored closely. Can anyone give me an estimate of just how many times a month this will need to be done? Charlie is terrified of other people. He was abused and has always been afraid since I have had him. I don't know if I want to put him through this at his age and his disposition. Can anyone share their experience with me as far as if they had to do it over again would they still do the treatment. I have read a lot of "In Loving Memory Of...."
stories. So it seems like there is no guarantee the dog will make it.
Thank you

[Harley PoMMom]

Hi and welcome to you and Charlie,

When prednisone is given for over a period of time Cushing symptoms can appear. I believe what Charlie has is a form of Cushing's called Iatrogenic (veterinary-induced) hyperadrenocorticism. The treatment for Iatrogenic Cushing's is to slowly taper the use of the steroid.

How long ago was the prednisone given and what was the dosage? Since prednisone interferes with the cortisol assay, no tests for Cushing's should be performed.

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[Charlie Browns Mom]

Hi Lori,
Thanks for replying to my post. So here's a quick story of Charlie Brown. I adopted him in 2005 and discovered he had some kind of allergy. The vet put him on Prednisone since he was itching and eating holes in himself. He was really miserable. In 2007 I got fed up and took him to a dermatologist. She did allergy testing and found a few things here and there but none of them were significant amounts. We kept Chuck on the Atopica and moved to WA. We moved from dry San Diego to the very rainy Olympic Peninsula.
This is where we discovered Charlie’s allergy was from fleas. Even though we kept him on Flea Preventative if he got one bite it would send him into orbit. Charlie came off the Atopica and has no problems until the very brief time of summer which is about 2 months when we have fleas. He has only had to use steroids a few times and the vet here put him on Temeril. So he really hasn’t been on Pred. for a really long time. I noticed that Charlie had started to slow down and figured that was natural since he is around 11 years old. When I took him into get his teeth cleaned the vet said his blood levels were off and sent off more blood samples. I don’t have the actual results but she said it looked like Cushings and recommended after he calmed down after the teeth cleaning that we take urine samples. Sooo that’s where we are at this point. I have just started doing some research and want as much feed back as possible. Charlie, doesn’t exhibit any other symptoms of Cushings. I would appreciate anything you have to share with me regarding your experience.

Hugs Back!!
Sharon

[frijole]

Hi! My dog Haley was diagnosed with cushings after having blood work done for teeth cleaning also. It would be helpful if you could get the blood work that was done and post the items that are out of range (high or low). Also have you done any tests to confirm a diagnosis? As Lori mentioned, it is a tough disease to confirm because so many other illnesses can mimic it and some tests yield false positives so you must do multiple tests to confirm.

If there are no symptoms all of the experts in the field say to do NOTHING but just keep an eye out for symptoms should they arise.

Hope this helps! Kim

[StarDeb55]

Sharon, here's a late welcome to you & Charlie! My first Cushpup, also had severe allergies, so I'm well experienced in dealing with both. I'm glad to hear that you have consulted a derm vet. I would like to encourage to keep in contact with the derm vet as most general practice vets have a limited skill set when dealing with severe, chronic allergies. I do want to let you know that if you are using Temaril, Temaril is actually Temaril-P, the P being prednisone. So if Charlie has to have the Temaril on a fairly regular basis, it's very possible that he may have developed iatrogenic Cushing's as Lori has already mentioned. Atopica is actually a better choice for an allergic cushpup as it is cyclosporin, & does not contain any steroids. My first boy was on cyclosporin for years, along with several other medications as my derm vet was very well aware that he could not use any steroid containing meds.

Please keep us posted.

Debbie

[JoannH]

In response to your question about how often blood work would have to be done, I guess it would depend on the medication. Daisy is in Vetoryl and she had to have her levels checked two weeks after starting the medication. She is due for another test 30 days after that. If that test goes well, then she would only have to have a test every 3 months or so I think.

I think I will talk to the vet about twice a day dosing. If the dose or dose schedule changes, I'll have to start over and have her tested after two weeks, then 30 days, then every 3 months.

[Squirt's Mom]

Hi Sharon and welcome to you and Charlie! :)

To answer the question posed in the title, if Charlie is not showing any signs, I wouldn't waste money on further testing right now. Signs are a critical part of diagnosing, and monitoring once treatment begins, and a responsible, experienced vet will not start treatment on a pup with no signs - it is too risky.

As for testing and expense, Trilostane (Vetoryl) is typically more expensive to use as it requires more tweaking of the dosage and with each change, an ACTH has to be performed. Most pups on Lysodren (Mitotane) stay on the same dose throughout requiring less testing. However, one key is which treatment your vet is most familiar with. But since Charlie has no signs, treatment isn't something I would be considering at all, period, right now. ;)

Also, doing a urine test is questionable unless the vet is talking about the UC:CR. This test can rule Cushing's OUT but cannot diagnose it. If it comes back normal, there is no Cushing's. If it comes back abnormal, that does NOT mean Cushing's, it simply means something is off and further testing is needed to learn what is off. There is no urine test that can diagnose Cushing's so be sure what test your vet is wanting to run and why before you spend money on it.

As Kim said before, if you could get copies of the actual testing done so far and post those results here, that would help us a great deal in helping you and Charlie. We LOVE details, so the more you can tell us about Charlie, the better. ;) Never worry about the length of your post...if you run out of room, post and keep going on another post. :D

I'm glad you found us and look forward to learning more about Charlie. We will help you both in any way we can.

Hugs,
Leslie and the gang

[marie adams]

Hi Sharon,

Welcome to you and Charlie!!:)

I see the experts have been by to help a little, but posting the test results help even more. They will know what to look for that could mean other illnesses.

As for me I was a Lysodren user with my Maddie. She had so many symptoms I knew without a test what she had, but still had tests run so the vet would believe me.

Take care and welcome to the family!!!:)

[molly muffin]

Hello and welcome. Hope Charlie is doing okay.

Sharlene