Ugga-7yr old french bulldog (calcinosis cutis)(Ugga crossed the bridge)

Hi. My name is Jackie and my boy, Ugga, was diagnosed with Cushings yesterday. He was diagnosed by a skin biopsy (he has calcinosis cutis). It really looked like he was having an allergic reaction and I had switched his food right around the same time so I just assumed that's what it was. At first he was just flaky. His hair as always been sparse around his ears and his sides so I didn't think that was anything to worry about (so stupid). His skin started turning really red and the flaky spots got big and raised and were spreading rapidly. Off to the vet we went. It happened pretty fast. He was drinking slightly more than normal but nothing dramatic by any means (that has changed dramatically in the last week, he's drinking A LOT now). He just looked awful. We did bloodwork and pretty much went right for the biopsy. Ugga has a worst-case scenario history at the vet clinic so this time we decided to be aggressive right off the bat (I really wish I had thought that way when his skin first started to look iffy). We put him on Cephalexin to help prevent a skin infection and waited for the results. His bloodwork came back really good. His liver enzymes were only mildly elevated (I'm sorry, I don't know the numbers and all the technical info but I'm sure I could get a copy of his lab results if needed) but everything else was right where it should be. So we waited for what seemed like a decade and found out he has Cushings. Our vet is waiting to talk to the pathologist on Monday before we decide on a medication. She is leaning toward Trilostane (I think that's what it's called) because that may be the safest option for Ugga. He's epileptic and takes phenobarbital and potassium bromide. I read that there are some tests you're supposed to have done to find out which type of Cushings you're dealing with and I don't think my vet is doing that. Do people begin treatment without knowing for sure? Maybe we have fewer options because of his other meds. I don't know. I hate that I know nothing about this. I'm hoping to learn as much as I can from all of you and your experience. I'm so sorry for rambling on and on, thanks for listening =).

Jackie and Ugga

Hello and welcome to the forum:) I am so glad you found us but so sorry for the reasons you are here. I want you feel very comfortable here. The members here are fantastic and very knowledgeable. They will be along shorty to help you. Please get copies of all bloodwork and tests that were done so you can post them. This will help the members give you advise. Also tell us everything you can about Ugga, his health and his weight. Hang in there. I know its alot to consume. Again you have come the the right place. We will always be here for you! Oh and never apologize about rambling on!! We are here to listen and help :)

Hugs xo

Hi Jackie!

Welcome to you and Ugga! So sorry for the circumstances that brought you here but glad you found us as we will help in any way we can.

Sorry I only have a moment to post but I wanted to welcome you and provide these links to a few Threads where calcinosis cutis is discussed: http://www.k9cushings.com/forum/show...lcinosis+cutis

http://www.k9cushings.com/forum/show...lcinosis+cutis

http://www.k9cushings.com/forum/show...lcinosis+cutis

If you could get copies of all test/s that were done and post the abnormalities here, that would really help us to provide you with more meaningful feedback.

Love and hugs,
Lori

Hi Jackie, and welcome to you and Ugga!

I am sorry for the unfortunate circumstances that brought you here, but you have found a wonderful site! We can all remember the fear, sadness, and confusion that we felt when we heard the Cushing's diagnosis. Luckily, there are many kind, helpful, and knowledgeable people here who will help you with all of your questions. Someone will be along soon to help you.

When you have a chance, please get the names of the tests your vet did, as well as Ugga's test results and post them here. That will help us give you the best information possible. Cushing's is a bit confusing and typically more than one test is done to make a diagnosis. There is a test (LDDS) that can help to determine if it is pituitary or adrenal Cushing's, and someone else can give you more information about that. Many of us also had an ultrasound done on our dogs, so they could look at the adrenal glands.

As I said, you have come to the right place. Please feel free to ask all the questions you have. We are a very supportive group and you and Ugga will not be alone as you figure things out. There is also a wealth of information on this site that you can read in the meantime.

Rest assured, we will be with you and Ugga every step of the way on your Cushing's journey.

Julie & Hannah

Jackie, welcome to you and Ugga! As a Georgia girl, I have to ask whether you guys have any connection with the U. of GA mascot? :o

I am so sorry to hear about the calcinosis cutis, because I know it can be a great problem for people. But one thing we also know is that it is pretty much a definitive symptom of Cushing's. However, one reason why you may want to dig further in the effort to find out the type is because with Cushing's caused by a tumor of an adrenal gland, surgery can offer a total cure. The surgery is a major undertaking, though, and not every dog is considered a good candidate, especially if there are other big issues going on.

As far as Cushing's medication, one factor you may want to consider is that trilostane is probably not a great drug to use in combination with phenobarb. Here is part of a reply that I posted to another member who has an epileptic dog (Dechra is the manufacturer of Vetoryl, brandname trilostane):

Quote:

---

OK, I just spoke with one of Dechra's technical reps, and what he told me pretty much coincides with what you were already thinking. Even though there is no documented interaction between trilostane and phenobarb (he is unaware of any clinical trials that specifically addressed that drug combination), dogs who are being treated with both drugs need to be monotored very diligently both in terms of liver function and also trilostane efficacy. He is aware of dogs that are currently being treated with both drugs, and no particular problems have surfaced thus far. But theoretically, phenobarb's effect on the liver could alter the way in which trilostane is metabolized by any given dog, leading to the potential for trilostane overdosing in the absence of appropriate dosing adjustments. Everything being equal, potassium bromide would probably be a preferable treatment choice for a dog suffering from both conditions.

---

I don't know whether you might want to try to shift Ugga to potassium bromide, exclusively. Or in the alternative, whether Lysodren might be a better choice altogether -- although off the top of my head, I'm not sure whether Lyosdren is a good combo with phenobarb, either. Strictly in terms of the calcinosis, Lyosdren may be the better choice. Here is another quote from Glynda, another staffer here:

Quote:

---

Originally Posted by lulusmom

...Calcinosis Cutis can be very difficult to resolve and you have already heard from our resident expert, Angela. As she mentioned, her Sabre treated with lysodren, which may be a better choice of treatment for dogs with calcinosis cutis. Dr. David Bruyette, one of our country's reknown veterinary endocrine specialist, stated in one of his lectures that his facility (VCA West Los Angeles) has not had good luck with resolving the calcinosis cutis in dogs being treated with Vetoryl (Trilostane). VCA West Los Angeles treats hundreds of dogs with cushing's so they have lots of experience under their belt. If your friend's vet is out of suggestions, you may want to ask her to ask the vet to contact Dr. Bruyette to discuss Vicki's case.

http://www.vcahospitals.com/west-los-angeles

---

Due to Ugga's multiple issues, a consultation with Dr. Bruyette might be really helpful to your vet. I have an epileptic dog on phenobarb, too, so I truly understand that you hate to rock the boat in any way in terms of additional treatments or medication changes!

I'm so glad you've found us, and we'll do everything we can to help you work things out for Ugga.
Marianne

Hi Jackie and welcome.

I'm glad to see that Marianne has provided you with some very important information. Unfortunately, Ugga is a complicated case. According to most well published endocrinologists, treatment without the common symptoms of cushing's is not recommended. Then one of those endocrinologists lectures and readily admits that he has had less that satisfactory results in resolving calcinosis cutis with Trilostane treatment. To compound matters, Ugga has epilepsy and for separate reasons, neither Trilostane or Lysodren is recommended if a dog is on phenobarbital. Marianne has already mentioned why Trilostane is not recommended so I will tell you that Lysodren (Mitotane) is listed as a drug whose absorption can be greatly altered by phenobarbital.

Calcinosis Cutis is scarey and it's not easy to get the upper hand on it so I would recommend that if your vet is not an internal medicine specialist or board certified dermatology specialist, you ask for a referral. An alternative would be to have your vet contact Dr. Bruyette and discuss Ugga's case with him.

We're here for you in any way we can and while we're always sorry for the circumstances that brings folks here, we're very glad that you found us. We've jumped on board and we're on the journey with you now.

Glynda

Hi Jackie and Ugga ... welcome.

My Hungarian Vizsla - Sabre had calcinosis cutis and was treated with Lysodren. Lori has provided you with some links to the threads which have discussions on calcinosis cutis so I willl not repeat these but will add that if you have any further questions on how to manage the skin condition then please ask. It is difficult, but once cortisol levels are where they should be under treatment things become more managable.

I can't comment on the epilepsy and drugs as I have no experience in this but I would agree with the other members ... Dr Bruyette may be very helpful to contact to your vet in suggesting what options you may take.

All the best
Angela

Potassium Bromide can be an alternative anti-seizure medication if pheno can not be used.

Here is a link to an article about other anti-seizure meds: Phenobarbital Alternatives for Dogs

Thank you so much for the warm welcome. I'm sorry it's taken me so long to reply. I come here with every intention of answering posts and I just get caught up reading. I will make sure to get copies of Ugga's labs as we're going along, I think it's time to start a new file. I'm calling the vet this afternoon to discuss treatment (she has a phone consult with the dermatolopathologist who diagnosed Ugga). I will definitely talk to her about the possibility of weaning Ugga off the Phenobarbital (he takes Potassium Bromide also). It seems like we almost have to. I am very nervous about losing control of his Epilepsy while treating for Cushings. He has cluster seizures and his episodes go on for days. He's been seizure-free for 3 1/2 years!! I really, really, really hope we can find a "cocktail" that works for both. This is all pretty scary for us. Well, not so much for Ugga. He has no idea he's sick and is acting completely normal . I'm sure he's wondering what the deal is with all the salty water on mommy's cheeks =). As far as the calcinosis cutis and the meds, I have been reading that the Lysodren seems to be more effective but there was one case (out of the few that I could even find) where the dog was on Trilostane and it was effective. I think it took awhile (4 months) but that seems to be the case regardless. We'll have to see what the specialist says and go from there. I will definitely print out the information I've gotten here and have my vet take a look when we go in for suture removal. I'll tell her about Dr Bruyette as well. I do trust her implicitly and if something is over her head, she'll be the first to call for backup. Thank you for the support, we really appreciate it. I'll check in when we know what our next step is. Hugs to you and your furbabies =).

Hi Jackie and Ugga,

Welcome!!!:) I see the experts have started asking questions and giving advice--they are the BEST!!! You are in good hands so ask as many questions as you like. If they do not have an answer they will research to find one for you.

Take care!!! :)

Just a quick update:: Ugga had his first dose of Vetoryl with dinner tonight. I was so preoccupied asking questions about the meds I forgot to ask for his labs when he was having his sutures removed this afternoon. We'll be going back for his ACTH stim test in a couple weeks so I'll get them then. We are starting with the Vetoryl because my vet feels it's the safest option for Ugga even with the calcinosis cutis. He is going to be taking 30mg once a day to start and we are slowly weaning him off the Phenobarbital (1 1/2 pills a day instead of 2 for a month then half and half, etc). He's been on the lower dose for 3 days now and so far so good (knocking on wood). I'm nervous about all of this but Ugga's a pretty tough little dude and I think he's going to do ok.

I posted some pics of Ugga and his calcinosis cutis on my profile page for anyone who wants to see what it looks like.

Oh, Ugga is such a beautiful boy and so are the rest of your furbabies.

Wishing you the best of luck with your treatment plan and hoping sweet Ugga is feeling better soon.

Love and hugs,
Lori

Hi Jackie and a belated welcome to you and Ugga! :)

What a unique name! I saw the pics and wanted to say what sweet looking babies you have Ugga is a doll!

Hang in there, sweetie!
Hugs,
Leslie and the gang

Jackie, good luck to you and Ugga!!!!!!! I'll be crossing all my fingers for you that the phenobarb weaning goes well. Will he be transferred totally to potassium bromide during this process? I definitely understand your concern about this. My non-Cushpup Lab started having seizures a year ago, but luckily has been seizure-free since starting on phenobarb. I would hate it if I had to change her medication at this point!

You may have already told us, but how much does Ugga weigh?

Continued best wishes to you and your sweet boy,
Marianne

Ugga thanks you all for the compliments =). Marianne, I'm sorry to hear you have an epi girl. I'm glad she's doing well on the Pheno! Ugga will be switched to Potassium Bromide exclusively provided we don't hit any roadblocks. We aren't loving that we have to mess with his meds but we think it's for the best. He's a pretty big frenchie and weighs about 31lbs.

Hi everyone. So it's been a week since Ugga has been on the Vetoryl and I am happy to report I'm already seeing a difference. He's not drinking as much and is sleeping through the night (yay)! His skin is not improving but we didn't expect to see any changes there for awhile. I'm a groomer but I'm very hesitant to wash him. Before he was diagnosed with Cushings, I thought he was having an allergic reaction to a food change. I washed him with a medicated shampoo (natural, lavender base) and it made the rash really angry. Poor Ugga was glowing bright red and he just kept rolling around. I felt so bad. That was the only time the calcinosis cutis seemed to bother him. I think he seems a little itchier now that he's on the meds. I do have an unscented oatmeal shampoo that should be ok but I'm so afraid it will make it worse. Has anyone had experience treating calcinosis cutis topically? Should I just leave it alone and let the meds do their thing?

Hi Jackie

I just have a moment to post but can comment on management of the calcinosis cutis. We tried medicated shampoos and they just made Sabre's skin more imflamed and reddened. We then tried oatmeal shampoos every three days for a while ... which seemed to work for him. The biggest thing is to let the meds work but in the interim (until this happens) to minimise any risk of infections. So we tried to keep all the spots as dry as possible using epiotic to scuff off any moistened areas (trying to avoid making it bleed) or the other thing we tried at one stage was betadine to try and dry areas out. We used t-shirts and jackets to stop him from trying to get at the reachable areas. If areas looked at starting to get infected we jumped on the antibiotics as fast as possible. It will take a while and it may get worse before it gets better, but eventually with Sabre it got to the stage where we never had to worry about it anymore ... even though he still had large plates of calcinosis cutis on his body.

Trust this helps
Angela and Flynn

Thank you for the info, Angela. We had a rough night last night. He was scratching, rolling, biting, panting like crazy...just a mess. He keeps stretching and scrunching, I can tell he's terribly uncomfortable :(. I got in touch with the vet and she said an oatmeal bath in semi-cool water would be ok. We're also going to give him Benedryl and put some topical cream on it. Nothing is open and bleeding so that's a good thing. He's been on Cephalexin for almost 3 weeks and has another week to go. We may have to keep that going if we see anything that looks like infection. As far as shirts and jackets go, they seem to make it worse. He goes nuts. I feel so bad for this boy. I even called off work today to keep an eye on him. My boss was less than thrilled but oh well.

Oh dear poor Ugga! You will probably find that with the sudden drop of his cortisol levels, with the vetoryl treatment, will be the reason for any increase in itchiness for Ugga. Thinking about things more (it was four years ago that we were dealing with this) I do recall sometimes we used an antihistamine when he became itchy. It is hit and miss with antihistamines and dogs but sometimes it works.

All the best ... Angela and Flynn

I know next to zip about calcinosis cutis so I have just been reading along but a thought kept occurring to me so I did some checking.

Talk to your vet about trying some Chamomile, either as a tea or essential oil. I can be used internally and externally, and has been shown to be effective for several skin problems including wound care, pruritis and allergic inflammations. Whether it could help Ugga or not, I can't say but I have used in on my itty bitty girl for itching and it did help. I made a tea with it, bathed her as usual, then rinsed her in the tea and left it to dry. She stopped scratching - but she didn't have a problem like calcinosis cutis, pruritis, etc. either. But it may still be worth a consideration so talk to your vet and see what they think.

Hugs,
Leslie and the gang

Well the Benadryl is helping a little. He's no longer rolling around like a maniac so that's good. However, he's still acting strange. He's trembling in his sleep and he's stretching A LOT. He's going back to the vet first thing tomorrow am. Hopefully we can figure out what's going on. Oh and the oatmeal bath... terrible idea. It irritated him something awful and he's bright red again. I really thought that would help him. Poor Ugga bugga :( I'm definitely going to ask about the Chamomile tomorrow. There has to be something out there that will help soothe my little man's skin. Hugs,

~Jackie and Ugga

Ok, back in business :). Gave 25mg of Benadryl at 11:30pm and everyone slept through the night, yay. We took Ugga to the vet this morning, got a new med for pain (Gabapentin 100mg BID) which also has some anti-seizure properties (bonus) and a topical spray (Humilac) to relieve the itching and soften his skin a little. Believe it or not, the calcinosis cutis seems to be healing (yay) which in turn, is causing the discomfort (:(). He is resting comfortably now :)

A nite's sleep! YAY!! :) Always good for the spirit!

I'm so glad to hear that his current discomfort is a result of healing. I hope this trend continues and he is feeling more and more like his old self in no time!

Hugs,
Leslie and the gang

Thanks Leslie, me too!

Hi :). I just wanted to give a quick update on Ugga. He's been on the Trilostane a little over a month now (30mg once a day) and is doing pretty well. ACTH stim went well I guess, we're keeping everything the same dosage wise. He's still drinking/peeing a normal amount and he's back to his old self again :D We've weaned him down to half his regular dose of the Phenobarbital and still no seizures which is AWESOME!! The calcinosis cutis is still an issue. It's not really bothering him which is good and the originally affected areas are healing. He's not hard to the touch anymore and it seems like the calcium deposits have broken up. They're still there but they've changed and we (hubby, vet, and I) think these are good changes. His hair is even growing back in a little. It's a different texture and it looks pretty patchy, but it's growing in nonetheless. I want to get some updated pics on his profile but my new iphone is too advanced for my mac right now. I'll have to update my software and that's not exactly high on my list of priorities. I may be able to download them (pics) from facebook or something, I'll have to tinker around with it. Sorry, getting off topic a little. Anyway, just wanted to pop in. Hope all is well with all the cushpups (and their parents) out there. Hugs, Jackie and Ugga

Yay, great update, Jackie. Thanks for taking the time to let us know that Ugga is doing so well. Please give Ugga a big hug from his Auntie Glynda. :D

Jackie

Great update on Ugga! Yes the calcinosis cutis takes time to sort itself out. Good to hear that it has broken up ... this didn't happen in Sabre's case but he just lived with it. Yes .... the hair does seem to grow back irregularly and in Sabre's case rather more coarse and longer - we no longer had the short haired Vizsla but more of a labrador coat!

Angela and Flynn

Hello All!
I am new to this forum and since I am at work can only ask a quick question here. I will introduce myself and go into greater detail regarding my dog's medical issues later when I get home.
Willow is being treated for Cushing's. We believe it to be pituitary based. Willow has had the ACTH tests and an ultrasound.
She is being treated unsuccessfully with Lysodren. She also takes phenobarbital for seizures. You mentioned that you are weaning your dog off of phenobarbital. What is your dog taking in it's place?
I intend to call my vet on Monday (because I'm sure the continued use of Lysodern is a waste of time, money and effort). I have mentioned to him numerous times that I have read that Lysodren and phenobarbital do not work well together. I want to ask him on Monday if we could try a different medication. I am interested in finding out what meds you are using.
I am really going to assert myself regarding the phenobarbital issue because I'm sure this is the root of the problem of her not showing any signs of improvement.
Thanks to all for any help you can give me.

Hi Ginger :). I'm sorry I didn't reply sooner, I don't visit as often as I used to. Ugga takes Potassium Bromide in addition to the Phenobarbital for his epilepsy. We weaned him to half of his original pheno dose but we're VERY hesitant to wean him off completely. His epilepsy was rather severe and it's been under control for 3 1/2 years...we just don't want to risk losing that control. We are treating his Cushings with Vetoryl and it is working amazingly well. He also takes Gabapentin but I think we'll be stopping that soon. That one was for the pain associated with the calcinosis cutis. It also has anti-seizure properties so we're not really in a hurry to stop it but his skin is almost completely cleared up now and we don't want him taking something unnecessarily. He goes back to the vet for another stim test/checkup in 2 weeks. How are you making out with Willow now?

Sorry off original question from "Ginger" ... but it is fantastic to hear that Ugga's calcinosis cutis has completely cleared up.

Angela and Flynn

I am thrilled, too, to read about how well Ugga is doing!! Congratulations to you both!!!!!! :) :) :) :)

And just to make sure that Ginger has the chance to read what you've written, I'm going to make a copy of your reply and add it to Willow's thread, as well.

Please do stop back again whenever you can It is so encouraging for us to hear such good news. ;)

Marianne

Hi :) I wanted to pop in with an update on Ugga. He was doing so well last time i was here (about 4 months ago). He's doing ok but he is drinking a lot again and he's starting to lose more hair. Poor guy is going to need a sweater this winter. He has been taking 30mg Vetoryl once a day and we are going to be adding another 10mg. He'll be taking the 30mg pill in the am and the 10mg pill at night. I'm pretty bummed that we are already needing to increase his meds-just a reminder that this isn't a cure and that makes me sad. On the plus side, his skin is not hardening this time so we're thinking he's just losing hair and it's not the calcinosis cutis rearing its ugly head. Hope all is well with everyone and their cushpups out there. *hugs*

~Jackie

Hi Jackie,

Good to hear from you again but wish Ugga was doing better. Really glad to hear that the CC isn't flaring up again, tho! :) I know that is a huge relief. Has he had any seizures?

Let us know how increase works for him. I am assuming he had an ACTH that shows his cortisol is elevated again? Just a reminder that he will need another one soon after the increase, in 10-14 days if I remember correctly, to make sure the increase is working. I hope splitting the dose helps him a great deal; it sometimes works wonders to do that. ;)

Hugs,
Leslie and the gang

Hello Jackie and Ugga:
I have a Jack Russell that was recently diagnosed, and was fortunate enough like you were to find this forum. Stay strong, and the people here will help you thru this awful disease. I am glad you have a good Vet and you are confident in her ability as that means a lot. I will pray for you and Ugga.

Hi Jackie, sorry to hear little Ugga is not doing as well and losing his hair. Your guy is like my little bostons, not much hair to start with. Kona was diagnosed with cushings this summer and to start last Feb she had her belly shaved for an ultrasound and the hair still has not grown back due to the cushings so I am in the same thought as you, she will definately need a sweater this winter, poor girl. :(
Im interested in your dosing too of higher dose in the am and lower in the pm because I am about do the same with Kona and have been wondering what effect it will have on her, she is currently on 10mg 2 xday and am going to change the am to 15 and leave the pm dose at 10.
Hugs, kona and deb

Hi Jackie,

Thanks for the update on Ugga ... albeit not the one we wanted. Hopefully the increase in vetoryl will do the trick.

Angela and Flynn

Hi Jackie,

Just so we'll know, can you give us Ugga's recent ACTH test result prior to this dosage increase? That will help us to monitor his progress alongside you.

Thanks so much!
Marianne

Hi guys :) Thank you so much for your concern and good thoughts, we really appreciate it! Unfortunately, we just can't afford 2 ACTH stim tests back-to-back right now so I don't have any numbers to share. We've had some setbacks with our other furkids-our 12 yr old kitty had 2 malignant growths removed (and 7 teeth pulled) and our newfie broke a toe right before we left for vacation. Between surgeries, xrays, boarding at the vet, and Ugga's meds (+ Pb/KBr level checks) our wallets have been left a little light. So for now, we are basing Ugga's Vetoryl increase on his symptoms and we will do the ACTH 2 weeks after the new dosage. I know this isn't ideal but we are doing the best we can for him. Other than the pu/pd and hair loss, he's doing really well...still no seizures! I'll be back with another update to let you know how things are going with the twice a day dosage. We're starting the increase when I get his refill in a week. Hugs to all of you and your cush pups (and non-cush pups :)).

~Jackie and Ugga

Oh my gosh, you guys have been through the ringer with your furbabies recently. Just keep a really good eye on Ugga, just like when you started to make sure that he is reacting alright to it.
Poor newfie with a broken toe. :( (my neighbor has a newfie put about 3 months old now, he is HUGE, but such a loving boy) I hope your kitty is going to be okay too. This must be a very stressful couple months for you and your family.

hugs,
Sharlene and molly muffin