Miss Millie Mayhem (Eng Bulldog) - NEW Dx: Cushings PDH and AWFUL Calcinosis Cutis

Hi all! And thanks for your encouragement and guidance - I just hate that my girl is going through all of this!

Update – Called Dechra,

So I called Dechra and spent about 30 minutes on the phone with one of their “techs“ (she even reached out to one of their on-staff Doctors to confirm a question I had about her Chloride level that she wanted to make sure she got additional input on!). She started a case for Miss Millie and now has all of her medications, notes on test performed, dermatology specialist contact info, general vet contact info, and notes on our discussion. So here are some of the key points I learned in my most non-technical understanding

1 – as it relates to her taking phenobarbital, she doesn’t feel that there will be much impact, however, for Cushing dogs that did show more of the elevated cortisol levels, sometimes reducing those levels can cause seizures to come back (cortisol can sometimes help suppress seizures with the phenobarb). Because Millie was not significantly high to begin with, the drop will probably not impact her tendency for small seizures.

2 – As it relates to checking electrolytes, I learned the following…when treating dog, one thing that they look at it through electrolyte testing that causes a warning flag to be raised is if Sodium decreases and Potassium increases (if Chloride tested, if that decreases is looked at). This can be compared to previous electrolyte test and the ratio of sodium/potassium (Na/K) can also be compared. If ratio goes down (meaning sodium is going down and potassium is going up), that is something to keep an eye on and can (I believe) be a warning that dog is trending toward an Addisonian state (which is life threatening)

3 – Millie’s ACTH baseline 11 days after Trilostane treatment was 0.8 and post ACTH was 5.0 (this baseline is considered low for a dog being treated – they do not like to see lower than 1.45 for pre or post ACTH), however, given Millie’s other testing, she was not overly surprised by this as her first ACTH test she really presented within normal ranges and hence the test was ruled inconclusive. She did say 0.8 would be in the normal range for a “normal” dog not being treated for Cushings. She said unfortunately, Millie is not a textbook Cushings Dog when it comes to the testing results, but all of her clinical signs and some testing signs certainly indicate Cushings.

I will be contacting my vet tomorrow as she did say that it is highly recommended given the results that Millie return for another ACTH test in 2 weeks and that she be monitored well in those two weeks. Any adjustments to dosing could take place then...as for now - no change (especially because I have the good fortune to really monitor her since I work from a home office - the Dechra Rep did state that she would be more concerned with someone who did not have the ability to be so vigilant). She also said she would be calling me to follow-up soon thereafter (was amazed to hear that and very appreciative). Just another voice that can help me be more educated managing this awful disease.

I know many of you were interested in how the call went, so I tried to learn as much as I could while I had her on the phone!

Thanks for all the encouragement as this is SOOOO frustrating as I just want a magic pill...make that 2...one for Millie and one for me. I honestly think I have gained 10 lbs in the past 3 weeks cause I can't stop popping M&M's in my mouth as a stress reliever! I fear stepping on the scale!

xoxox,
Kerry (Millie's Mama)

It sounds like you had a good call with Dechra. It is great that they will be calling you back to check on her. I agree if you weren't working from home it would be more risky than since you are and are able to keep an eye on her.

Sounds like you found a pill for you (m&m) just not the right one maybe. LOL Stay away from the scale!!

Just watch her and if anything looks off, back for an ACTH and elctrolyte test. :)

You're doing great!
hugs,
Sharlene and Molly muffin

I am so glad you called. :):):)

It sounds like a good conversation. Great job , Mom:):)

Thanks Addy and Sharlene,

FYI, I have finally gotten up the courage to post my girls journey thus far with Calcinosis Cutis. It is AWFUL, but I figure if anyone else is out there needing to see pics, this may help (please let others know if you come across anyone struggling with this). I know I always wanted pics to look at to see if there were any similarities.


http://www.k9cushings.com/forum/album.php?albumid=704

xoxox,
Kerry

I know it was hard for you to post the pictures but it may help someone else, you are so right. Zoe's hair loss was down her back through the spine area as well, almost the exact spots. Her cc did not progress to what Miss Millie's did. She just has the hyper pigmentation and small hard pimples looking bumps and on top of that she got brownish oily spots with scales and it looked like crusty spots, hard to explain. Zoe had two surgeries as well so was shaved in two different spots, that did not help her either. Then the back feet and legs got bad after the last surgery,they had also shaved her thighs, her butt, etc.

The pictures I posted last year of her hair loss are nothing compared to how she looked in March and April after her surgery.

Miss Millie's came on so fast, from one spot. In the last photo, her skin is not as red and angry looking.

I know how hard it is. You have a beloved pup with a beautiful coat and all of a sudden they look so painful and we just want to make them better as fast as we can.

Keep the faith, sweetie. It is what we all must do:):)

Thanks addy! It is hard to keep the tears back and was hard for me to post those pictures. I appreciate the words of encouragement... Definitely helps!

Xoxox,
Kerry

A belated welcome from me and Alivia. A lot of our dogs here have had difficult skin problems. Alivia's were much more worrisome to me than her Cushing's symptoms. Her backend looked awful for awhile and broke my heart just looking at it. I totally understand what you mean when you say you wish she could tell you what helped her and what caused more discomfort. It was very brave of you to post Millie's pictures. We all learn from each other. I so hope you are able to find what works for Millie and that your beautiful girl recovers quickly. You obviously are doing everything in your power to help her. She is lucky to have you.

Hang in there.

Kerry, you were so brave posting those photos. :o You love Millie so much that you were willing to do anything to help her. We totally understand and are right there with you. It is okay to cry, to meltdown, or start to crumble. It is perfectly understandable. This forum has picked me up and dusted me off a few dozen times after I have hit bottom. We are here for Kerry. Even if you don't feel like talking. Post a message that you're there, and we'll send you tons of love. Xxxxxx

Hi Kerry,

I am so sorry Miss Millie is having skin issues :( and I hope that it will soon improve, this Cushing's is a dratted disease.:mad:

It is so very hard to see them not feeling well, and we so do understand how you feel...we are here for you both.

Thanks so much for posting the conversation you had with Dechra, I am always so interested in what they have to say and what they recommend, so Thanks again.

Love and hugs, Lori

Amazing that it progressed that fast in 5 weeks. I do agree with Addy that it doesn't look as red in the last or first photo of 5 weeks. I don't know if that is the angle or what though. What do you think? to me it doesn't.
What did it first start out as? that first bump? small white, or a sore type of spot?
It really can take awhile for the cc to resolve. The idea, seems to be that the cortisol levels need to be low enough that she isn't having any kind of build up in her system, allowing calcium deposits to go away.
It is a bugger, but I do think you are on the right track here. Just a matter of keeping an eye on her so she doesn't go too low. You didn't start out with any high numbers, so that is real important. Give it time! patience grasshopper! LOL
Posting the pictures is a very good thing though. Thank you!

hugs,
Sharlene and molly muffin