My dog has had Cushings for over a year...high dosage...would love information!

Thank you Marianne!

In terms of symptom control his skin looks the best it's been in a long time and even some fur is growing back which is nice. He still drinks and pees a lot but not uncontrollably. My main issues with him now would be that his bones sometimes give a crack when he gets up after laying down for a while but he is still able to jump on the bed and do all of those things. Continuing with 1 Dasuquin soft chew each day. Also, he does have some fatty deposits/lumps showing up but the vet said they are fine??

Also they just got back to me on the tests...Jet's numbers continue to look good so no changes to his meds.

PRE - 2.7
POST - 5.7 (LOW) - but she didnt seem to think this was a problem, so no meds change

Urine -
Protein - 42.1
Creatinine - 35.3
Ratio - 1.2 (High)

URINE P:C RATIO INTERPRETATION ---------------------The urine P:C ratio must be evaluated in conjunction with urine sediment findings as gross hematuria or inflammation can cause elevated ratios.
Urine P:C ratios >/= 0.5 in dogs & cats indicate overt
proteinuria and are evidence of persistent renal proteinuria when found repeatedly (3 or more samples obtained 2 or more weeks apart) and are unable to be attributed to a pre-renal or post-renal cause. The urine microalbumin test is a more sensitive test and will be positive before overt proteinuria is detected.
In dogs, persistent renal proteinuria with urine P:C ratios >/= 2.0 is usually due to glomerular disease.

Let me know your thoughts, if any :)

Best,
Jennifer

Hi Jennifer! Yep, those ACTH results look good so I wouldn’t be changing the medication, either ;-). Good job.

As far as the fatty lumps, or “lipomas,” all my Labs have developed them as they aged. They truly are generally nothing to worry about. We had to have a large one removed from our Cushdog, Barkis, because it was right behind one of his front legs and was interfering with his gait. But both of our girls have had large fatty lumps, too, that we just left alone. My Luna now has a big one on her flank that hubby affectionately refers to as her “hockey puck” — it’s that big now! But it doesn’t bother her at all, so we just leave it alone.

As for the urine results, this test did indicate some protein loss. Protein ought not to be showing up in the urine under normal conditions. However, “proteinuria” can be caused by several different issues, including primary kidney problems. As it turns out, though, Cushing’s is a disease that can secondarily cause protein to leak from the kidneys into the urine. If the level of protein is high and continues for a lengthy time, some degree of kidney damage can result. For this reason, it’s good that your vet is keeping an eye on this. If Jet continues to exhibit proteinuria in subsequent tests, then your vet may very well add some more oral medication to his regimen. If she’s said nothing about this yet, I’m guessing it’s because she wants to wait and see whether or not the protein loss persists or worsens.

So overall, I think this is a good report, though. Continuing best wishes to you and Jet, and please continue to update us as time goes on.

Marianne

Thank you so much, Marianne, your reply is so appreciated. I am so thankful I am here. I will definitely keep everyone updated!

Has Jet's blood pressure been checked lately? Elevated blood pressure can weaken the blood vessels in the kidneys. This decreases their ability to reabsorb to protein, which flows into the urine.

Lori

Quote:

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Originally Posted by Harley PoMMom

Has Jet's blood pressure been checked lately? Elevated blood pressure can weaken the blood vessels in the kidneys. This decreases their ability to reabsorb to protein, which flows into the urine.

Lori

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Hi Lori! You know what, I am not sure actually...when is that normally checked? Is it normally done during a Stim test? I can call to ask...

If it wasn't, I guess I will need to make sure it is at his next exam?

Thanks for the tip.
Jennifer

For optimal results, blood pressure checks are done when no other tests are going to be performed, one wants their dog to be as calm as possible. When I had my Harley's BP checked, the tech would put us in a room and no one would come in for 10 minutes, I would try to calm him down as much as possible, he didn't like going to the vets, can't say I blame him. They would take at least 3 readings and average them, we found that one of his paws was more favorable to him than the others so they always took the readings from that particular paw.

Hugs, Lori

Good to know. That seems almost impossible since Jet gets so freaked out every time he has to go. I will inquire with my vet though. Thanks for the tip!

Hi all,
Jet will be going for his next stim test next week. It will be a little bit of a different type of visit because they want me to drop him off for the day. I believe the specialist is not doing regular appointments that day but they are making a exception for him?

Anyway...I really need them to do this urinalyses. Jet seems to be whining a bit at night to go out, and sometimes he just pees and pees even after not having much water. The last 2 times he would not let them do it. I am wondering if i will need to sedate him to get this test done. I am worried something else may be going on!

I also will check in again regarding his BP because that's another good tip.

Wondering if there is anything else I should be checking. I will report back with results.

Thanks!
Jennifer

Hi All,
Jet had his stem check up last week. The results came back great at Pre 2.3 and Post 2.8. The vet is going to check him in 3 months and thinks we're getting close to lowering his dose, which would be great.

I brought in some urine samples that I had kept in the fridge (eww) and this is what she said on the results on email:

His urine showed no protein!!! So we can put that to rest for now. ​It does show he is drinking in excess despite very good control of his Cushing's disease. In his case it could be anxiety driven OR it could still be related to the Cushing's disease as there is a small number of cases that despite adequate control remain apt to drinking and urinating in excess. There is something we can try for this (DDAVP injections) if you think this is still an issue affecting your and his quality of life. If so we can discuss if further when I return to the office.

Is anyone familiar with the DDAVP injections and do you recommend it?

Jet urinates a lot when he does go out, no matter the timing. He doesn't really beg to go out unless its in the evenings (like right now), and I always think he has a UTI but I guess not! It's just strange.

Thanks for all of your help.

Oh and I forgot to have his blood pressure checked, ugh! Unless they did that with the exam...sort of wish they did because the visit was $660 :( :( :(

Hi again, Jennifer! Thanks so much for giving us this update. I apologize for the delay in replying to you, but this has turned out to be a busy day of chores for me. I do want to add a couple of thoughts, but I'm afraid they'll have to wait until tomorrow. So thanks for your patience, and I'll be back again a bit later on.

Marianne

Hi Jennifer. I am sure Marianne will have some input for you when she has time to check in but I wanted to address your question about the DDAVP injection based on my own experience. DDAVP is a synthetic form of the anti-diuretic hormone (ADH) which regulates the amount of water in the body and increases sodium and water absorbed by the kidneys. It is rare that a dog being treated with Vetoryl does not see a complete resolution of excessive drinking and peeing but a small number of dogs will still have an ADH deficiency. If this were to be your dog's problem, DDAVP would likely be effective. My second cushingoid dog was a shelter rescue so I knew nothing about his history. Unfortunately, his excessive drinking and peeing never resolved with trilostane or mitotane treatment despite excellent control of cortisol His urine specific gravity (USG) never improved and stayed at a pretty consistent 1.008 which is quite low. If your vet is suggesting DDAVP, I have to assume your pup's USG is also below 1.015. Unfortunately my dog did not respond to either the DDAVP eye drops or pills so he was ultimately diagnosed with nephrogenic diabetes insipidus. To correctly diagnose diabetes insipidus through testing, a water deprivation test is done but I did not want to subject my dog to that so we did a trial with DDAVP. That is what most vets recommend so there is no reason why you can't give it a try. If there is an ADH deficiency, a dog usually responds quite quickly. I hope this helps.

Glynda

Welp, I finally made it back again — sorry for the delay! I’m really glad Glynda stopped by in the meantime, and especially because she’s had first-hand experience with this treatment. Coincidentally, you’ll see that another of our new members has already been using DDAVP injections with her dog, so you may want to check out her thread:

https://www.k9cushings.com/forum/sho...tes-insipidus)

Given Glynda’s thorough response, I really only have a bit of context to add. I’ll give you a link below that explains Diabetes Insipidus in greater detail. As Glynda has mentioned, there are two forms. Her dog suffered from the “Nephrogenic” form, but the one that we see most often among Cushpups is the “Central” form since it arises from a tumor in the pituitary gland, just as does Cushing’s itself. DI is an uncommon ailment among dogs in general, but we have seen our share of the Central form here due to the pituitary tumor linkage. DDAVP can and has been helpful in a number of these cases. So as Glynda says, I see no reason not to give it a trial run if your vet thinks it’s a good idea. Here’s the explanatory link, and definitely do let us know what happens if you decide to give it a try.

https://vcahospitals.com/know-your-p...ipidus-in-dogs

Marianne

Thanks to you both. Not sure why I didn't get a notification there were replies- I will look into that.

This is so helpful and I am going to talk to my vet about it. Sounds like it could be something that could work!

Glynda, sorry it didnt work for your dog. Did they start with the drops or injections?

Hi everyone and Happy New Year!
A little update on Jet - reached his 11th birthday on Christmas :)

He is pretty stable and still taking the 60mg AM and 30mg PM dose of Vetoryl. He is currently on no other medications. He always had gas problems (ugh) but the Nutro food I had him on was making it even worse....so, we switched him to Purina Pro Plan EN fiber balance and seems to be working well. He also takes 1 of the Purina probiotic packets a day to help with the GI issues.

In regards to Cushings, he is still drinking and peeing a lot, but nothing too uncontrollable. I have him on a routine. He went on Friday for his latest STIM test and I am waiting on the results. When I saw the vet we talked again about the DDAVP injections and I just don't have the ability to do that. I live alone and the thought of giving Jet injections once or twice a day seems miserable and too much for me to handle.

My bigger concern as he gets older now is the hing leg weakness and possible arthritis. I continue to give him 1 Dasuquin supplement per day. Don't see a ton of change but I am not too sure? Sometimes when he gets up his bones creak like an old man. It's so strange. I just hope over the next year or 2 it doesn't get worse but I am sure it will...

I will report back with his STIM results after I get them.

Regards,
Jennifer

Thanks for the great update, Jennifer! It's always good to hear a pup is doing well! My Bud is a larger dog, for me anyway at 50 lbs, and he is starting to show some signs of arthritis. I worry about being able to handle him physically if he gets bad....I don't know that I can lift him and I too live alone so I hope neighbors will be around if that time ever comes. I've got him and my Pug on Glycoflex III and it does help but I'm looking at other things to add as time passes.

Do let us know the test results when they come in. Based on the signs that are still present he may need a little increase. But the numbers will let us know.

Hugs,
Leslie

Hi lovely friends! I hope everyone is well. I visit from time to time - you all are so helpful and amazing.

An update on Jet (not a great one but could be worse....):

Jet had been doing pretty solid on Vetoryl for the last year. Taking 60 mg in the am and a rotation of 30 and 60 in the pm. He had 3-4 ACTH tests in a row that came back perfectly in range. Was doing tests every 4 months.

Always eating and drinking like crazy - I could barely get his bowl on the floor and he would be barking and barking for his food! Peeing a lot. Normal bowels.

I went on vacation in July and returned on August 7th. Since I have been back he has slowly lost interest in food and water. He gets a combination of Hills Rx wet food (which he will mostly eat) and rx kibble (which he does not). He also has started having arthritis so he is on 1 dose of Rimadyl as well. That is working well for his arthritis. For a dog who went from being so ravenous to this - it's just simply odd!! He sleeps a ton now too and doesn't want to get up in the mornings - in the past he would cry for me to get up!

I spoke with his vet last night and she unfortunately thinks he may be suffering from a macrodenoma. Thank God you all have a wonderful thread in this forum that I have read through and understand what other pups have gone through!

Jet is almost 12....so I wouldnt do anything too extensive...but, I do think it's a good idea I get an MRI for him to see the size of his tumor and if in fact it is a macrodenoma. If so, I can figure out a treatment plan from there.

I believe the options are radiation, surgery or trying doses of prednisone with the Vetoryl to see if it would at least help and have him start eating normally again.

If anyone has any advice happy to take it! I would also like to know from others once they started seeing symptoms like these how long before it got even worse...just so I understand approximate timing. Thank you all!!

Jennifer

Hi Jennifer and Jet! We’re always glad to see you, but definitely wish your news was a bit different this time around :-(. It sounds like you’ve made a good start reading through the Macroadenoma thread, though. And I’ll plan to stop back by tomorrow to add a couple more thoughts. In the meantime, though, I wanted to greet you two once again. And as I say, I’ll be back.

Marianne

OK it's me back again. I wish I had some great words of wisdom to add, but if you've read the Macroadenoma thread, you already know the story of my own journey with my boy. If you're able to have the imaging done, I do think that may give you a greater sense of peace regarding the path forward for Jet. Since I didn't do that myself, I'll always have some question marks hanging over my head. And if the macrotumor is confirmed, perhaps the size and growth pattern will offer some clues as to timing and optimal treatment approach.

I've always thought that it's such a cruel twist of fate when this sledgehammer of a diagnosis hits after we've finally gotten the Cushing's symptoms themselves under control. It's like winning the battle but losing the war. But it is what it is. And I'm afraid that there's no set time frame that I can offer out to you. As you probably noted on that thread, there are some similarities to most all of our stories, but also individual patterns.

I do want you to know how sorry I am that you may be dealing with this, though. And I encourage you to return and update us with any additional news. Sadly, we don't have many registered members posting here any more. But I suspect there are still a number of folks who read what's written. So whenever we can add any new info or thoughts regarding current treatment approaches, I believe it's always a help to other parents as well.

Best wishes to both you and your sweet boy. And truly, also the best luck possible to you in the coming days.
Marianne

Thank you, Marianne. I am sad :( :(

I surely understand. I’m so sad for you, too. I’m sending healing thoughts to you all. I so wish I could do more!

Hi Jennifer and sweet Jet,
I do not have any experience with Macroadenomas but I wanted you to know I am truly thinking of you both. Please keep us posted.
Terry