Alivia was recently diagnosed with Cushing's - Alivia has passed

Kim, thanks so much for taking the time to read all about Alivia. In answer to your questions:

1. Years ago when Alivia had IMHA and was on megadoses of Prednisone she drank and peed like a fiend - just as you describe. So, I do know what that is like. I would leave at least 8 puppy pads out for her when I went to work and come home to ALL of them being used multiple times. Now Alivia drinks a lot more than my other JRT but no where near what she did then. She (usually) gets up once during the night to use a pee pad. Most days when I am at work, although I leave one out for her, she does not need to use it. Initially, I attributed the night time pee to the fact that she is 13 years old.

2. I'd say her appetite has increased for Alivia, but not to the extent where she would get into the garbage or anything like that. She would eat her canned food faster than her normal. But, I always leave dry kibble out and she never finishes that, so obviously she doesn't think she is starving! Normal appetite - 60%, Increased - 30%, Decreased 10%

3. Her fur is extremely slow to grow back, but not thinned all over. Her belly was shaved for an ultrasound in March and is still bare. This happened before - her fur did not grow for a long time after having her groomed shorter for the summer last year. Then it suddenly started to grow and was just about back to normal. Now this. So, this too, seems to fluctuate.

4. She had an ACTH done with a full UTK panel in April. Everything was elevated before and after, except for Estradiol, which was always in the normal range. Cortisol was baseline 115.8 (2.1-58.8) and post ACTH was 249.0 (65.0-174.6); Androstenedione 3.90 (0.05-0.57) and post 7.85 (0.27-3.97); Estradiol 68.8 (30.8-69.9) and post 65.4 (27.9-69.2); Progesterone 1.09 (0.03-0.49) and post 2.55 (0.10-1.50); 17 OH Progesterone 0.91 (0.08-0.77) and post 3.25 (0.40-1.62); Aldosterone 222.1 (11-139.9) and post 414.5 (72.9-398.5). Her regular vet wants to do an ACTH now so she will probably have it done in the next week or so.

5. The only time I knew of her being feverish was during her pancreatitis. She stopped eating entirely (on her own) when that began. Her belly, since it is shaved, sometimes seems more pink to me than other times.

6. Yes, at times! When she loses her appetitie, I can HEAR it gurgling from 6 feet away.

The only time she has had scary panting breathing, as you describe, was during her acute pancreatitis and that was obviously from severe pain. Her symptoms have never been consistent. That was my biggest concern about putting her on Lysodren - I have no idea how or if I could know when she was loaded.

Alivia really is my miracle dog. When she had IMHA and I was taking her to Ohio State, they said she did things they could not explain and that they had actually thought were impossible. All of Ali's vets will say she does not have typical reactions/symptoms to anything. Even her pancreatitis results were not completely "typical".

Any thoughts? Anyone?

Hi Mary Beth,I can only go back to what Dr. Allen at Dechra told me when I voiced concern about starting treatment for Zoe. "Cushings progresses slowly. The symptoms Zoe has will worsen and she will develop new ones."

Zoe never panted unless her colitis was bothering her, Zoe never drank buckets, she never asked to go out in the middle of the night. Her main symtpoms were hair/skin issues, the colitis (which always tested normal everything so IMS thought could be repeat bacterial infections and stress from Cushings) hind leg weakness and huge appetite. Even the appetite was not as bad as some.

I waited a year to treat her, trying to improve the colitis and watching for stronger symptoms.

Alivia has been through a lot. Could it be her pancreatitis was starting to act up when you tested her and skewed the tests? What are all her health issues then and now other than Cushings?

Can you afford more tests, other opinions? Can you afford another ultra sound? What will it take to convince you she needs to be treated so you are comfortable with your decision?

These are questions I asked myself and you may need to ask yourself.


Sometimes there is not a clear cut answer when you have other health problems going on with the pup. If we all had a pup drinking buckets of water and peeing all night it would be an easier decision:):)

Hugs,
Addy

Addy, I wish I had answers to your questions. The problem is nothing has given us a straightforward diagnosis. And, Alivia has other symptoms/problems that are defintitrely not cushing's. She is not well again. She had no appetite last night and was in obvious discomfort - panting and trembling. I gave her Dramadol and it seemed to help some, for awhile. She had diarhea during the night and again this morning and was still in pain. It seems like it may be the beginning of another bout of pancreatitis. She has an appointment with her regular vet tomorrow (he wasn't in today). I really don't want her to end up back in the hospital because all they will do is restrict her food, give her pain medication and fluids. I think with her regular vet's help (he is one block from my house) I can do that at home, with less stress on her, as long as she isn't too bad. I would happily treat her for cushing's at this point, IF I knew that was what she had and if anyone could tell me it would help the possible adrenal tumor/hyperplasia/who-knows-what. And, if someone could explain why her symptoms are so intermittent. So far no one has any answers. :confused: I am really worried about her. :(

DRAT Mary Beth,

I sure hope it is not her pancreatitis again. It seems like Cushings is going to take a back burner again. Maybe that is the way it is supposed to be.

Sending healing prayers for little Alivia.

Love,
Addy

Did you mean Tramadol vs Dramadol? If so I can explain the diarrhea!!!! My worst nightmare was the night my Haley was given her first dose of tramadol... vet went with the normal dosage recommended and that drug will kick your butt... opiate... my dog was walking around all night into walls and standing and staring at walls, couldn't quit walking... i went to bed and just let her walk and woke up at 2 am to a house full of diarrhea.

Long story but we compared notes here and learned that every one of us that had used it had a nightmare story and had to cut the recommended dosage in half... so you might try that.

Kim

Yes, I meant Tramadol. She's taken it before and never had a problem. We are at the emergency hospital now. Alivia is back getting blood work and xrays. May be pancreatitis again. :(

Sending love and hugs Alivia will be okay, Mary Beth,

Lots of love and hugs.

Addy, Zoe and Koko

Thanks, Addy. They just said they think it is early pancreatitis. Amylase is 2200 and WBC are elevated. They wanted to admit her, but I don't want to put her through that again since there is nothing they can do for her that I can't do at home. They are currently giving her an IV with pain meds and antibiotic. Then I will take her home with sub q fluids as needed and she will have nothing by mouth for 24 hours. She has an appointment with her regular vet tomorrow evening anyway. I don't think they are happy with my decision. She is really aging me!

Home with Alivia...already second guessing my decision of not letting them admit her. She gets so stressed at the vet's that I know she can't rest and I worry that additional stress is too hard on her. I had never seen this ER vet before and she was really nice ...up until I said I didn't want to admit her. Then she became a bit abrupt. I don't think she was happy about that. Except, if I would have let them admit her they could have done an ultrasound tomorrow because she would have been "transferred" to internal medicine. Now I have to schedule it and it will take about a week. I didn't know that part until I checked her out. But, I am looking at her now sleeping soundly and peacefully and I know she would not be getting that rest in the hospital. On the plus side of this, all of her blood work looks good except for Amylase 2235 (200-1200) and WBC 23.1 (6.0-17.0). She also will see her regular vet tomorrow evening.

Addy - You're right. It does seem that cushing's is again on the backburner.

I'm tired.....good night all.

Hi Mary Beth,

You are much braver than I! No way I would have taken Squirt home with pancreatitis! :eek: When she had her acute attack, the things I read about the enzymes and the damage they can do to surrounding organs, etc. scared the crap out of me! I wanted her in the hospital so if anything else started going bad, they would be right there! I missed her terribly and was afraid the whole time but knew she was in the best place. You are brave!

How is Ali this morning? It's too bad the U/S has to wait. I guess I don't understand the delay when they could have done it sooner if she was there...if they could work her in then, why not now? :confused:

Continue to withhold all food and water by mouth - taking things by mouth triggers the pancreas to go to work and right now it needs to rest. That's why meds and fluids are given via IV...to help keep the pancreas from releasing those enzymes. ;)

Let us know how things are going, 'k?

Stay strong!

Hugs,
Leslie and the gang