Questions about Cushings - Charlotte has crossed the Bridge

Im not noticing any difference on the meds after a week. Would the antibiotic, Baytril, target pancreatitis? Its been many years but i had a lab who suffered with pancreatitis and symptoms included vomiting and loss of appetite. Charlotte still has her usual "piggy" appetite and she has not had any vomiting or diarhea. She has not had a fever either.

And yes the first bloodwork was done in-house and the second was a more indepth senior workup. I wasnt impressed with the first vet we saw, the second was much more thorough and seemed to feel that cushings was a real possibility. It scares me that she could be in pain and we might not be doing everything we could be doing but Marianne described, in her above post, exactly what happens to Charlotte when she trembles so evidently this is something that happens to some dogs with cushings. But of course i want to look at every possibility so is there a specific test that is done to diagnose pancreatitis? I remember it was easily diagnosed when my lab had it so i assumed it was ruled out in Charlottes case. Any advice would be appreciated.

I believe it's the elevated PSL reading on the second page of Charlotte's bloodwork that especially raises the question of pancreatitis. I'm really glad Sharlene noticed this. Here's a link that describes the interpretation of this test:

http://precisionpsl.com/faq.html

As you'll see, the diagnosis of pancreatitis is made from a combination of factors including this test result, imaging, and a dog's behavior. If a dog is behaving totally normally, then an elevated test result would be less worrisome. The fact that Charlotte retains her appetite and is not experiencing any vomiting, diarrhea, or fever is good. However, in reading back in your thread, I see that about ten days ago you noticed some odd squatting behavior, etc. that made you wonder whether she's in pain in the rear half of her body. Hunching the back and a tender abdomen are often listed as symptoms of pancreatitis, so that does make me wonder whether Sharlene is on to something.

Has the odd squatting behavior continued? Especially if so, I would call the vet and report it along with asking her about the elevated PSL reading. I know you'd hate to get involved with a bunch more diagnostics right now prior to your Davis consultation. But just on the basis of that test result and symptoms alone, your vet may advise you to temprarily switch Charlotte's diet to several small bland meals each day such as white rice and chicken. Since she is not acutely ill with vomiting or diarrhea, simply altering her meals may be the best therapy if chronic pancreatitis is suspected. Anyway, since you are still ten days out from the Davis visit, I'd want to let your vet know if Charlotte indeed seems to be exhibiting behavior that could signal an inflamed pancreas.

Marianne

Thanks so much for all the info and insight Sharlene and Marianne! I have put a call into Charlotte's vet but in the meantime I have made her up a big batch of chicken and rice and will keep her on a bland, low fat diet, feeding small amounts numerous times a day, for awhile and see if I can see a difference. I think the purpose of putting her on the Baytril and Ursodiol was to address any underlying infection that hadn't been detected. I've read that both drugs should address pancreatitis but I also know that diet needs to be changed so at this point I think she is being treated accordingly if the pancreas is involved.

Thanks again and I'll keep you posted!!!

Only a couple more days until our appt at UC Davis. The Baytril and Ursidiol didnt seem didnt seem to make a difference and she continues to tremble over her shoulders almost all day long, but especially when she is at rest. Im hoping we are accepted to the study but im a little concerned because she has lost some weight and im not seeing the typical pot belly of a cushings dog. Ive tried to be conservative with the tramadol but i worry she is in pain and she has continued to circle and squat and look back at her hind end about twice a day and always immediately after eating. Other times she seems almost normal, although she doesnt have the energy she would normally have. She definitely has lost a lot of muscle in her hind end and can no longer jump up on the bed. Its so sad, she isnt the same dog she was 6 months ago. My heart breaks for her.

Sorry, i know im rambling and just repeating what ive already posted. Somehow it makes me feel better to get it out in writing. Im just very scared and nervous, trying not to freak out. I dont have kids, my dogs are my babies, just so hard to watch her go though this.

Laurie

Dear Laurie,

There's no such thing as rambling here ;), and we totally understand your worry. It always helps me, too, to write things out amidst our family here. I remain so glad that Charlotte will be seen there at Davis. Even if she is not a candidate for the study for some reason, I remain hopeful that they will have some helpful feedback or suggestions to guide the path forward. Hang in there -- just a couple more days, now!

Marianne

See our motto at the top of the page and that first promise - "support"? We are here to listen anytime you need to talk, to scream, to laugh, to cry, whatever....we are here. Never worry about rambling, honey...besides you are talking to a champ rambler and you have a LONG way to go to catch up to me. :D So "ramble" away anytime!
Hugs,
Leslie and the gang

Charlotte was accepted to the Cushings study! Im here at UC Davis waiting on more tests. The vet thinks she also has a heart condition so we will also be seeing a cardiologist.

Ill keep you all posted, thanks again for all your support and kind words!

Oh Laurie, I'm so glad to hear that Davis will be following her!! That is really, really great news!! We'll be anxiously awaiting any and all info.

Marianne

Good news, Laurie!

Charlotte Update...

She was officially diagnosed with Cushings, the pituitary type. The Davis vet put her on Trilostane, 30 mg twice a day, although he had me start with 30mg only once a day for the first few days. We are scheduled for another ACTH stim test in 2 weeks. Although I sure didn't want her to be diagnosed with Cushings, I'm relieved we now know what is wrong with her and can start treatment. What we thought could be another issue, a possible mass of some sort in her abdomen, turned out to be nothing. They did detect some heart issues but they think it may be Cushings related so we will just keep an eye on the situation and see if it improves.

My question to all of you is what should I be looking for as far as symptoms of her not handling the meds? The vet said this was actually a low dose in comparison to what the manufacturer recommends but yet it's what Davis considers to be their high dose for her size (70 pounds) because her symptoms are so severe. I'm hoping she won't have any negative reactions to the Trilostane but I want to be prepared. The vet mentioned vomiting, diarrhea and severe lethargy as symptoms to watch out for. Anything else I should be watching for?

Laurie