14 year-old Shih Tzu With Recent Cushing's Diagnosis

I have some preliminary info. but I am waiting for a call from the vet. Hannah's ALT is now 186. I believe she said it was 254 two weeks ago, so it is dropping, but normal is 100 or lower. Another liver value (did not catch which) is also high. I believe she said it was 13 and was not supposed to be higher than 7. Her Bilirubin was normal, which she said was good. Her ALKP is now at 903 and it was in the upper 800s two weeks ago. They also tested her thyroid and it was just very slightly (a couple of tenths) abnormal. She said I could choose to do a full thyroid check for $96 but that dogs with other problems can have thyroid levels that are off, so that is up to me. She said I could proceed without doing anything since Hannah is not acting sick, or I could do an ultrasound to see if we can see more. Her biggest issue is the itching and the yeast at this point. I don't know what to do. I don't know if I check the thyroid to see if it is a problem, and a possible cause of the itching and skin problems, or if I do the ultrasound so we know if we can ever give her an oral med for the yeast, or if I wait and repeat blood work....I have a call in to the vet to see what she recommends.

I looked back at Hannah's ultrasound results and am worried because her birth date is wrong (it says 3/30/01) but the date was 3/30/11 when they did the ultrasound and I'm wondering if they just guessed because they didn't know the age. It said "10 years" and she would've been 12. I also am concerned because it says weight "10.8kg" and Hannah weighs about 12lbs. I am hoping it means pounds and it was one of the times that her weight was a little off because she was moving around on the scale. It does say Shih Tzu, so I sure hope I have the results to MY DOG'S ultrasound! You can bet I am going to ask, though!

I'll let you know more when I have more information, but I certainly would like your input.

Thanks so much!
Hannah & Julie

Crossing fingers and toes for positive results today!!

hugs,
Sharlene and Molly Muffin

I sure would have them double check the results to be sure they are Hannah's. I was at an office visit somewhere recently and whomever I was going to speak with had someone else's file on top and started referring to me as that person. It seems like everything needs to be triple checked these days.

-Susan

Guys, I'm losing it. Right now, I fear I'll be putting Hannah to sleep because she is so itchy and full of yeast/infections that she is miserable and we can't give her oral ketoconazole because of her liver.

I am still waiting to hear from one vet, but I am getting frustrated that I can't get any answers. At this point I am trying to treat what is actually "wrong" with Hannah, and that is her itching. She has been wearing an e collar for several weeks and she is scratching her sides and chest, and she bites her feet and scratches her neck when the collar is off. I wonder if there is yeast all over her body. When I told the vet that is my concern right now and I wondered if we should see if there is indeed more yeast, her answer was that if there is more yeast, they would still treat with the oral med, and because of her liver she doesn't want to do that. So where does that leave me?

I asked the vet tech who called me back to ask her what she would do if it was her dog. I'm confused about where this leaves me. If I do an ultrasound, we still may not know what is wrong. I will not biopsy anything. She is old and I wouldn't treat it if she had cancer anyway, and I don't want to risk any problems from a biopsy anyway. And what if we see nothing abnormal? Then we still don't know what is wrong with her liver. I guess I need to ask what the circumstances would need to be to give her the ketoconazole orally. Do the liver values need to be normal? Should I now do a bile acid test to see how her liver functions? Would that tell us if she could handle it? Do I do the thyroid test for $96 because her thyroid was off by a couple of tenths, and see if that may be the cause for the itching? It still wouldn't fix the yeast.

I am not handling this well today and am on the verge of a breakdown. To top it off, there is now a winter storm watch Sat. night into Sun. and Hannah is supposed to be groomed on Sun. She needs a haircut, especially to get the hair on her neck shorter. I'm worried the weather will be too bad to go (it's a bit of a trip bc I go to an in-home groomer who will just shave her down while I hold her to prevent back issues). The groomer had no other openings before Christmas. So that is stressing me out too, yet I don't even know what will happen.

I just don't know what to do anymore. I worry they are going to think I am crazy at both vet offices, but I am just trying to take care of my dog. They tell me I can wait to do further testing because she is acting healthy, but the problem that actually is manifesting itself, the itching, we can't fix. The ALT dropped 68 points in the past two weeks, but it is still 186, 86 points above normal. And some other liver value (still don't know what) is also high. But Bilirubin is normal. And ALKP is 903.

Ugh. I have to leave soon because I have plans to go to the Timberwolves game with a friend. I probably won't even be able to hear the phone when the vet calls, which is also frustrating. I feel helpless and hopeless right now. And I feel like I am failing Hannah because I can't make her better. I wish I knew what to do...

Julie & Hannah

Okay, deep breaths, in and out, there has to be other ways to treat yeast.
1- did they do a scraping- what kind of yeast is it?
2- what do you feed Hannah?
3- are the topicals not working?
4- did you start a probiotic?

can we try to change her on the inside? I know an aquaintence whose dog had such bad allergies the traditonal vets gave up on her and told her mom to just put her down. She went to a holisitc vet and started her on a raw diet. She has to switch the proteins around, rotate them, but the dog is fine now, has hair, minimal itching, you should see him.

I am bringing this up just so we can talk about what Hannah's diet consists of becuase if she has yeast, I think her diet needs to be meat based with no grain, no sweet potatoes and a good probiotic.

Would that not start the healing on the inside? I am just throwing this out there to start the discussion if you cant use the oral ketoconazole because of her liver.

Maybe you are already feeding that:o:o:o:o


You are not failing Hannah, nor have you ever failed your little girl. Compared to some of the dogs here, her numbers are not as high as some.

The storm will probably end up being nothing, just a bit of snow, it will be fine.

Go enjoy the game and lock it all up for the night. You will be able to think better tomorrow and hopefully others will chime in.

(((((((((((((((((((((((hugs))))))))))))))))))))))) ))

Okay, Addy is right, deep, deep breaths, slow.

Now, okay, so, lets see what kind of options are available.

I've got two sites, that talk about the yeast infections:

http://www.westiemed.org/health/malassezia/

http://www.peteducation.com/article....2+2102&aid=321

This stuff you probably already know.

Now, this one is sort of an alternative medicine site, in that I'm mainly reading the comments to see what others are doing for their dogs yeast infection.
One is wiping down with an infusion of steeped jasmine tea. That sounded interesting. Oh and just read another one who is doing the jasmine tea thing and both say it is working. Because of not being able to give ketoconazole, and everyone seems to agree that if there is a preexisting liver condition, then that shouldn't be used, at least orally, then maybe could find something to try on there.

http://www.earthclinic.com/Pets/yeas...ions_dogs.html

As far as food goes, nothing with starch in it, sweet potatoes, etc. that turns to sugar is something that yeast just loves, so if healing from the inside, that might not be a good bet.

I'm just trying to come up with things that might work and save you from having to take that step that would just break your heart. You are such a great mom. I hope you know that.

hugs,
Sharlene and Molly Muffin

well just fyi.a friend has a lab/mix and suffered for months with yeast/skin stuff.she switched his diet to only Natures Variety Instinct Raw Boost and in a short time her baby was not itcy,rashes subsided and is now just a fine happy little boy.i was thinking about putting my two on this,but i wanna wait until milo gets through his stuff.hope this is helpful,pulling for you ...patty and milo

Julie, I don't remember, but has Hannah ever been seen by a derm vet? If she has, then never mind. If not, a derm vet may be able to offer you some hope. Barkley's severe allergies were managed by a derm vet who was very well aware of B's Cushing's, & therefore not steroid containing meds could be used. The derm vet put B on several alternatives which were nothing short of a miracle.

Debbie

ps i have also been using Vetericyn VF spray on milo for his collorettes (skin inflammations under both armpits) and it always helps alleviate these symptoms.it is for wound and infection care you just spray it on 2xdaily.i see it has truly worked for milo when he has his outbreaks.he does not have cc....

I believe I read where some yeast infections can be attributed to food allergies so maybe an elimination diet could help. Also I have read where a 50/50 solution of vinegar and water can be used on the dog for yeast infections as long as there are no open sores.

Sending tons of healing and loving hugs, Lori