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

Of course I second guessed myself all night. Called the hospital back this morning at 7:00 and asked if I brought her back to the ER (and paid another ER visit) if they would refer her for an u/s today. No. They make the referrals to internal medicine at 6:00 A.M. so if I brought her back she would have to be admitted and referred TOMORROW morning! However, once again, and as always with Alivia, things are not so clear cut. She slept soundly but when she stood up this morning she yelped in pain. She is walking like the pain is from walking and will not even attempt to jump or go up or down a step. I was going to put her on my bed and barely touched her back and she yelped. Now I am seiously wondering if it is her spine causing this pain. I got the radiologist reports from May and last night - both say "spondylosis deformans" which is basically old age arthritis that causes the bones to fuse together and NORMALLY is not a problem in dogs and does not cause much pain or require treatment....BUT, sometimes it can cause a pinched nerve or spinal compression resulting in pain and neurological deficits INCLUDING rear leg weakness. So now she needs an exam from an orthopedic vet, too. :eek: She sees her regular vet later today...hopefully he can figure something out. Poor Alivia keeps having problem after problem and I can't get any answers for her.

PS - Leslie, I have sub q fluids to give her if needed but they said she will be alright without them today. They gave her all the meds they would have last night before we left the hospital. I wouldn't have risked anything with her. She has had no food since Sunday and no water or anything at all for almost 24 hours and won't until given the okay. After the last bout, I have learned more than I ever wanted to about pancreatitis! Now I am learning more about spondylosis deformas than I care to know, as well!

I know what you mean, Mary Beth! It seems we stay in the "classroom" sometimes, huh? :eek::D

Spondylosis could certainly cause some nerve damage and pain so I think you are wise to have an xray/US of her spine done again. Her yelping when you touched her back sure sounds like some sort of issue there.

I hope you get some answers today at the vet's office and some sort of plan to help her feel better soon.

Hugs,
Leslie and the gang

Let us know, we are here, hoping for good news.

Hugs,
Addy

Hi Mary Beth,

Im so sorry you and Ali are hurting again. ((((((MaryBethAli)))))))

When Ali went through this the last time one of the things you were questioning was the back pain before you got the diagnosis of the pancreatitus.

Our working Shepherds and Malinois had a tendancy to develop Spondylosis after retirement...sometimes severe. They formed spurs or bridges on the underneath side of the spine. Sometimes this can fuse parts of the spine and/or cause narrowing of the spinal and nerve column. When it was minor to moderate narrowing (spinal stenosis) ours boys functioned just fine unless something else (inflammatory) came up.

As we both know when our babies are having a pancreatic episode a classic symptom is the arching or rounding up of the back.

I can't help but wonder if when Ali is having an pancreatic episiode the holding herself up or "rounding up" is applying additional pressure to the already sensitive nerves and cronic inflamation along the under side of the spine, as this would be a closing action around that diseased area.

Also, by chance did the x-rays show that the Spondylosis was located at the thoracic lumbar junction as there is a notion that damage at that area can relate to increased stomach and pancreatic issues. If so it may be that Ali's condition is circular.

Just a thought.

Big HUGS...Rene & Snoopie

PS...which Hollistic Select r u feeding?

:( So sorry it has been a rough day. Annie has spondylosis also. Give Alivia a big hug for us tonight. Kim

Okay, I didn't see this one coming. I was giving Alivia a bath on Sunday and she was losing clumps of fur. I assumed it was cushing's related and thought I better try to get an accurate diagnosis. Last night in the hospital I pointed out her belly, where she had been shaved for u/s and the fur never grew back, was pink and scaly (this was new). The ER doctor said it was probably a bacterial infection and to just use a medicated shampoo on it.

So today I took Ali to her regular vet and he takes a closer look. Separates her fur and her skin actually breaks open and bleeds and Ali snaps at him in pain! Looking through her fur the worst of it is over the area of her spine where the spondylosis changes are. He said he really can't tell if she is having spine pain because the "intermediate pyloderma" is causing her so much pain and obviously you can't feel the spine without touching her skin!! Looking through her fur, all of her skin is really pink. He thinks currently that is her most pressing issue.

He thought I did the right thing taking her home from the hospital last night and he agreed the stress on her outweighed anything beneficial they would have done. He gave her an injection for pain and started her on antibiotics. She may have a touch of chronic pancreatitis, but that doesn't seem to be her current problem. We discussed what's next. I asked about getting a third u/s with an IMS at the hospital where I took her last night and he brought up a good point - which of the three would I then believe? He thinks I should go ahead with the consultation with Dr. Peterson and hopefully based on his recommendations we can start treatment. I think he feels at this point Ali needs an expert in endocronology to figure things out and he is willing to work with him and follow his recommendations. On the plus side, he thinks Ali is really holding her own under the circumstances and that her blood work looked good. I am just so thankful Alivia has such a caring and knowledgeable regular vet to oversee all this. I had put the Dr. Peterson consultaion on hold when Alivia developed pancreatitis in May, so I guess it is time to move forward with that.

Sending you and Alivia hugs and prayers.....

Thanks, Laurie. I really appreciate that. Alivia has definitely hit another bump in the road this week. Her vet reminded me tonight what a fighter she is, though. I just wish we could get some relief for her. It is so hard to see her suffering like this. :(

Hi-
Just wanted to tell you I'm sorry to hear Alivia is having such a tough time. I've been reading your posts and just wanted to let you know I'm thinking of you and hoping she is feeling better soon. She sure is a fighter, and you are lucky to have such a wonderful, caring vet.

Julie & Hannah

Thank you, Julie (and Hannah). It really does help to know people are pulling for her. She slept comfortably and seems a little bit better this morning. So, I am hopeful we are moving in the right direction!

Hope you are getting some rest, too!

Dear Mary Beth
So sorry to hear about your sweet Alivia. I hope she will feel better soon. It just seems to be one thing after another. Will be praying for you both.
Hugs Sonja and Apollo

Hi Mary Beth,

How is Ali today? I hope you both had a good nite's rest and are feeling stronger today!

Hugs,
Leslie and the gang

Hi Mary Beth and Ali,

Thinking about you guys and hoping you are doing well.

Love,
Rene & Snoopie

Hi, everyone!

I actually took a break from all this yesterday and celebrated my birthday. Since they continue to happen every year, might as well make the best of it! :p

Looking back at my post, I realized I mis-typed. Alivia has "Intermediate Pyoderma" (not Pyloderma!), but I am sure most of you already knew that. Originally, it seemed extremely painful for her. After two days on the antibiotics, she started to look much better but, it became intensely itchy. I did some research and found several things recommended to ease the itching and found a shampoo that contained 2 of those ingredients. I have been bathing her with that every other day and she has significantly improved! She's shedding like crazy and now has some patchy looking fur, but she's an old girl and I love her even if her looks have faded a bit! Happens to us all. ;)

Thinking about all of this I am starting to wonder if I am focused too much on the two differing ultrasounds and trying to determine if Alivia has a adrenal tumor ("suspect mass") or not (since she suppressed on her LDDS, "possible hyperplasia"). She also does not have an atrophied left adrenal which seems common with a right adrenal tumor. Maybe, she actually just has pituitary based cushing's?? My primary concern about starting her on either med has been would the risks be greater than the limited results obtained with an adrenal tumor? Maybe that's not the issue at all. :confused:

Her food and water consumption do not seem excessive and she is not urinating excessively, either. But, her fur does not grow, she had acute pancreatitis (possibly mildly chronic now) and now Pyoderma. I think I need to make a treatment decision soon.

Comments anyone???

Hi Mary Beth,

I really want to wish you a belated Happy Birthday!!!!!!
I also am glad Alivia is recovering. Poor little girl has been through so much and I hope she gets a break from it. You take such good care of her.:):)

I can't comment on starting treatment. I can tell you I appreciate your dilemma as it was mine as well. You will reach a decision and whatever that may be it will be the right one for Alivia and for you.

Sending love and hugs,
addy

Happy Belated Birthday to You, Mary Beth!!!!

If Alivia is not displaying strong Cushing symptoms then IMO, I would not treat her with the Cushing meds. Dr. Feldman, who is one of the top Cushing's expert says:

Quote:

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No dog should be treated unless it has obvious and worrisome clinical signs seen by the owner.

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http://veterinarynews.dvm360.com/dvm....jsp?id=672663

So glad to hear that Alivia is improving, You are such a loving and wonderful mom.

Love and hugs,
Lori

Quote:

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Originally Posted by MBK

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. :(

---

Ohhh I'm really sorry to hear that! I hope everything goes well and you manage to get Alivia's condition sorted out.....:(
Hugs, Leah and Maya

Thank you for the birthday wishes, Lori!

Although Alivia does not seem to have the day to day "symptoms" of Cushing's, she definitely has indications that something is going on. She's had pancreatitis, pyoderma (which is usually secondary to something - often cushing's) and her fur does not grow. So, I worry that the cushing's is negatively effecting her internally. I usually seem to have many more questions than answers. :confused:

Thanks, Leah. I think we dodged pancreatitis this time as her pain seemed to be related to the acute pyoderma, which came on suddenly and was quite severe. Fortunately, that is resolving very well and she seems to be feeling MUCH better. She even has some pep in her step, which is SO good to see! Such a roller coaster this all is that it is especially nice when there is a period when things are going well!

Cool news!:)

Hi Mary Beth-

I agree with two things: it sure is nice when there is a little break and things are going well! And, it is definitely a roller coaster!

I'm glad to hear Alivia is doing a little better, and even has pep in her step!

Hang in there!
Julie & Hannah

I just read it was your birthday. Happy Belated Birthday! Hope you had a good one. Mine sneak up too quickly each year, lol.
Glad to hear Alivia is feeling better, too. :)

Thanks, Lauri! I had a wonderful day and my birthdays seem to come faster and faster, too!! :eek:

Alivia continues to do well! She was peppier today than she's been in quite awhile. I am thrilled to see her doing so well, but almost afraid to type this out loud! I don't want to jinx things!

Hope everyone has a great weekend!!!

Oh my, Mary Beth, I am so sorry that I missed your birthday.

Happy belated birthday!

I missed it too!!!!!!!!!!!!!!

Dang, I hate it when I do that!!!!!:o:o:o:o

HAPPY BIRTHDAY DEAR MARY BETH

I am glad Alivia is feeling better.

Love,
Addy

Happy belated birthday! Glad to hear it was a wonderful day and that Alivia had a good day too!

Julie & Hannah

Wow, Mary Beth! You snuck that one in on us! :D

Happy Birthday a few days late!

Hugs,
Leslie and the gang

Hi Mary Beth,

I too missed your Birthday!!! Happy Birthday!!!:p:D:)

Just trying to get some stuff done with Ella always around is exhausting, but not really complaining. :p

If I was reading right you are holding off any meds to treat just yet--I would do the same. It was too far into the game of Cushings with Maddie so I had to do something. I would have started back in July '10 if I had know what it was....of course she didn't have anything else sickness wise going on to deal with. You are the best one to make the judgement call because you are always with her...;)

Happy Rest of the Week!!

Hi, everyone!!!

Thanks for all the birthday wishes - so nice of you all! I haven't been here for awhile so that was a nice surprise to see. Wish you could all join me in a glass of Chocovine! :)

Alivia is still on her antibiotics for the Pyoderma. It seems to be clearing up, but she lost patches of fur where it was most severe and she has little black discolorations - they aren't pimply-like, they are flat. Anyone know anything about that? Other than the residuals from the Pyoderma, she seems to be doing VERY well. She seems stronger and has more energy.

Her primary vet and I were talking about sceduling a LDDS test and deciding on a treatment course, when she got Pyoderma. So, that's delaying any testing and treatment decisions for now. I'm starting to wonder if someone is trying to tell me something....we were all set to begin treatment and I had even bought the Lysodren back in May, when she developed pancreatitis, delaying treatment then. :confused:

Welcome Back Mary Beth,

Snoop had that big black bald spot on her nose. Not pimpley, but flat and shiney black and not a bit of hair. It has almost all grown back in now. Pictures on her "Food Change Progress" album. I also have been giving her Vetri-Science Oli-Vet 250mg. It is Olive Leaf Extract and is a natural antibiotic which supports immune response function and the L-Glutamine I told you about. Maybe the two have helped her with her pancreatitus and infections but she has not had any bouts and she is doing well.

Happy Belated B-day!

Rene & Snoop

I am a mess again. Alivia is still on antibiotics twice a day for what we thought was Pyoderma. The sores have improved but there are LOTS of black freckly patches where she has lost fur. She is VERY itchy. Leslie suggested I read about calcinosis cutis and after reading about it and looking at pictures, I am fairly certain that is what Alivia has. Her regular vet was not in today. I am waiting to hear back from her dermatologist's office - they were going to try to fit her in sometime soon. I took some pictures of Alivia's skin and posted them in an album here if anyone wants to take a look and comment.

I have Lysodren here and I am so tempted to start her on it now, but I guess I should wait until at least one of her vets sees her. Especially since my mind is not working properly at the moment and I can't even remember how to start the dosing! In some ways she seems better, but I am so worried about her and this latest issue.

Mary Beth, if you have read up on it and feel it is calcinosis cutis then get her into that dermatologist asap. I am no expert on it but from what I have read here the sooner you are on it the better the outcome. It can be very tough to get rid of. Hopefully someone with experience or greater knowledge will reply soon. Hugs, kim

Hi Mary Beth,

Im sorry your in this place right now. I hear what you are saying...Are the illnesses presenting as signs that she should be treated?...or...Are the illnesses preventing me from treating for a reason as a sign? Very tough place to be. Only you know what is best for Ali and you have trusted your gut before.

However, Don't do anything on your own. If you choose treatment for Ali you should be well informed and under the guidance of your vet. He or she should be aware you are loading so you can call with questions and concerns. This process will make you more knowledgable and comfortable during Ali's load.

Wether its Calcinosis Cutis or Pyoderma they both usually indicate underlying illnesses often adrenal in nature.

You can sort this out with a clear head tomorrow when hopefully you will hear back from the dermatologist's office and your vet will be avaiable.

I am certian I have not told you anything you already do not know. Relax and cuddle with Ali tonite and enjoy your girl. Get some rest, you have been a wonderful mom to her.

With much love,
Rene & Snoopie

Hi Mary Beth,
I went to look at the photos as I first thought it sounded like Zoe's skin but it is not the same. Sonja's Apollo just went throught some black spots, etc, and a skin infection. Check on her thread or PM her. I believe he got some time of shot. It may not be the same but ask her about it and have her look at the photos.

Please do not start any drug without working with a vet.

Hugs and love,
Addy

Well, I am actually feeling MUCH less panicked today. I have been bathing Alivia with Sulphadene every 2-3 days - it seems to help a lot with her itching and she is still on the antibiotic 2x a day. Last night I bathed her again and checked her skin very closely. There are no more crusty or bleedy areas and other than the black freckles it seems to be healing very well. I e-mailed her regular vet pictures of it (he's on vacation) and she has an appointment with her dermatologist on Wednesday, to be safe. But overall, she seems to be doing REALLY well. Her pot belly is completely gone and her belly fur is all of sudden growing back!! Her energy is much better. It is actually like she doesn't even have cushing's! Very strange!!! Anyway, I definitely would not start her on any treatment without further testing.

Hi Mary Beth,

I am so glad to hear that Ali is doing better and that her skin is looking a bit better. Hopefully, the derm doc will have a definitive answer and plan of action for you. Please keep in touch and let us know what you learn.

I had another thought - Squirt has sebaceus adenomas which look like very teeny volcanoes which will erupt with black crusty stuff and sometimes bleed. Once the eruption is past, they go back to pick volcanoes. Periodically they will burst with the crusty stuff but she doesn't itch and they don't seem to hurt. They do not look like freckles, tho. They are raised up from the surface of the skin. Once she started the Lyso maintenance, they have completely disappeared for the most part and the few that remain, don't erupt anymore that I have seen. I haven't heard nor read anything that says these are connected to Cushing's but this is how it has worked for Squirt. ;)

Hugs,
Leslie and the gang

Thanks, Leslie.

No, that definitely does not sound at all like Alivia's. Her skin was really red under her fur, she had a few sores and she was definitiely in pain. She lost fur where the worst lesions were. Her regular vet said it was intermediate Pyoderma. Now where the sores have healed, she just has black freckle-like marks that are not at all raised up or seepy in any way. I posted pictures. I trust her regular vet, but having her dermatologist look at it and maybe biopsy it will make me feel much better (and hopefully Alivia, too!). ;) Other than being itchy, which may just be seasonal allergies that she tends to get, she seems REALLY good. Bathing her in the Sulphadene seems to help immensely - I just don't want to do it too often and cause problems drying her skin out! It's always something! At least I have it under control until I can talk to the dermatologist! I swear she is aging ME!:p

Hey Mary Beth and Alivia,
Just wanted to say hi and I am glad to hear Alivia's skin is doing better. You are a very strong woman and Alivia is so fortunate to have you as her mom. Her photos are so adorable - she must be the sweetest girl ever.
I haven't been on here, either lately. I had to give my poor brain a break from all this information. It's been overwhelming trying to take it all in.
Sassy is starting her 3rd week of Ketoconazole and so far, I don't think it has done one bit of good, but will wait to hear what the vet says when we go back next week.
Hope you have a good rest of the week/weekend :)

Thanks, Lauri. Good to hear from you! I do understand the need for a break. I have to do it myself sometimes. All the information about Cushing's can be really overwhelming to those of us newer to this. Good thing there are some really knowledgeable people here that are always available to help or just listen!

A few years ago - way before I ever heard of cushing's - Alivia was on Ketoconazole, with another med for skin problems that they thought was an allergy to something. She was on it for quite awhile and I didn't think it helped with that, either. I'm sorry it's not helping Sassy. I know you always hope the least scary things will work. Let me know what her vet says.

Thanks again for checking in!