Trying to help a friend (possible calcinosis cutis)

Hi all: Brand new here & looking for help for a friend who doesn't have a computer.

She has a 10 yo Boston Terrier who has had Cushings for a while. Her vet kept telling her that she didn't have Cushings & I was concerned because I thought her symptoms sure sounded like Cushings. I'm not a vet tech or anything like that but I have read a lot about dogs & various diseases. I started doing research because poor Vicki was breaking out w/those lump (calcinosis cutis?????) & she was getting worse by the day. Finally, a different vet diagnosed Cushings (rah rah)!

Now she's on Vetoryl but because this has gone undiagnosed for so long, her skin is in really bad shape. There are some meds she can't take because she has problems w/dry eyes so antihistamines are out. She keeps calling & asking me what she should use on her topically & I just plain don't know. Looked around on the internet but only can find info on hot spots, not calcinosis cutis (that's a real mouthful, huh?) She's using something for hot spots which her vet said was fine (sorry, can't remember what it is right now) but she said it isn't working.

I decided to come to the experts..........:D

Does anyone have any ideas? Any input would be greatly appreciated & I will pass it on.

Thanks.....

Welcome ... and what a good friend you are!

Our Hungarian Vizsla had calcinosis cutis and was treated with Lysodren.

We tried to keep infections down and to keep the areas dry. Things we used were:
• Medicated Shampoos (this did not work for Sabre as it just made the areas more red and inflamed)
• Oatmeal Shampoos
• Antibiotics when infections looked likely – here we found that we could get away with cheaper antibiotics.
• Betadine
• A t-shirt or jacket (depending on the weather)

Here is a recent link to a thread which has some info on calcinosis cutis. http://www.k9cushings.com/forum/showthread.php?t=3765

Angela

Hi and Welcome,

How nice of you to try to help your friend. We have members who have dealt with Calcinosis Cutis and I am sure they will all be along soon to relate their experiences.

I am so glad you found us!:)
addy

Hi and welcome to the forum.

Thank you for having a compassionate heart and wanting to help Vicki. Calcinosis Cutis can be very difficult to resolve and you have already heard from our resident expert, Angela. As she mentioned, her Sabre treated with lysodren, which may be a better choice of treatment for dogs with calcinosis cutis. Dr. David Bruyette, one of our country's reknown veterinary endocrine specialist, stated in one of his lectures that his facility (VCA West Los Angeles) has not had good luck with resolving the calcinosis cutis in dogs being treated with Vetoryl (Trilostane). VCA West Los Angeles treats hundreds of dogs with cushing's so they have lots of experience under their belt. If your friend's vet is out of suggestions, you may want to ask her to ask the vet to contact Dr. Bruyette to discuss Vicki's case.

http://www.vcahospitals.com/west-los-angeles

Many thanks for your helpful suggestions. I have some reading to do on that thread to see if I can find help for her.......I did look around before I posted but I missed that thread......:rolleyes:

I have a Lab w/allergies so this is why I'm always researching something on the internet having to do w/dogs, allergies, diseases, etc. etc. & why she always comes to me for help.

Last vet just put her on a/b because the mess on her skin is getting infected. She also said she cut up a T shirt & put that on w/an E collar to try to keep her away from it.

I will keep reading all over this forum to see if I can come up w/some suggestions for her........& many thanks from her too. She is a nervous wreck right now (plus her mother is in a nursing home & not doing too well) so my heart really goes out to her. I just don't know what to tell her to do!!!!!!! I thought if I could find something to make Vicki more comfortable, that would lessen her stress just a tad.

Thank you for the nice welcome.........

Quote:

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Originally Posted by lulusmom

Hi and welcome to the forum.

Thank you for having a compassionate heart and wanting to help Vicki. Calcinosis Cutis can be very difficult to resolve and you have already heard from our resident expert, Angela. As she mentioned, her Sabre treated with lysodren, which may be a better choice of treatment for dogs with calcinosis cutis. Dr. David Bruyette, one of our country's reknown veterinary endocrine specialist, stated in one of his lectures that his facility (VCA West Los Angeles) has not had good luck with resolving the calcinosis cutis in dogs being treated with Vetoryl (Trilostane). VCA West Los Angeles treats hundreds of dogs with cushing's so they have lots of experience under their belt. If your friend's vet is out of suggestions, you may want to ask her to ask the vet to contact Dr. Bruyette to discuss Vicki's case.

http://www.vcahospitals.com/west-los-angeles

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Thank you so much for your thoughts on this. I think we were posting at the same time so I didn't see your post until I finished mine.

My friend heard somewhere that lysodren is a very harsh med & is very harmful to the dog so my guess is she told the vet she refused to put her dog on it. I don't know that for a fact but she did tell me that she would not allow Vicki to take that lysodren. I researched that also & found good & bad about it. I will go to that website you gave me & if need be, print it out & drive over to her house later.

Again, many thanks to all of you..........my friend will be very grateful for your help. I already told her that I'm no expert.:confused:

I should add to my first post .... it takes time!! It took probably about 4 to 6 months before we had everything sorted with Sabre. He not only had the calcinosis cutis but had lost a lot of hair .... more lumps would come up and he would lose more hair. So we controlled the calcinosis cutis ... areas healed up..... the hair grew back once the scabs disappeared .... then it just remained there .... never being an issue for him. Most of Sabre's calcinosis cutis were more like "plates" of deposits ie some were 3cm x 5cm in size!

Angela

I do have one question........you mentioned Betadine. Exactly how do you use it? Just dab it on full strength or what? I always keep that in the house because it's wonderful stuff but wouldn't it stain a dog's coat???????

I have a feeling that the skin problem was allowed to fester for a little too long because it took so long to diagnose Cushings. It seems to me that I told her months ago that it sounded like Cushings to me but I'm certainly no expert.

I also don't think she's seeing a specialist, I think she's going to a regular vet. Do you think I should suggest she go to a specialist?

I printed out that thread where you were all giving another poster some helpful hints on calcinosis cutis. I will bring it over to her later on.

You are all wonderful........thank you.

I am really trying to recall with the betadine ... to my recollection we just followed the instructions on the bottle. I suppose it would stain the coat but in Sabre's case he had little hair ... and his coat was "russet gold" ... near the colour of the betadine! At one stage we also used Epiotic to scuff the thickened skin off as well. A lot of it was trial and error. We did also add EPO (Evening Primrose Oil) to his diet.

We just used a regular vet as there is only one specialist clinic in the North Island (I also think this is the only clinic in NZ) ... yes we are a small country ... and they are VERY expensive! A lot of members here do use an IMS .... if her regular vet is what she is comfortable with .... and is knowlegable or willing to learn and listen about treating cushings and calcinosis cutis then I wouldn't rock the boat. Dr Bruyette, will do a phone consult with your vet so this may be helpful.

Calcinosis Cutis, although is a symptom of cushings, is not commonly seen and many vets have never seen a case before. This was the case of the vet who diagnosed Sabre .... and his next vet (changed due to the first vet only working part-time and she was not comfortable with treating a dog on Lysodren when she would not be available for me all the time) had only seen one previous case when she was practising in the UK.

The other comment I would make is that the dog's "cushings" needs to be controlled ie the dog's treatment must in range. How long has her dog been on the Vetoryl? Are her ACTH stim tests where they should be?

Angela

She was just diagnosed so she hasn't been on any meds but maybe two or three weeks, month at the very most. She was on a/b for a long time because of the skin problem & also because her kidney numbers were off. I hope that's accurate........this poor dog has had so many problems, I'm getting confused! The one vet that told her it was NOT Cushings was treating her for some kidney problem & also for the eruptions on her skin. This has been going on for a few months & the only thing I know that she's been giving her are a/b.

I can get any information for you that will help but she has been to so many different vets that I have lost count. She has spent so much money on testing but I honestly don't know which tests she has had. Far as I know, she has not seen a specialist for the Cushings. I can't speak for her as to why she's been changing vets a lot recently because she finds one she likes & then she calls me to tell me that she's been to yet another one. Maybe she has not been comfortable w/them, don't know.

She went to see my vet (very special man).....he told her that he felt the testing that was done up to that point was what he would have ordered. She was just looking for a second opinion. I think this was when she got the results for the kidneys but not sure if she had the skin problem then.

I have Betadine here........I'll check it out. Thought maybe you were doing something special w/it. Her dog has a lot of white but I haven't seen her so I don't know how much fur is left on her! I also don't know when she is scheduled to go back for another checkup. I don't imagine much has changed simply because she's just started on the meds. Most meds need a few months to "kick in".......

If there's anything specific you need to know, I can call her & find out for you. I still have to drop off that thread I printed.

(I hope I'm not giving you inaccurate info........this is all from memory & that is not one of my best assets........& each yr it gets much worse........:-)

Ok, here we go.......Janice (Vicki's humommie) just left & gave me a bunch of info. I also gave her that wonderful thread about the skin problem for which she was very grateful.

We're in So CA so she's going to call that VCA Hosp in West LA to see if they can recommend a vet down here that has worked a lot w/K9 Cushings.

Vicki has been on Vetoryl for approx a month, a higher dose was just prescribed about a week & a half ago (she wasn't sure what the dose is). The ACDH was 17.1, it was the liver enzymes that were high, not kidney (sorry), she had a skin biopsy to confirm the cal cutis, ultrasound of the liver & adrenal & that particular vet said everything looked ok.

She's on her third or fourth vet but would feel better if she found a vet who knows a lot more about Cushings than this present vet.

She said to thank all of you for your help.

So that's where we stand up to today........:D

i think the betadine....you can mix that with baby shampoo and make it a dark tea color do not put near face though. i will confirm.

baby shampoo and tea tree oil....medicated tea tree oil....
1 ml for every 8 ounces of shampoo
then shake really good.

this might work better............

Skye: Thanks for info on Betadine. Will pass it on.

Thanks for all the info and the update. Things will become easier when the dog's ACTH stim post number is in the range required. It would be good for her to have one good vet or IMS treating her.

Angela

Word of caution - be extremely careful with tea tree oil. It can have some awful effects. ;)

First of all, I guess it's ACTH........duh........goes to show what I know. I don't have a clue what that is but not sure it matters as I'm just the go-between.......:p

Also have no clue what IMS is.......sorry, you have to understand I'm flying blind here, so to speak........:confused:

This is why I turned to you........Janice only knows what the vet has told her & what I was able to find & print out from the internet. A while ago, I knew somebody who had a dog w/Cushings & this is why I recognized some of the symptoms when this all started w/Vicki. It's also why I kept telling her I thought it might be Cushings but her vet at that time said it was not. We both assumed that the vet knew better than me.........scary, huh?

She isn't sure that this new vet really knows all that much about this disease & I think she would be more comfortable if that place in LA knows of a good vet down here that's had experience w/K9 Cushings.

I think just knowing that Janice can call me & I can post her questions here has made her feel a lot better.

I bought tea tree oil a while ago & I must have read some kind of warning about it because I was afraid to use it (it's still unopened). I think I bought it for a recipe for an all-natural flea spray & I think it says you can add a couple of drops of tea tree oil. I do use that flea spray but I never did add the tea tree oil. Guess I need to do some reading about it.

My thanks again to all of you.:D

Sorry ... IMS= internal medicine specialist.

Yes ... tea tree oil is extremely toxic. I used it a few times as a VERY diluted solution for an ear cleaner for Sabre as we did not want to use steriodal based ear drops - I think it was only like a drop or two in a large bowl of water. Personally I would not use it on calcinosis cutis.

Love your avatar pic!

Angela

I looked up ACTH but couldn't pronounce that one.........

I bought the tea tree oil simply because this flea spray recipe said to add a drop or two for a shiny coat. Then I read some warnings about it so I never added it.

Janice said she had heard some bad things about it also & wanted to stay away from it so that's out for treating Vicki.

The avatar is my baby girl (well, she's almost 7 yo so she's no longer a baby). Really wonderful dog & sweet as could be. I've been very lucky in that the worst of her medical problems have been her allergies. She is allergic to everything but air.......& even that I wonder about! I have learned so much about canine allergies, trust me.......:D

Vicki goes in for a recheck sometime soon so will let you know how that goes. Perhaps she may wind up going to a specialist if she can get a name from the place up north.

Just 'cause I'm nosy: what is a normal ACTH? Wondering how high Vicki's numbers are.

Quote:

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Originally Posted by 4Vicki

Just 'cause I'm nosy: what is a normal ACTH? Wondering how high Vicki's numbers are.

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What a beautiful girl you have there!

Some labs may be different but the "norms" for an ACTH for a "healthy dog" are pre draw: 1.0-5.0 ug/dl and post draw: 8.0-20.0 ug/dl.

Love and hugs,
Lori

I just wanted to add that a dog treated with Vetoryl should have a post draw between 1.45 and 5.4 mcg/dl. There are circumstances that it can be higher (ie post draw of 9.1) if symptoms are resolved. These are found on the product insert which you can find on the following link -
http://www.k9cushings.com/forum/showthread.php?t=185

Angela

i knew tea tree oil is not to be used on cats but if used correctly on dogs can benefit them....you can even buy dog and or human shampoos with that already in it, however i do not know the benefit it would bring for certain but have heard great healing properties from others in regards to it. BUT if the risk out weigh the pros then by all means i fully agree to NOT.
my sister has used tea tree oil mixed correctly with baby shampoo for over 12 years, and has loads of experience is many things including how to even hook up emergency IV's till animal is transported to vet. BUT that is her not us. i would only use it if knew without any doubt it was mixed correctly.

Thanks again to all of you for all of this information. I will have to do some research & reading about tea tree oil before I decide if I'm going to use it on my dog. Janice can decide what to do for Vicki.

I do remember hearing wonderful things about it & then I remember reading something that scared me so I never even opened the bottle.

I'm making some more flea spray tonight but for now will once again pass on the tea tree oil. (By the way, if anyone is interested, I can post that recipe........it works pretty slick & there are no chemicals of any kind in it. I'm into all natural stuff which is why I cook for my baby girl.)

I will print this thread w/all this nifty info for Janice.........so keep those handy dandy hints/tips/info coming..........

I love and respect Dr karen Becker...holistic vet in chicagos top ten best! this is sorta long clip...but at about 6:18 she says something about tea tree oils.
I understand there is risk if used incorrectly, HUGE risks, liver, kidneys, paralyze, death. By no means allow them to ingest it! and mix it properly. I personally would not use full strength on an animal ever. I know some people have put full strength right on to animal and i just cringe. some have suffered some have healed. Not worth the risk on that before trying other methods. But mixing diluting and such okay....as long as it is done properly. anyways here is the link
http://www.youtube.com/watch?v=i1voV6BLr8U
you can jump to 6:18 to hear specific
and then part two
http://www.youtube.com/watch?NR=1&fe...&v=MH6gjJHtUhM

Terrific video........I wrote down that Betadine rinse. That sounds like a great rinse for after a bath.

I had to chuckle.........when Dr. Becker was talking about the medicated dog shampoo w/tea tree oil it reminded me of something..........guess who has some of that.:rolleyes: That didn't bother me because I'm sure there's just a tiny amount but for now I think I'll make my flea spray w/o it until I've done more research.

You have a way of making a newbie feel very welcome........I just had to say that.......

i am thrilled that you feel welcomed here. This is greatest place ever with tons of experiences and knowledge. Not by any means vets and such, just lots of experiences and knowledge. the support, love and care is amazing, I can honestly and truly say from my heart i love and respect the angels here. known as the Cush angels. Remarkable amazing people. The passion, compassion is endless. People who truly care. Whatever the question, whatever the emotion your heart carries, the cush angels are here to always help. I hope that your flea spray receipe is posted, would love to have it, and hope your furbabies are doing awesome and i hope your friend is doing great and her furbaby is feeling better. give her cyber hugs for us!

I have to agree........I not only feel very welcome here but what a relief to find people w/knowledge & a willingness to help. I'm worried about my friend because she's got so much on her plate right now & I really don't know enough about Cushings to help her. Like I said before, just knowing that I can post a question here for her has taken a big load off her shoulders. And I thank you for that.

Should I post the flea spray recipe here or on another thread??????

We have a section called Everything Else where you can post your flea recipe. I look forward to seeing it as we battle fleas and ticks in our area a LOT!

Hi Vicki,

Welcome to you. Unfortunately, I do not have anything valuable to add regarding calcinosis cutis, and am sorry your friend's furbaby has to endure it:(. I hope she find a good and effective treatment. Please keep us posted.

Warm regards,

Jeanette and Princess

ps: love your avatar pic btw, is that a chocolate lab? I love chocolate labs...haaaaaaaa....:D

We have a wealth of information in our Helpful Resource Thread about Cushing's disease and other related material, please feel free to print out anything you think might be useful: http://www.k9cushings.com/forum/foru...aysprune=&f=10

Love and hugs,
Lori

Hi

Welcome - Isnt this forum great:) Its the best group of people I have met!! You ask something and they are there with tons of advice and support!! Glad you are so comfortable here -- will be looking forward to the flea recipe - my brother has a golden/lab with ton of skin issues and would be interested -- love the picture!!

hugs xo

Jeanette: Yes, she is a Choc Lab........I can see why you love them! Yuk yuk. Her name is Hannah, better known as Hannie Wan. Don't ask me where that came from but that's what I call her.

The flea spray recipe is now in Everything Else. Just posted. I have to make more today but I've had pretty good luck w/it. Sometimes in the summer if we are having an exceptionally bad flea month, I will put the drops on much as I hate to........but I can't stand to watch her scratch. Plus that, they get on me & that makes me mighty unhappy.

My friend, Janice, is the one who is the humommie to Vicki & why I started this thread in the first place. Never realized what a great group of people are here........but I know now........:D

I will continue to pass on info to her & as soon as there is any additional info on Vicki's condition, will post.

Thanks again to all of you.......

Janice called me because she got the results of the latest test. She gave me two numbers: flat 1.7 & post 2.6........the numbers are right but I wasn't sure if she did say flat & post. You already know that this is like another language to me!

Was also very surprised that she could go from 17 down to 1 or 2 in such a short period of time. Is that the norm????

She said the cal cutis doesn't appear to be spreading any more but it still looks really bad. Vet said he was going to order DMSO (I think that's what she said) to be applied topically. Again, foreign language.

I hope my dog never gets Cushings but if she does, I know where to go for help!!!!!!!!!

So that's where things stand for Vicki as of Friday.........

Thanks again for all of your input. Appreciate it.:D

Some links on DSMO for you and Janice -

DSMO info

http://www.dmso.org/

http://www.dmso.org/articles/information/muir.htm

http://www.herpes-coldsores.com/dmso.pdf

http://www.bevanpotter.com/DMSO_bp.html

http://www.ncbi.nlm.nih.gov/pubmed/1124535

http://curezone.com/forums/am.asp?i=1249191

http://books.google.com/books?id=CvH...0cutis&f=false

http://books.google.com/books?id=x6c...0cutis&f=false

http://www.itchnot.com/images/_7_Endocrine_Alopecia.pdf

Thanks for all those links. I did try to get info for her because she doesn't know much about it either but I really couldn't find anything worthwhile.

Will check those links. She was most interested in how it's used, if there are any side effects........that kind of stuff.

Hope vet will instruct her in its use......:confused:

Quote:

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Originally Posted by 4Vicki

J
Was also very surprised that she could go from 17 down to 1 or 2 in such a short period of time. Is that the norm????

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We have seen many dog's cortisol get lowered significantly in a short amount of time. Could you remind us of the dosage of Vetoryl your friend's dog is on and the dog's weight?

Many dogs have had their cortisol drop even lower while on the same dosage, so please ask your friend to keep a watchful eye out for any adverse reactions of low cortisol.

You're such a special person and a very good friend to be helping your friend like this.

Quote:

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Originally Posted by Harley PoMMom

You're such a special person and a very good friend to be helping your friend like this.

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Thank you for saying that. You are too kind........

Vicki is on 40 mg once a day.........she's a Boston Terrier & off hand I don't know how much she weighs. I can find out if you need that info. She's not fat or underweight, I think she's at a perfect weight for her size if that helps........but I also haven't seen her since all this has happened to her.

What are the "adverse reactions" of low cortisol so I can tell her?

Thanks again for all the great tips.

The initial starting dose of Vetoryl/Trilostane is based on the dog's weight. UC-Davis recommends a starting dose of Vetoryl/Trilostane at 1mg per kg of a dog's weight. Dr. Tim Allen, who was a vet tech from Dechra's Kansas office, verbally was recommending a starting dose of Vetoryl at 1mg per pound. If you could find out your friend's dog weight that would really help us.

Adverse reactions are, but not limited to: lethargy, vomiting, diarrhea, loss of appetite, and/or a dog just not acting like him/herself. If any adverse reactions are seen, the Vetoryl/Trilostane should be stopped and an ACTH stimulation test and the checking of the electrolytes should be performed.

I just called Janice: 20 lbs. That's what I thought but I wasn't sure so I didn't want to give you incorrect info.

If this is the case (not sure if it's 1 mg per kg or lb), sounds to me like 40 mg is kind of a high dose.........ya think? I will have to give her info on low cortisol because she may just have that problem, esp if this is too much for her.

I don't want to scare her but if this dosage is too high, I will print out the info on low cortisol so she can watch for that. This is why I wish she'd go to a specialist but they are expensive around here.......

Quote:

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Originally Posted by 4Vicki

Vicki has been on Vetoryl for approx a month, a higher dose was just prescribed about a week & a half ago (she wasn't sure what the dose is). The ACDH was 17.1, it was the liver enzymes that were high, not kidney (sorry), she had a skin biopsy to confirm the cal cutis, ultrasound of the liver & adrenal & that particular vet said everything looked ok.

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You posted your reply above on 1-27, so it sounds as though Vicki was on a lower dose for about 2 1/2 weeks, and was then increased to this higher dose of 40 mg. which she has been taking for 3-4 weeks? Does that sound about right? If so, a post-ACTH result of 2.7 sounds like a good result -- right in the middle of the desired ideal therapeutic range between 1.45 - 5.4 ug/dl. And if she has already been on this higher dose for nearly a month, it is more likely that this is a good dose for her to remain on -- assuming she is behaving normally with none of those problems that Lori spoke about.

It is true that the Dechra technical reps have recommended an initial starting formula of approx. 1 mg. per pound. But that is just a starting point and dogs of any size can end up needing to be dosed with higher or lower amounts. The "proof of the pudding" is really the ACTH monitoring testing and the manner in which the dog is behaving. So from what you've told us, it sounds as though there was a reason why Vicki's initial dose was increased (maybe that's when the ACTH was approx. 17? -- if so, that's too high for a Cushpup being treated with trilostane), and that the 40 mg. dose has now lowered her cortisol into the desired range. And what with the calcinosis cutis, I'm guessing her vet was anxious to lower her cortisol as rapidly as was safely possible.

Lori is right that dogs can continue to require dosing changes throughout the time they remain on trilostane. So it will be important for your friend to always mention any physical or behavioral changes to the vet. But from what you've told us so far, it sounds as though this is curently a good dose for Vicki. :)

Marianne