My Pug Scoop (Precious Scoop has passed... )

[scoora]

Hi everyone,
I have been reading some posts on here for a couple of weeks. Seems like a great place with wonderful people. I don't have much time right now to get into details. I just wanted to get started. I feel so helpless and frustrated. I cry so much. My heart is breaking for my Scoop. He's had diabetes for 2 years and was diagnosed on 9/20 with Cushing's. Although we thought that might be the case a couple of months ago. Things started in July with infections in both ears and both eyes. Then came Vestibular disease, he still has the head tilt. He had an ulcerated ear. So much, it makes my head spin. Scoop will be 12 on 10/7. Last week he weighed 18.8lb. He was holding steady between 21 and 22lb since he started with diabetes until a couple of months ago. So he has lost weight, not typical of Cushing's. Vet says could be all the muscle wasting, which looks like a lot on him or another problem. I wish they could find out for sure. I have been so upset lately. It's so hard to see how much he has changed in a couple of months. The Vet says well he is an old dog and the diabetes might have just worn him down and the Cushing's hit hard. The Vets keep telling me to prepare myself. Scoop started 20mg Vetoryl last Thursday. I'm hoping it will help but I might be asking for a miracle. I was wondering if others have experience with diabetes and Cushing's? The Vet said it is hard to control both. Thanks everyone for listening. I'll be checking back tonight.
Vicki

[Steph n' Ella]

Yes...there are a few here who are managing Cushings and diabetes. There is a sister forum to this one that deals with just diabetes.

Hopefully you have copies of all of lil Scoop's blood work and tests. Post them here ASAP. Cushings is very often misdiagnosed with false positives. If the diabetes was uncontolled during testing for Cushings, that result is probably not a good one to go on.

Hopefully you have been keeping a close eye on Scoop! Did your vet give you any prednisone incase his cortisol drops too low? Did he/she tell you want to watch out for?

Glad you are here and can't wait for more details on Scoop! Love that name!

[Squirt's Mom]

Yes, if you are not a member already, please do register at k9diabetes.com. They are our sister site and the experts on diabetes.

http://www.k9diabetes.com/forum

I'm glad you found us and am sure our members who are dealing with both conditions will be along soon to share with you.

Welcome to you and Scoop!
Hugs,
Leslie and the gang

[molly muffin]

Hello and welcome from me too. Absolutely recommend joining the k9diabestes forum mentioned. They are very well versed in dealing with the diabetes/cushings mixture. It is good to be a part of both.
All those things going on, it is possible that the cortisol would be high as a result of those. What other symptoms have you seen of cushings? Was an LDDS test done also?
Poor little thing. It is so hard to see them lose weight and not be themselves.
We are practically the owners of the Kleenex brand around here by now. So very well versed in tears and share them freely. If you hurt, we hurt. It is that simple.
So when you have time, lets get some test results posted showing the abnormals and talk about the cushings. Also what kind of BG numbers are you seeing. Is the diabetes under control?

Hang in there!
Sharlene and Molly muffin

[scoora]

Hi and thanks to everyone for the welcome.
Steph n' Ella-my daughter picked the name Scoop. Scoop is a fawn Pug. I also have a black Pug. His name is Raleigh. He is 3 years younger than Scoop.
Yes, I have been watching him, like a hawk. I do have prednisone and the vet did say what to watch for. I have been asking her lots of questions.
I will definitely check out the diabetes site. Scoop's diabetes have not been much trouble the past 2 years. He's done well till this July. He had surgery Aug 2011 to remove some lumps. He has had mast cell tumors in the past. After the surgery the hair on his chest never grew back. On his side and leg the hair grew back but not totally. You can still see where he was shaved. He has had what the vet calls a rats tail for a year or two. He also has hair missing at the top of his back and the skin is dark there. His ALK PHOS levels have been going up the last couple of years. This July it was 1712. A couple of years ago the vet did UCCR test because of his levels going up but was neg. He had the LDDS test done 9/20/12. The vet then did an ultra sound. I asked her if she was sure he has Cushing's. She said yes. He had a BG curve done on 8/30 so that was before he had the Cushing's test. The vet said she was happy with it. He is having an ACTH done on Monday and the vet wants to spot check his BG. He has the excessive drinking and urinating, couple of accidents in the house, and all he wants to do is eat. I have the results from his blood work in July. There are quite a few out of range. I will post tomorrow night when I have more time.The LDDS results were:
Pre Dex 12.1 Ref range 1.0-6.0 ug/dl
Post 4 HR DEX 8.7 Ref range less than 1.5 ug/dl
Post 8 HR DEX 11.1 Ref range less than 1.5 ug/dl
Further testing required to differentiate adrenal tumor from pituitary-dependent hyperadrenocorticism.
On the ultrasound his liver is enlarged and both his adrenal glands are enlarged but normal shape. L adrenal 30x10mm R adrenal 23x12mm
His liver has a spot of some kind but she said she didn't know what it was unless a biopsy is done. I will get the blood test results posted tomorrow night. Got to get to bed. Thanks everyone for all your help and concern and especially the love.

[scoora]

Hi-I have Scoop's blood test results. They are from 7/17/12. These are the ones that are high or low.

Test- Result, Reference Range

ALK. PHOSPHATASE - 1712, 10-150 U/L
ALT(SGPT) - 392, 5-107 U/L
AST(SGOT) - 64, 5-55 U/L
GGT- 21, 0-14 U/L
AMYLASE- 424, 450-1240 U/L
CHOLESTEROL- 513, 112-328 mg/dl
GLUCOSE- 190, 60-125 mg/dl
CHLORIDE- 101, 105-115 mEq/L
ANION GAP- 27, 12-24 mEq/L
T4- 0.5, 1.0-4.0 ug/dl
HGB- 19.1, 12-18 g/dl
HCT- 57.3, 37-55%


Thank you.
Vicki

[Steph n' Ella]

Well...what really sticks out to me is the T-4. That measures thryroid function. At .5, Scoop is hypothyroid. Hypothyroidism (low thyroid) is comon in dogs with Cushings. It is also one of the endocrine disorders that can give you a false positive on a LDDS test and other Cushings testing. There is a very simple solution for hypothyroidism and this is synthetic replacement hormones that are readily available and cheap.

I would talk to your vet and request a test called a "Free T-4." This is a blood test that will tell you more information about your Scoop's thyroid hormone levels. These results can tell you and your vet if the low thyroid is primary or secondary because of Cushings. After the test, hopefully your vet will perscribe Scoop some thyroid medicine. My Ella is on Soloxine.

A rule of thumb is .01 mg of hormone per pound 2 times a day. For example Ella is 29 pounds and she is on .25 mg of soloxine 2 times a day. The first vet that I worked with didn't do the calculation and put her on .5 mg and that threw her to the other end of the scale into a hyperthyroid state!

Once on the synthetic hormones, my Ella perked up right away. Before treatment, she was very lethargic, had very oily/waxy skin, and hair loss. Hopefully Scoop's issues are all related to thyroid problems (oh and the diabetes) and he will improve quickly! AND NO Cushings!

[scoora]

Steph n' Ella-I wish that were the case. The vet and I did talk about a test for the low t4 but she thinks the low results are caused from the Cushing's. She said if I want she would do the test but she would rather wait and do a repeat of all the bloodwork once he's been on the Vetoryl for a while. I wish it would be something simpler than Cushing's. There is a connection between hypothyroidism and Vestibular disease and since Scoop still has the head tilt from when he had it I thought maybe it was that. The vet doesn't think so. The vet is going to do a test that will show if he has a ruptured eardrum. That could be causing the head tilt. The poor little guy has trouble keeping his balance. I don't know if it's the arthritis in his front legs, the head tilt, he's losing his sight from cataracts, the muscle wasting or all the above.
Thanks for the suggestion. They are always appreciated.

Vicki

[Squirt's Mom]

ALK. PHOSPHATASE - 1712, 10-150 U/L
ALT(SGPT) - 392, 5-107 U/L
AST(SGOT) - 64, 5-55 U/L
GGT- 21, 0-14 U/L

GLUCOSE- 190, 60-125 mg/dl

Mornin,

What I see are the liver values - the ALK, ALT, AST, and GGT - are ALL elevated. To me that is a clear sign the liver needs to be more closely looked at to be sure there is no primary hepatic disease going on before starting treatment. IF she does have liver disease, this could skew the tests causing false positive and Trilostane (Vetoryl) is not recommended for pups with liver disease so you want to know before you are given Trilo (Vetoryl).

I also see elevated glucose. Did your vet do a urine check to verify this is not diabetes rearing its head?

I really, really, really, really wish I, or someone else here, could explain these results but I don't have the knowledge.

How is Scoop doing this morning?

Hugs,
Leslie and the gang

[scoora]

Hi Leslie and the gang,
Thanks for asking how Scoop is doing today. He had a pretty good day today considering all his problems. Today is Scoop's birthday. "Happy Birthday to my Scoop". He turned 12 today. He had a little something special today and he enjoyed it very much.
I'll have to bring the liver levels up to the vet. You would think she would know about that about the liver. She also saw a spot on his liver when she did the ultra sound.
Scoop has been on Vetoryl for 10 days.
Scoop has had diabetes for 2 years.
My "baby doll" sure has his share of health problems.
Thanks for all your concern.
Vicki