adrenal tumor--starting Trilostane--darling Chey passed away

[cheydogger]

Hello everyone. My name is Ro and my dog's name is Cheyenne. Cheyenne is a 13 yr old spayed female, mixed breed (lab, chow, shephard?), 53 lbs. Cheyenne has been going through Cushing's testing for about a month now and we still don't have a definitive diagnosis. As I have read from most of you, I have been devastated....crying, sad, mad, anxiety ridden, constatly on the internet researching this disease. I will give you a little background on Chey's case even though I don't have all of the numbers. I should ask for copies of all of her tests. Cheyenne has mild heart enlargement, thickening of the valves and a murmur for which she started taking Enalapril 1 1/2 weeks ago. I have given her 1000 mg. of fish oil for at least two years and she has been taking Glucosamine/Chondroitin for about 4 months. I feed her EaglePack Senior dog food. I took her in for her yearly in July to which the vet detected a heart murmur. The vet suggested I do a senior panel blood work up and possibly an echo to stage her murmur. I declined at the time because I had just had a miscarriage and was trying to pay for all of that since we didn't have maternity insurance. I also thought they wanted to make more money. Chey has displayed exercise intolerance for at least 6-7 months (I attributed it to her age at first, then the heart murmur) and she quit jumping into bed around that time. After declining the blood work, I started noticing things the vet said to watch out for---excessive water consumption and frequent urination. I also noticed she was eating dirt and had a broken tooth. I took her back to the vet on Oct 12th and that is where it all began. The vet initially said she suspected Cushing's, so the tests began. I will post the numbers I know and remember.

Oct 12th-senior panel blood draw and urinalysis. 3lb weight gain from July visit (53-56lbs)
Results: Alk phos: 2400
Cholesterol and triglycerides: triple
Thyroid: a little low
Urinalysis:dilute

Oct. 22nd-ACTH stim test and abdominal ultrasound. Weight back
down to 53.
Results: ACTH stim test- "very Cushingoid"
Ultrasound:bilateral adrenal enlargement. Right adrenal: 3
cm, left adrenal gland: 1 1/2 cm. Her adrenals are
supposed to be .7. The radiologist report stated a neoplasm
in the right adrenal gland. My vet suspected adrenal
dependant Cushing's, so she ordered chest x-rays and and
an echocardiogram.

Oct. 25th- Chest x-rays and echocardiogram. They were only
going to do the echo if not signs of metastises were
evident.
Results: no obvious sign of chest metastises from x-ray
Echo: mild heart enlargement, thickening of the valves
and definite murmur. Treatment: Enalapril 10mg 1xdaily
Referal to a surgeon.

Oct. 30th- Surgeon consult: He only talked to me for about 5
minutes because he didn't think it was adrenal tumor
related. He suspected Pituitary. He then turned me over
to the internist. She was suspicious of pituitary also, so
she ordered two more tests (LDDST and Endogenous
ACTH.

Nov. 6th- LDDST and Endogenous ACTH
Results: LDDST-According to my vet, if she
was reading the results correctly (she actually said this),
Chey didn't test positive for Cushing's. My vet said she
would have expected a higher reading at 8 hrs. We are
still waiting for the Endogenous ACTH results. I guess it
takes a week. My vet called me to tell me the results of
the LDDST and she was really confused and could only
say she is going back to thinking it is an adrenal tumor.
She put a call into the specialist to discuss the LDDST
results and she may call me today with their combined
thoughts.

What the heck is going on? Thoughts from your experiences? I will add, Chey does not have any noticable hair loss, but she does appear to have a downward slope in the middle of her back. I personally don't notice the pot bellied appearnace though. She has a ravenous appetite, but she always has in my opinion.

[labblab]

Hi Ro!

Welcome to you and Cheyenne. I am so very glad you've found this forum and joined our family. I only have a few minutes right now, so I'm afraid I will have to make this first reply fairly brief. But if I had to bet on it, I'm betting that your vet will find that Cheyenne did indeed test "positive" on the LDDS, and she was initially interpreting the results incorrectly. Everything else about Cheyenne screams Cushing's: lab abnormalities, symptom profile, "positive" ACTH, and adrenal enlargement. So if the LDDS somehow comes back negative, I would actually be distrustful of that result.

Another piece that leads me to suspect that your vet is misinterpreting the results is her statement that she now is back to thinking the issue is adrenal. If the LDDS is negative, it is negative for both types of Cushing's. It is only if the result is positive that the numbers can sometimes point towards pituitary Cushing's.

So we will anxiously await those test results. And in the meantime, please know that you and Cheyenne are now in wonderful company. Our members will be here, right by your side, as you move forward.

Marianne

[cheydogger]

As I sit here and cry, thank you for accepting Chey and me. This has been so hard. I am so glad I found this forum during my many, many hours of researching Canine Cushing's Disease. Thank you again.

[labblab]

Oh you are so welcome. And I know it's hard for you to believe right now, but before long, you'll be posting helpful hints to other new members, too! I know it's impossible for you not to feel very worried and upset right now. But truly, if Cheyenne does have Cushing's, we have SOOOO many treatment success stories to share with you. With proper treatment, it can be amazing how quickly you can see improvement in your dog. And many dogs are then able to go forward and live out their normal lifespans with their Cushing's symptoms under control.

There may still be more tears along the way, but also the smiles that come from knowing you are not alone, and that Cheyenne is getting the treatment she needs!

[Squirt's Mom]

Hi Ro and welcome to you and Cheyenne!

Feels like your world is ending, huh? I remember well. The first time I heard the word it was more of a "huh?" response but when I saw the look in our vet's eyes as she confirmed the diagnosis, my heart stopped. I started crying then and didn't stop for months. All I could think was that my Sweet Bebe was dying. The more I read and the more I heard, the worse it seemed. I felt helpless, hopeless, scared, angry, guilty all the time, day in and day out. I couldn't understand most of what I read or what others told me; it was almost like being dropped into a foreign land in my sleep. Until I stumbled into this group. They gently threw a net over that bug-eyed, frazzle-haired, blabbering, blubbering, drooling old broad and started to teach me with a patience monks are envious of and a gentleness not found in any other group. That was nearly five years ago and my Sweet Bebe, Squirt, is still here doing good for one who will be 15 in Feb.

You and Cheyenne are in the best of hands here. The knowledge available is amazing and wide-reaching, yours for the asking. The first-hand experience goes far beyond what most vets are taught in school - they read about it, we live with it - and are more than happy to share with you. The support found here is unbeatable, pure and simple. You and Cheyenne are no longer alone. You are part of our family now and you will never walk alone again.

I'm glad you found us and look forward to learning more as time goes by. Keep your chin up!
Hugs,
Leslie and the gang

[addy]

Oh, dont cry, it will be okay. Gosh, I cried for months, was in denial for months, what a roller coaster when we first get the news.

Yell and scream if you have to to get it all out. We are very good at supporting melt downs We all have had them so we know how it feels.

It'll be okay. You are not alone anymore. My Zoe was diagosed on her birthday, April 17th, 2010, diagnosis confirmed in June of that same year. We started treatment the following June, 2011. She still has a good quality of life and she has other health issues besides.

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

[labblab]

By the way, I just saw your photos of Chey and I love your avatar.

What a sweetie-pie!!

Marianne

[cheydogger]

Thank you, Marianne. I just love her with all my heart. She is a really good dog.

I didn't hear from the vet today.

[molly muffin]

oh my gosh, she is a cutie! LOL

Hello and Welcome! Tears is one of things that we all know, way to well it seems sometimes. I swear I cried forever over Molly's diagnosis and we're still trying to figure it out. I cry because I read of someone else crying or going through a tough time with this disease. Heck, I cry because something good was posted about one of our furbabies. As everyone has said, there is so much support here. It's really wonderful to be a part of that and know you aren't alone.

It does sound terribly confusing all the results back from Chey's tests. Lets see what the vet says and the specialist. It does sound like cushings, but when it comes to the LDDS, the question is did she suppress under 1 for the full eight hours. Also, you have to be wary of false results, which can be caused by a number of things, either on the yes or no side. Don't worry, the gang here is pretty good at figuring it out.

Definitely get copies of all test results. You're going to want to have your own file to refer back to off and on as you go forward. Plus if anything crops up, where you have to take Chey to an ER, you'll want to have those handy. We've all been through that.

I'm so sorry to hear that you have gone through some tough times yourself. It is very hard worrying about so many things at once. HUGS.

Feel free to jump in with questions or comments, whatever you feel like. Everyone here is really wonderful.
We're all a bit of worry warts though, so be prepared. LOL

hugs,
Sharlene and Molly Muffin

[cheydogger]

Thank you all for your kindness. I look at all of your fur babies and want to give them a big hug. They are all so precious.

I guess my biggest fear is an adrenal carcinoma. I have just been a nervous wreck. The radiologist believes there is a tumor in her right adrenal gland, but there aren't any calcifications or obvious mets to other organs or the vena cava on the ultrasound. The surgeon didn't feel this was the case since both adrenal glands are enlarged. I guess the text book sign of a tumor is one extremely large adrenal gland and one atrophied. On the contrary, why aren't her adrenals symmetrically enlarged as would be consistent with pituitary?

The thing I really miss is her sleeping with me. She has slept with me since I got her at 6 months old. She loved to snuggle. For about the last 5 months or so, she has no interest in sleeping with me. My husband or myself will lift her into bed since she can't jump, but she doesn't stay long. She would rather be on the floor beside the bed. I have even turned the ceiling and floor fans on to keep her cool, but she still gets down. She used to play bite my husband when he would try to get her off the bed when he was ready to get into bed.

Also, watching her creep along on her walks is so sad. She can gallop for a few seconds, then she walks as slow as a snail.

I just feel horrible for letting it get this bad. I should have caught on to the changes in her disposition, etc. much sooner than now. At the least, I should have done her senior panel blood work at her yearly visit in July even though I was going through a tough time. Her last blood panel was in 2009. I also got her shots last year at a clinic, so I doubt she had a thorough exam. I feel like it is my fault she is in this predicament. I am so thankful for every day I still have her here with me because I feel our time is limited at this point.

Sharlene- thank you so much for opening my eyes to the importance of having a file of all her tests and labs. I didn't even think about it like that.

Thank you all. Keep your opinions coming, please