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Thread: Daisy - 6yo labrador diagnosed with Cushings (Daisy has passed )

  1. #11
    Join Date
    May 2016
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    170

    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    I am a fairly new member, only my own experience to share. Read my thread, my young boxer got this out of the blue. A healthy, happy, sweetie pie. I give her a few things that have helped with her weight, it is maintaining, despite everything.
    Good luck to you, go by your gut extinct. Listen to it and don't second guess yourself.
    This forum has wonderful members who have a wealth of information about this disease.

  2. #12
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    Jun 2016
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Our regular vet was concerned about the liver values so the ultrasound orders to the specialist vet included instructions to check the liver.
    My husband asked specifically about the liver at the ultrasound appointment and the specialist told him it looked normal but that she did have a gallstone.

    The report says:
    "A stone was noticed within the gallbladder incidentally during the ultrasound today. There is a future risk for biliary obstruction which could require surgical intervention. Please monitor Daisy Mae for vomiting, diarrhea, lethargy, inappetence, and yellowing of skin/eyes/gums, as they could all be signs that this stone has become a problem. No specific medical interventions are required at this time."

    I wasn't aware until now that the elevate liver is not related to the Cushings. Thank you so much for bringing that to my attention. I will continue to press about the liver values with our vet.

  3. #13
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    Jun 2016
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Quote Originally Posted by Aunt Jana View Post
    I am a fairly new member, only my own experience to share. Read my thread, my young boxer got this out of the blue. A healthy, happy, sweetie pie. I give her a few things that have helped with her weight, it is maintaining, despite everything.
    Good luck to you, go by your gut extinct. Listen to it and don't second guess yourself.
    This forum has wonderful members who have a wealth of information about this disease.
    I read through your thread and my heart is breaking for you and Bubbs. I'll keep your girl in my thoughts.

  4. #14
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    Apr 2008
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    Tennessee
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    It sounds as though the radiologist didn't express much concern with the gallstone but I do know they can cause bile duct obstruction which is why I asked about the gall bladder. Anything that causes bile duct obstructions can cause some pretty high elevations in ALT as well as GGT. It is very rare that a dog with cushing's has a normal liver on imaging. The liver is usually enlarged and has distinct changes (hyperechoic) caused by the glycogen accumulation that occurs as a direct result of cushing's. Can you check the ultrasound comments to see if the liver truly is completely normal? If Daisy were my dog, I would want to have her liver values checked in three to four weeks to see if they have dropped. If they haven't, I'd ask the vet to do a bile acid test. I just can't help but wonder if there is more going on with Daisy because a more than six fold increase in ALT and a completely normal liver are definitely not common in a cushingoid dog.

  5. #15
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    Jun 2016
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    My husband has been the one going to all the appointments since our vet is right across the street from where he works and he brings Daisy and our other dog Lily with him to work everyday. I think I'm starting to drive him crazy asking him all these questions! He said the paper I quoted above is the only one he got from the specialist and he believes thats all that was forwarded to our regular vet who is directing the treatment. He said he also specifically asked about the liver during the specialist consult and they told him it looked fine, that it wasn't "shriveled up" like a damaged liver would be.

    The numbers are really high though so he understands why I keep asking about it over and over. The ATCH re-check is on a Friday and I get off early that day so he said we can go together and express all our concerns and get a new blood panel done to make sure everything is ok.
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  6. #16
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    Jun 2016
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    4 days into treatment. I was really hoping that the pee accidents would subside There was a huge pee spot on the bed when I went to go to sleep. Had to wash everything - duvet, sheets, and mattress cover. Didn't get any sleep until 2 am when the sheet and mattress cover were finally dry. We never saw her do it and we keep the door to the bedroom closed while we aren't home. Is it possible she peed while laying down on our bed?
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  7. #17
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Thank you for responding. With respect to my comments about the liver, I am aware that dogs with primary liver disease have smaller livers on imaging as the liver cells are dying. However, dogs with cushing's have enlarged livers and it is rare that a cushdog's liver on an ultrasound is normal in size or structure. I apologize if your husband was annoyed that you were asking so many questions. When I first arrived on the scene on this fabulous forum, I learned a great deal about the disease by answering questions from experienced members, some of whom I believe could teach gp vets a thing or two. I thought I was a great advocate for my dog but I discovered rather quickly that I was woefully inadequate. It is not my intention to second guess your vet or you. My intention is to put everything about Daisy's medical history on the table so we all can provide you with more meaningful feedback, appropriate reference material or simply share our own experiences that may mirror your own.

    With respect to Daisy's pee accident on your bed, it is quite possible that she peed in her sleep. Dogs with cushing's whose symptoms include voluminous intake of water and peeing lakes aren't concentrating their urine so a once housebroken dog can start to have accidents, including peeing in their bed and yours. Can you remind me again how much Daisy weighs and what dose of Vetoryl (trilostane) is she getting and is it once a day or twice a day? Treatment can drop cortisol rather quickly and if Daisy is on an appropriate dose, you should start to see improvements in her drinking and peeing soon. However, a small number of dogs can take longer to see resolution of those issues depending on how long they've not been concentrating their urine. If you don't start to see improvements within a week to 10 days, the dose may be too low. The acth stimulation test done at 14 days will tell the tale.

    Reminder: Always give Vetoryl with food, including the day of the acth stimulation test. Makes sure you have Daisy to the vet's office within 3 to 5 hours of the morning dose. Stick to the same routine with every acth stimulation test so that your vet will be comparing apples to apples.

  8. #18
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    It's very much appreciated! I was feeling overwhelmed and hopeless when we first got the diagnosis but the wealth of information and comments from members has been awesome and very helpful to me.

    I think my vet was also concerned about the liver values but it hasn't been brought up again after the ultrasound. In fairness to him we haven't had another office visit with our regular vet since the ATCH test. After the ultrasound with the specialist we have spoken to our vet over the phone a few times to discuss treatment, it was then ordered and we picked it up. We go back in 10 days for the ATCH test. I feed the dogs at 7:30 and we will probably drop her off at the vet around 9:30. I will make sure to tell the the precise time the dose was administered for accuracy. I'll bring up the liver values when we meet with the vet. It's really easy for us to just pop over there to do another blood draw if they want her fasted for it.

    At her last weigh in about a month ago Daisy weighed 65 lbs. This is the heaviest she's ever been but she looks very thin in the rear due to the muscle waste. From the front she looks ok, ribs are easily felt but not showing. We are giving her a 60mg dose of Vetoryl. It's only been four days and no side effects so far.

    I'm not really sure how long she hasn't been concentrating her urine. The first ever accident she had was probably 6 months ago and never happened again. It was a one off thing so we didn't stress about. She's always peed 2x every outing since she was a puppy so we didn't think much of it when 2x turned into 3-4 times as if she was marking. We noticed the increased water drinking about a month ago. My in laws brought it to our attention. Around the same time she had two accidents in the house. Both times she panted heavily for a few minutes then squatted to pee on the rug. That's when we knew something just wasn't right. She's normally very good about letting us know. We have bells at the front door that she rings. Ever since the diagnosis we've been taking her out constantly. During the day she is very good at letting us know that's what made me think maybe she peed without realizing it. It happened the other day on an area rug and I never saw her squat. I suspect that it's probably been longer than we realize that she hasn't been concentrating.
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  9. #19
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    Jun 2012
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    Canada
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Day 4 is still a army days. Sometimes it takes a bit longer than that to see results. I usually say around day 10 but that isn't a given, just a generalization I have noticed. Mao hang in there and hopefully the peeing accidents will get better.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  10. #20
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    Jun 2016
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    I have the results back from our 14 day follow up
    Pre - 6.5 ug/DL
    Post - 6.6 ug/DL

    The reference range from the lab says 2-6 for pre and 6-18 for post. We are right on the cusp for pre and the vet is pleased with how Daisy is responding to the Vetoryl so he doesn't want to change anything just yet. We are continuing on the 60mg dose for another 30 days and then we'll see where we are at when we retest. Just to clarify this is still the starting dose of 1mg per lb.

    He also did an in-house blood panel. I am not super familiar with what all the things mean but here are the values that showed up outside of normal. Reference is in parenthesis.

    GLU - 129 mg/dl (75-125)
    TCHO - 403 mg/dl (120-310)
    GGT - 121 u/l (0-14)
    ALT - 467 u/l (0-120)
    K - 3.7 (3.8-5.3)
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

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