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

  1. #21
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    For dogs receiving treatment with Vetoryl/Trilostane the reference ranges are 1.5 ug/dl - 5.4 ug/dl and that post number can go as high as 9.1 ug/dl if symptoms are controlled. Those other reference ranges that you posted (2-6 for pre and 6-18 for post) are for a dog that is NOT on treatment with Vetoryl/Trilostane, I know it can get confusing.

    Daisy's ACTH stim results are great and the vet's decision not to raise Daisy's Vetoryl/Trilostane dose at this time is in accordance with what many cush savvy vets are doing, which is also great!

    Regarding her chemistry blood panel the GLU (glucose) can be transiently elevated from the Vetoryl but should normalize so you may want to keep an eye on that because diabetes is common in dogs with Cushing's. Another thing that concerns me is the increased GGT and ALT, both of these are liver enzymes and usually are only slightly elevated which warrants monitoring too. I'm not sure what TCHO is hopefully someone else will know. How are her symptoms?

    You're doing a wonderful job!

    Hugs, Lori

  2. #22
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    Quote Originally Posted by Harley PoMMom View Post
    For dogs receiving treatment with Vetoryl/Trilostane the reference ranges are 1.5 ug/dl - 5.4 ug/dl and that post number can go as high as 9.1 ug/dl if symptoms are controlled. Those other reference ranges that you posted (2-6 for pre and 6-18 for post) are for a dog that is NOT on treatment with Vetoryl/Trilostane, I know it can get confusing. Daisy's ACTH stim results are great and the vet's decision not to raise Daisy's Vetoryl/Trilostane dose at this time is in accordance with what many cush savvy vets are doing, which is also great! Regarding her chemistry blood panel the GLU (glucose) can be transiently elevated from the Vetoryl but should normalize so you may want to keep an eye on that because diabetes is common in dogs with Cushing's. Another thing that concerns me is the increased GGT and ALT, both of these are liver enzymes and usually are only slightly elevated which warrants monitoring too. I'm not sure what TCHO is hopefully someone else will know. How are her symptoms? You're doing a wonderful job! Hugs, Lori
    Thanks Lori. I looked it up, TCHO is cholesterol. My vets in-house blood panel results were harder to follow than the original one from the lab. Liver enzymes are still high but they are down significantly from our first blood test about a month ago so we will continue to monitor that.

    The symptoms have mostly resolved, ya'll were right day 10 was the magic number. She is drinking normally and appetite level has mostly gone back to normal, for a lab lol! No more pee accidents. The biggest improvement has been in her overall mood, she is back to her happy playful self and has more energy to fetch. Agility is still on the back burner for now but we are hoping to get her into the pool for some swimming.

    As soon as I got the results for the ATCH test I checked the Dechra insert and noticed the reference ranges are different. The vet told us she was very close to where we want her at so he didn't want to increase and I think that's the right call based on the progress we've made in a short time.
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  3. #23
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    That is excellent that you are seeing really good results on the 10mg. Sometimes you just have to tweak it a little bit and Wa La.

    So good to hear to this report
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  4. #24
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    I apologize in advance for the long update!

    Daisy had a strange episode on Thursday night. Around 2 AM she hopped on our bed and started panting heavily and digging the sheets like she does during a thunderstorm. There was no storm but we thought maybe she was trying to tell us she needed to go out. We walked her downstairs but she refused to go out the door. Came back upstairs and she stood in the corner and wouldn't move or respond to her name being called. I got down on the floor with her and she became responsive again. She laid down and calmed down. A few minutes later I walked her down again, this time she went out like normal, peed and ate a treat. First available at the vet was the last appointment on Saturday.

    The vet was concerned about an Addisonian Crisis so he did another blood test and sodium/potassium levels were perfect so that was ruled out. The test also showed that the elevated liver enzymes have dropped a little further. So that was a good thing. I forgot to get a copy but I'll post those values this week.

    My husband has been complaining that Daisy still pants a lot and breathes loudly (like snorting sounds). So we are doing a chest x-ray on Tuesday.

    Daisy also had a little patch on her leg where the hair literally got ripped out. We pointed that out to the vet and he said the thin skin is common with Cushings and gave us an ointment for it.

    Lastly, while we were in the waiting room we noticed a ridge going down Daisy's back where the hair won't lay flat. When we lifted the hair we noticed red irritation. The vet said it could be CC but he wasn't exactly sure because he's only seen it in the later stages when its really bad and more crusty than what he was seeing on Daisy's back. He gave us a hypoallergenic shampoo to bathe her with twice a week and we're just going to keep monitoring it. Also, no topical flea and tick medications for the time being. We normally bathe Daisy about four times a year so this should be fun! :roll eyes:
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  5. #25
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Daisy's odd behavior could have been caused by a partial complex seizure. There are a lot of different seizures but this type is a bit different as symptoms can look just like a dog who suffers from anxiety from loud noises. Hopefully it's a one off episode and you'll never see it again but you may want to mention it to your vet. One of my cushdogs had infrequent petit mal seizures that were hard to watch.

    The results of Daisy's first stim test were very good and I suspect those numbers will drift downward before the next stim test is scheduled. That is a very good thing because if Daisy does have calcinosis cutis, you want to get the pre and post stimulated cortisol below 5 ug/dL. I've seen calcinosis cutis on side view xrays in veterinary textbooks so if your vet is doing chest xrays, it may show up on imaging, but not sure as Daisy will be on her back.

    Until I adopted my current furkid who weighs 55 pounds, I've always had tiny dogs who I could bath in a sink. I'm praying that I never have to give frequent baths for skin issues. I sincerely feel for you.

    Glynda

  6. #26
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    Seizure instantly came to mind during the episode but I guess the vet didn't think it was. I'll ask about it when we go back.

    If the skin irritation turns out to be calcinosis will the baths even help? I did the first bath last night and will probably give her another one on Wednesday or Thursday.
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  7. #27
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Quote Originally Posted by arentspowell View Post
    If the skin irritation turns out to be calcinosis will the baths even help? I did the first bath last night and will probably give her another one on Wednesday or Thursday.
    If Daisy has calcinosis cutis (CC), the baths may ease any discomfort and will keep the areas clean but it will not heal it. It will likely continue to break through the skin and get a lot worse before it gets better. It is a rare symptom of cushing's that is very difficult to resolve. Getting cortisol down is the only thing that will help and even that is not a 100% guarantee that it will resolve completely. However, most members have seen much improvement with treatment. I think your vet gave you the shampoo in the hopes that the problem is an allergic irritation and I'm keeping fingers crossed that he's right.

    I am hoping that Renee, our resident CC expert, will drop by and share her extensive experience with you. She knows what the onset of CC looks like. I'll send her message with a link to your thread. In the meantime, I've provided a link to one member's thread whose dog had CC. There are a links to other threads and pictures, including Renee's that may help you identify CC.

    http://www.k9cushings.com/forum/showthread.php?t=6093

    Glynda

  8. #28
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Hi there!

    Popping in to talk about the dreaded CC.

    Without seeing pictures, I cannot say if your girl does or does not have CC, but your description sounds about right, and the area you describe is also consistent with where it usually occurs.

    The good thing is that you've already brought Daisy's cortisol down, so any new formations of CC should get nipped in the bud.

    If your vet has a high resolution x-ray machine, it may pick up imaging of the CC along her spine, depending. My girl has had a CT and x-rays, and in all of them, the CC can be visualized.

    As far as how bad your girl's CC may get, I just don't know. We've had other members here that seemed to 'catch it early' and get just a mild case, while other cases get a lot worse. I would like to think that if you have just one lesion and you've already brought her cortisol down, you shouldn't get the worst of it. But, it does get worse before getting better. The CC has to work it's way out, then the new skin underneath can come through.

    Are you able to take pictures and post them?
    Reneé
    Mom to Tobey, Ichiro & Skeeter. Foster mom for Polar Pug Rescue


    “Animals have done us no harm and they have no power of resistance…there is something so very dreadful…in tormenting those who have never harmed us, who cannot defend themselves, who are utterly in our power.”—Cardinal John Henry Newman

  9. #29
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    It's a little tough to see but it's all along this back ridge where the hair won't sit flat and it looks like her undercoat has actually fallen out in this area.









    It's worse in some areas, particularly near her butt. There were some small white lumps in that area too You can't really see them in the picture though
    Ashley, Daisy (yellow lab), Lily (mini dachshund), Thor (black lab)

  10. #30
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    Default Re: Daisy - 6yo labrador diagnosed with Cushings

    Hmm, it looks sort of like the very beginning of what could be cc, before they turn red or crusty or anything like that but I'm certainly no expert on it. I'll leave that to Renee who has seen it Way too often.

    Did they do any kind of scraping to send to dermatology or anything?
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

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