Tyson has passed; Approx 10yr old Pit, with many problems Cushings related..

[TysonsHuman]

In an attempt to stimulate his appetite she has prescribed today "Mirtazapine" 1/15mg a day. And he is currently eating Science Diet Z/D since last week. There has been not much change in his desire to eat with the change in the diet, so maybe the stimulant will help. She would like to do biopsies on his intestinal tract and any other areas that she feels would be appropriate to try to definitively investigate the GI issues and to rule out cancer. But at this point I really don't think he has cancer as I feel his decline would be a lot worse over these many months. Also the cost is prohibitive right now, approximately 3,000, and I have spent in the last 2 months over 4,000 on his eyes and all this blood work and Xrays & Ultrasound. With still more to go on his eyes. So this will be on the back burner for awhile. She still does not want to restart the Vetoryl until his eating situation improves.

[TysonsHuman]

These, I believe, are results from the last cortisol testing done on Tyson while he was still on the Vetoryl

511312017 00:32:49
Test Results Reference Range Low Normal High
CORTISOL 1 1.7 ug/dL 1.0 - 5.0 I
CORTISOL 2 3.6 ug/dl L 8.0 - 17.0 l

Lab Comments: Ascn: ORA802944184 Profile: CortisolSerial2 (ACTH) RE: 5032 Tube Labeled Pre RE: 5034
Tube Labeled Post
CORTISOL 2:
HYPERADRENOCORTICISM (HAC): Post ACTH results greater than 20 ug/dl
(dog) and greater than 15 ug/dl (cat) are consistent with HAC.

[WinstonTheWestie]

Hello there! I will let the others more knowledgeable about managing Cushings continue to help you out, but wanted to let you know I'm following along and hoping for the best with Tyson. My own dog had an adrenal tumor and we were worried about Cushings (that's how I ended up here, but we now know Winston didn't have Cushings), but he also has inflammatory bowel disease we've been managing for 20 months. My dog was on a different prescription diet than Tyson (Winston gets Royal Canin hydrolyzed food), but my dog's IBD signs (chronic vomiting) have completely resolved with the diet change. It only took a couple weeks on the diet to stop his signs. That isn't always the case, but I'm hoping the diet change works for Tyson too. We just tried treating Winston for a long time and I only very recently did the biopsies to confirm what we suspected for over a year. The only reason we even did them was because he was having surgery already to remove his adrenal gland. I can maybe answer a few questions about IBD if you have them, and I'll let these wonderful ladies continue with the Cushings advice.

[labblab]

These, I believe, are results from the last cortisol testing done on Tyson while he was still on the Vetoryl

511312017 00:32:49
Test Results Reference Range Low Normal High
CORTISOL 1 1.7 ug/dL 1.0 - 5.0 I
CORTISOL 2 3.6 ug/dl L 8.0 - 17.0 l

Lab Comments: Ascn: ORA802944184 Profile: CortisolSerial2 (ACTH) RE: 5032 Tube Labeled Pre RE: 5034
Tube Labeled Post
CORTISOL 2:
HYPERADRENOCORTICISM (HAC): Post ACTH results greater than 20 ug/dl
(dog) and greater than 15 ug/dl (cat) are consistent with HAC.

I'm so glad Kellie has stopped by to offer her support and information about the treatment of the inflammatory bowel issues!

Also, wanted to let you know that Tyson's monitoring ACTH results were indeed ideal for a dog being treated with a Vetoryl. So as I suspected after reading your vet's overall treatment plan summary, she seems to be capably "on top" of things, and that is very good in such a complicated situation.

Marianne

[TysonsHuman]

Thanks Kellie for the info. Actually the dog food you are giving your dog was one that was also recommended for mine as well. She left it up to me to decide which one I wanted to use. I am certainly glad Winston does NOT have Cushings, it is a very difficult issue to deal with in many cases. But I was wondering if Winston was suffering from loss of appetite before you started treating him, or was he just suffering from the issues you described, such as the vomiting? And thanks for the well wishes and i wish the same for Winston as well.

[TysonsHuman]

Yes Marianne, one of the really distressing and frustrating things for me was the fact that Tyson was doing real well with controlling the Cushings, except for the excessive drinking and urination. Then all of a sudden a number of months ago this sudden downturn of his overall condition. It was like he aged 10 years in a matter of a week. Then he just stopped eating and lost weight rapidly as well as strength and his ability to walk. But hopefully my vet can put it all together along with any suggestions ya'll can come up with to turn him around. PAWS CROSSED. So thanks for all your input, it's much appreciated.

[WinstonTheWestie]

Winston's main issue was vomiting. He would vomit between 4 and 6 am the majority of mornings for at least 2 years. My vet thought it was "bilious vomiting syndrome" when dogs vomit in early mornings because the bile in their empty stomach is irritating. It worsened to be several times a day, at all hours of day for a couple weeks before we went to see the IMS and she said we were likely wrong about bilious vomiting syndrome and it was likely IBD. There were a few times when he did not want to eat, but for the most part he doesn't have the loss of appetite you describe in Tyson. In hindsight, I was feeding Winston "human food" off my plate in the evenings and that is what made him vomit...when I shared!

With IBD, all dogs are different, from what I've been told. Some vomit, some have diarrhea, some have both. I'm hoping that as the food starts to take effect with Tyson, his intestines will "calm down" and he will then want to eat. I'm sure they told you, but it is really important that he not get ANYTHING else to eat but the special food (once he is fully transitioned onto it over a week or two like the vet recommended). That includes any treats or flavored medications. Even medications like Rimadyl can sometimes contain beef flavoring and be enough to 'set off' a flare of IBD.

Your vet's recommendations sound fairly similar to what was discussed for us. It can be really hard to tell for sure whether it is IBD or intestinal lymphoma because the symptoms are so similar. Since Winston was eating we did things a little more 'stepwise' is the only difference. We dewormed to be safe, gave a monthly B12 shot, and switched diets first, then the plan was to start the antibiotics (Tylan), ideally get biopsies, and maybe start steroids to reduce the inflammation in his gut. Luckily the vomiting stopped after step 1 so I never did anything else (besides research!).

I can imagine how difficult of a case Tyson is where his intestines may need the cortisol/steroids for possible IBD but his Cushing's needs to be treated too. Are you feeding the dry form of the Z/D? I think Z/D comes in cans (with a strange gel-like consistency if I remember right)...maybe Tyson would like the canned food to get him started eating this food? I've warmed canned food up too to entice an appetite, you just need to make sure it's not too hot if you do that. I hope the mirtazapine works for him tonight!

[TysonsHuman]

I started Tyson on the dry Z/D with a slow transition from his other food, as the vet advised. He ate it a few times, then stopped eating it. So today I started with the canned and he seemed to like it. He ate an entire can today and that's a good start. Tyson never had any table food or treats. Always ate Science Diet. In fact I bought today their treats that are compatible to the main food and he seems to like them as well. So my paws are crossed that this good start today continues. But sadly I have learned to be VERY cautious and not get my hopes up to high. And once again thanks for your info and I am so glad that Winston is doing well. Stressful for the dog & stressful for their humans.

[molly muffin]

I just wanted to stop by and say hello to you and Tyson.

That is a good result from when he was on vetroyl and it is likely the high cortisol he has now has contributed to the cc and calcification in his eyes. It can be a nasty bugger and the cortisol needs to be under 5.0ug when on vetroyl to get control of it and it still takes months usually.

It does seem that this is going to be a fine line balancing act getting his cortisol controlled while trying to maintain his appetite and his stomach problems. Not easy for sure. My dog was never a good eater, and it didn't take much for her to decide to not eat during the day. She didn't have IBD though, that makes it all more difficult.

[TysonsHuman]

It's been 3 days now since I switched to the canned form of the Z/D from the dry and I do have good news on that front. Tyson seems to have rediscovered his appetite. He is eating like his old self again. I have been giving him a reduced amount of food, basically just one can, to not stress his delicate system and he is eating it all up and looking for more. He has not eaten like that in many months, since his decline in health and loss of weight became a major problem. If this continues and he can maintain his weight and hopefully put weight on, we will soon be able to start treating his Cushings again. If all goes well with his eating I will start to give him a bit more as his appetite and digestion is able to tolerate it. After many months he finally has an interest in eating again and this is very hopeful and I haven't had much hope for many months, especially since his eye operations. Will keep all posted on his progress and thanks for all the comments and advice. I greatly appreciate the help and advice and will continue to welcome any others that wish to add their thoughts.