Confused and scared as to go traditional or alternative?

[scully]

I have a 7 year old Pit mix.
I started noticing excessive water drinking and urinating and increased appetite.
Then one evening after walking her she had a funky collapse?
Did not no if it was a seizure or fainting spell?
I rushed to my vet on a ER call and another vet was on duty and examined her and thought she was having a spell of A-fib?
I had a appointment made with a cardiologist and had a Echo and EKG and blood pressure testing.
All were normal and cario suggested following up with regular vet for routine blood work and exam.
I did and the vet noticed a pot belly like appearance starting and did blood work and showed elevated liver enzymes and cholesterol levels.
Did urinalysis and had protein in urine but rest was okay.
She suggested possible Cushings and ordered a test for next Monday to go in 3 times for blood drawls to determine 100% if it is that and she feels it is.
I am scared because about almost 20 years ago now, I had a lab/ shepherd mix who was diagnosed with it and the vet gave her to much Lysodren and killed her adrenal gland off.
She kept crashing and we finally had to put her down.
My current vet says the new med Vetrosly is not as dangerous but I am honestly scared to death.
I feel my dog does have it with her symptoms.
I struggle already with the decision of traditional meds versus supplements.
I have researched The University of Tennessee incredible studies with Melatonin and Ligans therapy but no vets close to me understand it.
I am struggling with whether I trust and try and have faith in my vet and go ahead with traditional med or go it alone via research and try Ligans and Melatonin and adding liver support with Sam E and Milk Thistle?
Please feel free to post this when accepted as I really need help!
Thank you!

[labblab]

I’m so glad to see you made it here to the forum! I have only a moment to post right now, but wanted to let you know that I’ve moved your thread here, to our main discussion forum. This way, more of our members will be likely to see your questions and respond. I’ll come back, myself, just as soon as I can in order to write more. But in the meantime, welcome!

Marianne

[LeahCC]

Hi, Scully. Sorry your fur baby is having a rough time of it, and that you had a really bad experience the last time you heard this diagnosis. I have a pit who was recently diagnosed and we're making our way through the treatment process. Please bear in mind that I am not in any way a medical/veterinary professional so take what I say with a grain of salt. I can tell you that the treatment for Cushing's in dogs has advanced in the last 20 years, and the best way to arm yourself and your dog against over-prescribing or other complications is to be as informed as you can and be able to accurately judge your vet's familiarity and competence with treating Cushing's. You can ask questions about their experience treating the disease (how many former/current Cushing's patients they have,) the outcomes or current status of those pets, and their opinion of how you should proceed with treating your baby. And remember that you don't have to agree with or continue with their prescribed treatment if you don't think it's accurate or in the best interest of your dog. You can also choose to be referred to an internist who specializes in endocrinology and should have a good deal of experience with Cushing's patients. You can get a referral from your current vet, or speak with a bigger animal hospital in your area to see if they have some referrals.

As far as treatment goes, the common form of Cushing's is pituitary-dependent, and the most common treatment for that is Vetoryl (trilostane) and Lysodren (mitotane). My experience so far has only been with Vetoryl, which is a newer drug that works differently than Lysodren did to treat the issue. I won't go into detail about what Cushing's is and how it works, or how the drugs treat it, because there are a lot of good resources on this site and on the web that can do that with far more expertise than I can. I can tell you, though, that (according to studies) with accurate diagnosis and at proper doses, it is highly unlikely that they will kill your dog. I completely understand the concern; I was watching my dog like a hawk when she started taking it, ready to rush to the vet at any sign of distress. But I find that the more I educate myself and learn about the treatment, the more informed my decisions are, then the better I feel about it (and the better my dog feels!) This forum is a really great resource and the members have talked me off a panicked ledge several times, and I've only been on here a couple of weeks. Do the research so that you can trust the process.

I can tell you right now that the members will want you to post any relevant test results you have access to: blood tests, urinalysis results, the results of the test next week, etc, as well as your dog's weight. From your description (blood drawn three times,) it sounds like this may be an LDDS (low-dose dexamethasone suppression test) which is a good test to diagnose Cushing's, and determine which type it is (which will determine which treatment path to take.) The weight will determine the recommended dosage of whichever drug you and your vet decide to use to treat.

Alternatively, you absolutely have the option not to treat at all. Cushing's is a finicky mistress and sometimes the treatment is worse than the disease. If your dog has limited symptoms that don't appear to be significantly impacting his or her quality of life, you may decide to hold off on treatment and re-visit that choice if the situation changes. Some people find that a more holistic treatment (various supplements) works just fine at keeping symptoms at bay. There are different treatment options that are well documented here, so don't be afraid to explore and ask lots of questions.

I hope that this helps ease some of the initial concerns that you may have. Here is a handy general overview of Cushing's that you may find informative:
https://www.petmd.com/dog/conditions...rticism?page=2

And here is the insert from Vetoryl that includes the results of their testing (it will download a PDF):
https://www.dechra-us.com/Admin/Publ...ack-insert.pdf

There are a lot of additional resources in the Helpful Resources forum:
http://www.k9cushings.com/forum/foru...Cushing-s-Dogs

And welcome!

Leah

[Squirt's Mom]

Hi, welcome to and your baby girl!

I am one who prefers Lysodren over Vetoryl and am willing to bet the vet that treated your Shepherd didn't know how to use the drug properly. When prescribed at the correct dose for loading and for maintenance, and when both vet and parent are educated and observant, Lyso does not cause the result found in your Shepherd. Vetoryl has the exact same risk factors when it is misused as Lysodren does - it can also destroy the adrenal glands causing a condition that is the opposite of Cushing's called Addison's - which is what your Shepherd more than likely developed. Addison's can be treated and, in fact, several other countries intentionally destroy the adrenals in cush pups because they feel Addison's is easier to treat. I don't agree with that approach personally. HOWEVER, if her vet is more comfortable with and has had better success using Vetoryl then that is the drug you want to go with.

Melatonin and lignans as described by UTK (University of Tennessee in Knoxville) are used as a treatment for a form of Cushing's called Atypical in which the cortisol is NORMAL but two or more of the intermediate, or sex, hormones are elevated. For this form Lyso is the preferred treatment if the melatonin and lignans don't take care of all the signs and elevations. On their own, these two supplements will do very little to control elevated cortisol tho. Most cush pups do have elevations in these hormones even when the cortisol is elevated and some vets consider Atypical a precursor to conventional, or true, Cushing's with elevated cortisol. That was the case with my own Squirt - she started out Atypical with normal cortisol but after a few years her cortisol did start to rise so we added Lysodren to her melatonin in and lignans. btw - she was diagnosed at 7 and lived to 16 + a few months. I tell you that to prove Cushing's is not necessarily a death sentence - most cush babies who receive the correct treatment using the correct protocol and who have educated, observant parents live out their normal lifespan and beyond.

Cushing's does cause weakness in the hind legs making it hard for a dog to jump on furniture, etc. and causing exercise intolerance. It also weakens tendons and can result in things like torn ACLs in the knees. Did any of the vets who saw your baby girl after her collapse discuss these possibilities? Were her spine and/or legs examined for problems?

Are you seeing any of the other signs common with Cushing's beside the pot belly - increased urination, increased drinking, HUGE ravenous appetite, hair loss or failure of the hair to regrow after being cut/shaved, panting for no reason? The signs are just as important in diagnosing as are the test results. It would help us give you more meaningful feedback if you will get copies of all the testing done so far and in the future and post them here. For now we would love to see the results on the test that showed elevated liver enzymes and cholesterol. We only need to see the abnormal results, too high or too low, along with the normal ranges and little letters that follow. It will look something like this when you type it in -

CHOL 135 80-120 ug/dl

The three-draw test the vet is talking about is probably the LDDS tho in Canada the ACTH uses 3 draws. So be sure to get copies of those results when they come in and share with us, too.

Herbs like Milk Thistle can help with the liver but right now I wouldn't start any herbs or supplements OR change her diet. Get thru the testing phase first - some of those things may effect the test results and you want to see a clear picture of where she is today. Later you can look into supplements and so on if needed.

I fully understand how scared you are right now. When I first heard the word "Cushing's" and started researching the disease I nearly lost my wee little mind. By the time I found this group I was a full-blown basket case! Terrified, guilty, angry, frustrated, confused....and did I mention terrified? Squirt was my world and the thought of losing her was more than I could bear. But these kind folk took my hand and gently led me along until I could breath again...then they began to teach me what I needed to know to give Squirt the best care I possibly could. We will do the same for you. You and your baby girl are part of our family here at K9C now and you will never be alone on this journey. We will be with you all the way. Look at the top of the page - you will see the words "support....educate....encourage....remember". That is our motto, our mantra, and we live by those words. You are in the best of hands here with us, I promise.

I am very glad you came to talk with us. I can't wait to see test results and get to know you both better.
Hugs,
Leslie

[scully]

Thank you all for your responses!
Scully is my dog and she just had another mystery spell that I feel is a seizure.
I was able to video it so I can show my vet.
I also talked to University of Tennessee today and they confirmed Ligans and Melatonin was great for atypical Cushings but not for regular kind.
They suggested to also proceed after test on Monday and go from there with traditional first.
I am really worried and just read that seizures can be caused by Cushings.
It is so strange as most of the day Scully is beyond calm and quiet and then like clock work around 3 pm she starts panting and hyper until she gets her dinner and then back to quiet.
I had a Lab years ago that had seizures and that is what this looked like.
She gets scared to death and looks at me like she does not no me and just looks around with eyes dilated.
It is so hard not knowing for sure what is happening.
Trying to be strong but terrified.

[Squirt's Mom]

My Pug has a form of seizures called Focal Seizures or partial seizures. When she has an episode she acts feral -terrified of everyone and every thing. She acts as if she does not recognize her people, her places, or her things. She used to have them often but she was in a place that was not secure and she was alone much of the time. Since she's been with me her episodes have dropped dramatically in frequency. She does not require medication at this time. Her vet diagnosed her seizures and the type based on her behavior. There may be tests for seizures but I'm not familiar with them. Other members here have or have had pups with seizures of different types so hopefully they will drop by to share their experiences with you. Videoing her was a great idea and should help your vet with diagnosing what is happening with her.

And yes, seizures are one of the signs of Cshing's. Unless it is Iatrogenic Cushing's, caused by steroid use, this disease always involves a tumor - either in the pituitary gland in the skull or on the adrenals, which sit on top of the kidneys. The pituitary form, PDH, is the most common and in most of those pups the tumor remains microscopic, causing nothing more than the usual cush sign. In rarer cases, the tumor begins to grow causing what is called a macroadenoma and can cause many neurological signs. Unless you are seeing things like circling, head pressing, and so on I would not worry about a macro right now. In dogs without the macro seizures can occur.

So I would certainly discuss these episodes with her vet and if she is not seeing an IMS, Internal Medicine Specialist, I would try to find one nearby and let them check her out asap.

Please keep in touch and let us know how she is doing!
Hugs,
Leslie

[scully]

I am gonna be honest with everyone.
Something in my gut is saying stop.
I of course do not want to lose Scully and I am afraid but I see her right now and she is at least eating and drinking and functioning.
I also feel in gut she does have Cushings.
I just have done enough research and for myself feel the drugs side effects and constant monitoring is gonna put her through a lot.
Financially, I am also struggling with all it is gonna involve.
I have spent 1,000 on tests already and cannot afford to think where I am gonna get the rest for 2 weeks and one month and three months and 6 months of blood work plus the meds.
My vet cost per blood chemistry and cortisol test each time 500.
Thats not even meds.
My own research is also this med itself.
This is a awful and cruel condition for sure and looking at treatment side effects is making me wanna run for hills.
I think in my heart if Scully was 10 or older it would come easier for me to choose but the fact she will be only 8 is harder.
I think I am gonna try holistic approach.
Ones that jumped out is Adrenal Gold formula by petwellbeing and possible adding Tumeric and added liver supports?
I wanna do right for her but I cannot shake this feeling that the drug is to strong and harsh on system and she is already overloaded.

[scully]

A lot changed in a couple of hours.
I had a call to talk to vet and list of questions and addressed all of the big concerns.
My vet was aware of dosage issues with bigger dogs needing smaller doses.
She shared about every 3 months they our getting a dog with Cushings.
She has used Vetorly for 8 years now and shared that in that time period only 3 dogs stopped from not handling the drug.
She said she was aware of the death to gland from drug but she had not experienced it and only about 2% of cases have happened and drug company reported this.
She said that she would use lowest dose on my dog she could since she is very sensitive to meds.
She said she felt we proceed Monday with test and results should be back by Wednesday.
She said the fact that my dog would only be 8 years old next month factors in even more to try and fight.
She said most issues arise when the dose is to much for the dog.
She said she understood how scared I am both because of past dog that had it and bad result from over use of Lisodren but she said today this new drug was safer and worth it.
I cannot believe I am gonna say this but I am also understanding there comes a point and time you have to have trust and faith in you have a good vet and I feel I do.
I guess it just depends whether my dog can handle the dug honestly?
Scared but surprised to say I am moving foward.
Will take one day at a time both health wise and financially too.

[labblab]

We surely understand why you’re very worried, but we’ll do our very best to help you and Scully, every step of the way! It sounds like your vet is doing a really good job of keeping up on all the latest research, so that’s a very good thing. In that vein, here’s some brand new info that we just learned, ourselves. It’s a new method for monitoring Vetoryl/trilostane treatment, and it can be a lot less expensive. Your vet may not know about it yet, so you may want to print out this post and share a copy with your vet. Since she’s treating other Cushpups, as well, she may be very interested in this information.

http://www.k9cushings.com/forum/show...=1252#post1252

Definitely let us know how things go next week, OK?
Marianne

[scully]

Thank you!
Will print off and take with me and let you no what happens!