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Thread: New Diagnosis and 7 day update

  1. #21
    Join Date
    Apr 2009
    Location
    Georgia
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    14,010

    Default Re: New Diagnosis and 7 day update

    Hello again from, too! I do think it’s a good idea that you’ve advanced Macie’s monitoring testing, because it may be the case that her cortisol level is not being controlled sufficiently right now, and a Vetoryl dosage increase may be in order. In looking back at her April ACTH results, they were in a range that would be considered OK as long as symptoms are being adequately controlled. However, her cortisol may have drifted upward during these past three months, or even the previous post-ACTH level of 6-7 may just not have been low enough to keep symptoms from rebounding. Some dogs need to keep their post-ACTH level consistently within a lower range of 2-5 ug/dL in order to keep all symptoms under control.

    Another thought relates to Macie’s thyroid level. It is not uncommon for Cushpups to suffer from low thyroid, as well, and hypothyroidism can cause significant problems with coat and skin issues. For some dogs, low thyroid readings are actually secondary to the Cushing’s, and resolve once effective Cushing’s treatment is underway. However, other dogs may develop genuine hypothyroidism in its own right. This is easy to treat with simple, inexpensive medication. Since it seems to me as though it may be a possibility, I’d want to make sure that a blood chemistry panel including thyroid analysis is performed alongside the ACTH.

    Please do let us know what you find out with her testing, and continue to update us re: her progress, OK?

    Marianne

  2. #22
    Join Date
    Mar 2018
    Posts
    17

    Default Re: New Diagnosis and 7 day update

    Thanks Marianne. She is getting a full blood panel screening done tomorrow in addition to the ACTH testing so I expect they will have a good idea of what's going on. Will definitely discuss the thyroid concern. I appreciate your input.

    More tomorrow after we have results.

  3. #23
    Join Date
    Mar 2018
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    17

    Default Re: New Diagnosis and 7 day update

    Macie did well at her vet visit and through the ACTH test. I don’t have all the test numbers but her post number was 6.8 and the vet was happy with her progress and response to the 15mg Vetoryl dosage. Her blood panel will be in next week and we will be meeting to review those results as well. Nothing definitive on the flaking skin and small blister like spots on her underside. She was given antibiotics for 10’days to help with the skin issues. She seems to be responding well. More later but she is a happy little girl and for that we are grateful.

  4. #24
    Join Date
    Jan 2016
    Location
    Glen Cove, NY
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    1,592

    Default Re: New Diagnosis and 7 day update

    Sounds great! Happy is just the best, isn't it!
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  5. #25
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,010

    Default Re: New Diagnosis and 7 day update

    Thanks so much for the update, and we’ll sure be watching for those other results next week. It’s wonderful that Macie is basically doing so well. I do want to point out once again, though, that her cortisol level can safely be brought lower than 6.8 if all her Cushing’s symptoms are not being well controlled. If nothing is amiss other than the skin issues, then perhaps you don’t want to rock the boat in terms of her dosage. But one warning in that regard: there’s a particular condition called Calcinosis Cutis to which Cushpups are vulnerable. It involves calcium deposits that first form under the skin and then work their way to the surface, causing weeping and blistering lesions. This condition can get out of hand quite quickly and create genuine quality of life issues for afflicted dogs. You can Google the condition and view images to compare to what you’re seeing with Macie, but for your reference, here’s some samples from a photo album of one of our members:

    http://www.k9cushings.com/forum/album.php?albumid=805

    This certainly may not be what’s going on with Macie, but I do want to just mention it for your vet’s consideration in the event that Macie’s skin worsens over time rather than improving. For dogs who suffer from this condition (or other unresolved Cushing’s symptoms, for that matter), the general recommendation is to lower post-ACTH cortisol levels to a range between about 2.0 - 5.0.

    That being said, hoping you guys have a great weekend, and we’ll definitely watch for those other results next week.

    Marianne

  6. #26
    Join Date
    Mar 2018
    Posts
    17

    Default Re: New Diagnosis and 7 day update

    Hello everyone. We completed the 6 month ACTH testing and had a full blood panel done just to gauge any changes from her last blood work which was done in February when Cushing's was suspected. For those of you that have been following our journey, you will recall that Macie had recently (last 30 days) began to exhibit some skin issues, mainly flaking with small little dark areas and some pustules. The vet put her on a 10 day course of antibiotics which has seemed to do a good job of clearing the skin condition. In addition to the skin improvement, a great surprise is all her hair is growing back and quickly! Her beautiful brown undertones came back in a week's time and her little boney tail is returning to normal. According to the vet, this is probably due to getting the skin issues under control and the natural progression of Cushing's when treated with Vetoryl. Her pre and post ACTH test numbers from a couple of weeks ago were 2.8 and 6.8. based on her appearance and overall demeanor, we are keeping with the 15 mg 1X daily of Vetoryl. Her blood panel numbers were terrific. Just about everything was in the range that the doc was looking for. Even her liver values were improved since the initial diagnosis so all in all, we are on the right track and she is doing really well. We are back to daily walks of nearly a mile and she has regained her rear leg strength.

    I know I have said this in a previous post, but if you are new to Cushing's, it can be confusing, worrisome and scary. We have no guarantees and regardless of the progress that is being made, once diagnosed, unless you have the tumor removed causing the excess cortisol production, it is a condition for life. That is just the reality. However, with a good doctor, a generally healthy pet and the commitment and diligence to treat with the prescribed medications, you can beat this and return to a sense of normality and happiness for your four legged friend. So don't despair, find a good vet that understands this condition and give your pup the chance to return to his/her pre Cushing's condition.

    So for now, we will continue with the daily medicine in the morning, walks in the afternoon, dinner in the evening and general happiness and contentment that life with a pup is supposed to be. Next update is in 6 months unless something changes.

    Take care all and may your journeys with your four legged friends be full of wonder, excitement and happiness.

    Thanks!

  7. #27
    Join Date
    Apr 2009
    Location
    York, PA.
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    10,634

    Default Re: New Diagnosis and 7 day update

    Thanks so much for the update and what a wonderful update it is! So glad that Macie is doing well and that her skin/hair have improved!!

  8. #28
    Join Date
    Mar 2018
    Posts
    17

    Default Re: New Diagnosis and 7 day update

    Hello, we're back! So another 6 month update. Macie has been doing fantastic. Changed her food to Honest Kitchen dehydrated lamb/chicken topped with Northwest Naturals dehydrated lamb back in October to minimize carbs and she just devours this food. We still give her a bit of Nutro small bites kibble but she is mainly on the Honest Kitchen. Her weight has been maintaining right around 12.5 lbs. We did run into a bout with a UTI late last fall that we finally have gotten under control with the use of 60 days of antibiotics. She also takes Cranberry Bites 1X daily to help with UTI's.

    She went in for her annual wellness exam and 6 month STIM test at the end of January. We have noticed just a bit of panting late in the day which we noticed at the onset of Cushing's. Overall blood panel results were good. Cortisol results were just outside the acceptable range: pre 6.3 post 7.8. The doc wants the post to be under 7 so she made a change to 20mg/day of a compounded chewable version of trilostane. After two weeks on this, she was tested again and the numbers did not change much: pre 4.4 post 8.2. So, we are back to Vetoryl capsules 20 mg/day. We will run with this for 30 days and check her again. However, overall, she is doing just great. All the energy level has returned as has rear leg strength. Her coat is just beautiful. Appetite is very good, normal in all other aspects. We are back to long walks - anywhere from 1-2 miles/day. She will come find me everyday around 3:30 to let me know its time for her outdoor adventure. It has been a personally rewarding time for us as this is "our" time to just be. I let her smell every tree, rock and anything she finds interesting. I have a new appreciation for the joy a pet brings to us.

    As I have been doing, I will post her next STIM test numbers in 30 days. Take care!
    Last edited by my2sons; 02-08-2019 at 06:39 PM. Reason: Omitted some info

  9. #29
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,066

    Default Re: New Diagnosis and 7 day update

    A great update! I am so glad you are enjoying each other again and pray that trend continues for a very long time to come!
    Hugs,
    Leslie
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  10. #30
    Join Date
    Mar 2018
    Posts
    17

    Default Re: New Diagnosis and 7 day update

    Macie has been on 20 mg 1X daily of Vetoryl for about a month. We had her STIM test last week and results are in. Cortisol Pre ACTH was 1.3 and post was 4.2. Doctor seems pleased and wants to check her again in 3 months to ensure we are not over suppressing her cortisol. I'm glad I insisted on going from 15 mg to 20 mg and not the 30 mg the vet had suggested. So, onward we go on this journey. She is still taking her long walks, eating well, very playful and seems normal in all ways.

    Again, for anyone just now reading this or have recently received a Cushings diagnosis, I encourage you to read and learn as much as you can and pay close attention to your pet. You know them best and will know if something just doesn't seem right. With excellent veterinary care and you staying on top of the meds, etc., this is definitely a disease which can be treated and can be managed. It's not cheap, but in my opinion, it is worth every penny for the joy we get in return.

    Next update in three months. Take care.

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