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Thread: Yukon, American Eskimo - Experience w/ Lignans and Melatonin?

  1. #1
    Join Date
    May 2018
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    29

    Default Yukon, American Eskimo - Experience w/ Lignans and Melatonin?

    Good Morning,

    I have a 13 year old American Eskimo named Yukon and I have to say he has been a very high maintenance dog over his life. He has allergies (beef, grass) in which we had testing done and order serum and have injections. He has also had Invertebral Disk Disease (getting Laser), ate a Chicken Carcase and had 100 bones pulled out of his belly in which he then developed Pancreatitis which became Chronic, and last year I was told that he might have IBD.

    His last Pancreatic attack was last August, 2017 and recovered quite well. This winter I noticed he started gaining his normal winter weight but it looked like a little more than usual. Over the last couple months I noticed he was drinking a lot more water and panting a lot.

    I took him to the Vet for his Heartworm and Bloodwork on March 25th and the vet said he had high Liver enzymes - ALKP was about 508 and ALT was 155. She advised that I put him on Denamarin and we monitor his liver. For some reason I suggested that maybe we do a Cushing's test because I started walking him over a mile a day and he was not losing the weight and panting a lot. I also took him in for an ultrasound of his liver and she noted it was enlarged, but she could not see any masses.

    April 13th we did the Low Dose Dexamethasone test and the following results came through

    Pre Dex 3.9 ug/dL
    4 Post Dex 0.3 ug/dL
    8 Post Dex 1.8 ug/dL

    She indicated he has Pituitary Cushings and they begin treating at 1.5 ug. He is 32 pounds and we started him on 10mg of Vetoryl since he is very sensitive to a lot of medications. I started giving him the Meds on Monday, April 16th.

    The first day he seemed ok, but the second day within an hour of me giving it to him it seemed like he just totally zoned out and for hours he would walk around in a daze and sleep most of the time. I did notice the panting reduced and the water intake was not as much, but he was by no means perky. I advised the vet after about 4 days that his behavior was a little strange. We went about 6 days and my both myself and my vet contacted Dechra and asked about his symptoms. My vet told me on April 25th to stop the Vetoryl because the company said his body might be used to the high cortisole and the medication might be making it too low. I also took him off the Denamarin.

    We went back to the vet on April 21st and had more bloodwork pulled and his Liver Enzymes went up to ALKP 585 and ALT 290. She also confirmed that he had Pancreatitis - his level was 712.

    Since then I have been off everything, on May 2nd I brought him back to the vet because he was not acting right - very lethargic. I had her pull more blood and his Liver Enzymes ALKP went up to 923 and ALT rose to 309. She also pulled blood to check his pancreas level and cortisole level and told me that if his cortisole was high we would put him on 5mg of vetoryl right away, even if it wasn't 14 days since he was off the other dosage.

    My vet went on vacation and the tests came back so I called and spoke to another vet at the clinic. His pancreas went down from 712 to 538. The cortisole test showed 2.8 and the vet said that normal is between 2-6 so he is on the lower side.

    I am very confused now because I don't know if I should put him back on the lower does of Vetoryl. He still has the symptoms of Cushings but in the last 4-5 days he has regained his spunky attitude again. I did put him back on the denamarin for his liver.

    Any advise would greatly be appreciated - this is very frustrating. Thank you :-)

  2. #2
    Join Date
    Mar 2009
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    rural central ARK
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    Default Re: New to Site - American Eskimo - Cushings????

    Good morning and welcome to you and Yukon!

    My concern is with the validity of the LDDS because it is notorious for giving false positives when another illness is present and pancreatitis most certainly falls into that category. The body, both human and canine, will release extra cortisol in response to stresses - internal and external. If a pup gets very stressed just going to the vet that can skew the Cushing's tests...pancreatitis would definitely skew the results. My own Squirt was diagnosed with Cushing's but as testing proceeded and we did the ultrasound a tumor was found on her spleen. Once that tumor was removed her cortisol returned to normal and remained normal for several years. So that is a lesson I will never forget nor fail to share when I see a pup that tested positive for Cushing's while under stress from some other source.

    So having said that, there is no way in you know where I would restart the Vetoryl. The diagnosis for Yukon is very iffy in my mind. There are two drugs used to treat Cushing's - Vetoryl and Lysodren. Vetoryl WILL cause problems if the Cushing's is a misdiagnosis, like my Squirt's was. However, Lysodren will not cause problems - it works ONLY on the adrenal glands so if there is nothing happening with them it does nothing. So I would NOT restart the Vetoryl right now - I would give Yukon time to recover as best he can and then retest.

    I'm glad you found us and look forward to learning more as time passes. I am sure others will be along to offer their insights as well.

    You need to know that you and Yukon are now part of our little family here now and we will be with you every step of the way on this journey. You and Yukon will never be alone.

    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.

  3. #3
    Join Date
    Apr 2009
    Location
    York, PA.
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    10,684

    Default Re: New to Site - American Eskimo - Cushings????

    Hi and welcome to you and Yukon!

    My oh my your sweet boy has been keeping you on your toes! American Eskimo's are such beautiful dogs with that lovely fur coat! Regarding his cortisol level, was that checked with an ACTH stimulation test, and if so, was the 2.8 (I assume the units of measurement are ug/dl) a post cortisol result? If the 2.8 ug/dl is a post reading and even though he is still presenting symptoms I wouldn't restart the Vetoryl until his cortisol has had time to rise a bit more (since he was off the Vetoryl for 7 days and cortisol was only 2.8 ug/dl) and I would instead try to get his pancreatitis under some kind of control.

    Pancreatitis can be a bugger to get an upper hand on, my boy Harley, had chronic pancreatitis and we were never able to get his numbers in the normal range. Is Yukon on a very low fat diet? Also, with pancreatitis it is recommended that dogs be given several small meals throughout the day instead of one big meal.

    So, my advice would be to retest pancreas in 3 weeks and if better have a full ACTH stimulation test performed to see where his cortisol levels are and if high than restart the Vetoryl at 5 mg once a day (given with a meal).

    I'm sorry for the circumstances that brought you here but sure glad you found us and we will help in any way we can.

    Lori

  4. #4
    Join Date
    May 2018
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    29

    Default Re: New to Site - American Eskimo - Cushings????

    Thank you so much for all your feedback Leslie- I have been very leary about putting him back on the Vetoryl. Unfortunately my vet has not really been assisting me in all this since the testing - she recently told me she is not sure which way to go at this point :-(. I feel as though I am recommending things to her and she is going for it.

    Yukon is a very stressed dog as it is - afraid of fireworks, thunder, rain, etc. and he trembles every time I bring him to the vet. That's why I was a little surprised that the last blood test where they tested the cortisol level was only 2.8. I think my vet even expected it to be more. I do notice that he pants a ton only at night - I am wondering if because his liver is enlarged and enzymes elevated that is why. I read someone that the liver becomes active between 1-3 am.

    I still don't know about all the other symptoms, excessive drinking, eating and weight gain. I was even thinking about going to an Internal Med doctor for a ultrasound of his organs to see if in fact it is something else. I think right now I am going to just keep giving him the Denamarin and see if his pancreas and liver levels go down.

  5. #5
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    May 2018
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    Default Re: New to Site - American Eskimo - Cushings????

    Hi Lori,

    Yes he has really kept me on my toes - and I would do anything to keep him happy and healthy because he is in essence my baby. The cortisol level of 2.8 was just a blood draw and they sent it out. Yukon is currently on the Royal Canin Hydrolized Protein Dog Food and Treats. That is all he gets besides occasional green beans - lol. I have been trying to feed him smaller meals throughout the day, especially since he is always so hungry and wants to eat all the time. The funny thing is my husband said he never bugs him for treats all day - he only starts when I get home. I guess maybe I spoil him.

  6. #6
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    Apr 2009
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    Default Re: New to Site - American Eskimo - Cushings????

    Quote Originally Posted by YukiesMom View Post
    The cortisol level of 2.8 was just a blood draw and they sent it out.
    The ACTH stimulation test is used to check cortisol levels, a "full" ACTH test consists of 2 blood draws which are a pre and a post reading. It is really important to know if that 2.8 ug/dl is a pre or post blood draw result, could you find that out for us...thanks!

    Quote Originally Posted by YukiesMom View Post
    Yukon is currently on the Royal Canin Hydrolized Protein Dog Food and Treats. That is all he gets besides occasional green beans - lol.
    It is recommended that a diet with less than 10 percent fat on a dry matter basis to be fed to a dog with pancreatitis, by my calculations his feed is 18% which may irritate that already inflamed pancreas. I've found these articles from the dogaware site to be very informative regarding canine pancreatitis, it also includes a list of dog foods that are low in fat: Healthy Low-Fat Diets for Dogs and Pancreatitis in Dogs

    Quote Originally Posted by YukiesMom View Post
    I have been trying to feed him smaller meals throughout the day, especially since he is always so hungry and wants to eat all the time. The funny thing is my husband said he never bugs him for treats all day - he only starts when I get home. I guess maybe I spoil him.
    It is so hard not to spoil them, they worm their way into our hearts and we love them deeply. I have no children so my furbabies are my "kids," Yukon is very lucky to have such wonderful parents!

  7. #7
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    May 2018
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    Default Re: New to Site - American Eskimo - Cushings????

    Hi Lori. My vet did a base cortisole blood test. She called yesterday and is baffled at what is going on. I told her his panting is getting worse at night between 1-4 am. I made an appointment with an internal medicine doctor on may 15th. They are going to do an ultrasound of his organs. I am hoping we can get to the bottom of what is going on. Thanks for the articles on the dog food. I was feeding him Nutro sensitive stomach for his entire life (chicken, rice and oatmeal). They changed the formula and it was really hard to find a new dog food with him being allergic to beef and having chronic pancreatitis. He has been on the royal canin hydrolyzed protein over a year and it seemed to be working.

  8. #8
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    Default Re: New to Site - American Eskimo - Cushings????

    It is not uncommon for GP vets to be stumped by complications of endocrine disorders so I personally think it's an excellent idea that you will be consulting with an internal medicine specialist as these vets are highly trained and experienced in all things endocrine.

  9. #9
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    Default Re: New to Site - American Eskimo - Cushings????

    I think going to see the internal medicine specialist is a good idea. Let us know how that goes and what the IMS thinks is going on.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  10. #10
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    May 2018
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    Default Re: New to Site - American Eskimo - Cushings????

    So I went to the internal medicine doctor yesterday and it was a little disappointed. My vet sent him all the records and did a summary page and he didn't even read it. I told him everything going on and he then performed the ultrasound. He indicated in his notes that the ultrasound revealed nonspecific hepatopathy and mild renal remodeling. Said that the former is likely multifactorial, both inflammatory bowel disease (argued based on his elevated folate and history of recurrent diarrhea) and early onset pituitary dependent hyperadrenocorticism (based on normal adrenal glands on the ultrasound and the recent LDDS test) are contributing to the hepatic changes.

    He sent out two urine tests - one culture for PUPD and a UCCR to characterize the adrenal glands further. He then wants me to get another ACTH stimulation test from the University of Tennessee. He wants to send it there because he thinks that maybe something else is triggering the Cushings (ie: Hormones, testastorone, etc.)

    Has anyone ever heard of other factors that are contributing to the cortisol over producing? He said not to give him the Vetoryl because it is not helping him and that once we find out what it might be we can medicate accordingly.

    Now I am even more confused :-(

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