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Thread: Vet thinks my boy has Cushing's. I'm very worried.

  1. #31
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    Aug 2018
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Just FYI...

    Kobe did wind up eating his dinner of dry kibble last night. Much later than usual. After I primed the pump by giving him one of his favorite treats. Apparently he realized "Hey I'm still hungry".

    So he ate his dinner, and then begged for more treats.

    Surprisingly his water consumption was only 2500 mL yesterday. Though today he looks to be on track toward the more recently typical 3500 - 4000 mL (1 Gallon).
    Glen, Kobe's dad.

    (pronounced Kobay)

  2. #32
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Glad to hear that Kobe finally gave in and ate his kibble, they sure do keep us on our toes!

  3. #33
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Indeed they do Lori.

    Hello Cushpup friends,

    Just wanted to give an update on Kobe's ultrasound. So it would appear that Kobe is one of "lucky" 15% that have an adrenal tumor. Well... the doctor's diagnosis was "Suspect a Functional Adrenal Tumor". The tumor itself wasn't imaged (presumably it was too small to distinguish). I was there during the ultra sound and she didn't point out a tumor on the adrenal gland. Just that one of Kobe's adrenals was larger than normal, while the other was normal size. It was weird though because from what the doctor could tell (and honestly I don't know how they can make heads or tails out of those fuzzy ultrasound images) only one side of Kobe's adrenal was enlarged, while the other side of that same adrenal gland was not.

    What the doctor wrote there was that "The left adrenal gland is normal size, but the right is a little wide. This could be the start of a benign adenoma. "

    Also she noted that Kobe "did not have the typical big white liver, but could happen over time."

    She said that while surgery is the treatment of choice for adrenal tumors that symptoms can sometimes resolve with Trilostane/Vetoryl.

    For the time being she recommended that Kobe continue on Vetoryl and if he improves and then later develops symptoms again she can recheck the adrenal glands. Though thankfully, she said it will be at a much reduced cost. Not sure why. Maybe because she only needs to check the adrenals or because it's wrapped up in the original testing.

    In any case Kobe is only getting 60mg of Vetoryl, which I started the next day (Thursday). That's lower than his weight would typically require, but it may be enough. We'll see. He's now had his 3rd dose.

    He seems to be tolerating it well. He's had some "soft-serve" poops. But then that's not entirely atypical for Kobe, though it's more frequent than he usually would have that, so I'm not sure what to think about that yet. He hasn't vomited. His appetite is still good, still overly good. And he's been sleeping as much as usual, maybe a little perkier since he started his Vetoryl. He seems more willing to go up and down stairs and jump on the bed. He did have another pee accident in the house yesterday, but this time it was at the back door, so apparently he WAS wanting to get out, and was able to get himself to the back door first, but apparently couldn't hold it long enough to alert anyone and for someone to notice he needed to go out.

    The doctor did find a little fat around his heart (she briefly looked at it). But then he's not been exercising much. Still.... I have to cut back on his, daily yet fairly small quantity, cheese intake (or get fat free cheese for him, does that even exist?), and trips to get ice cream (though it's cooling off now anyhow and the ice cream place will soon be closing for the season).

    *sigh* Why do so many of the things which make life worth living have to be bad for us (and dogs) Food wise anyway.

    Well, 10 days till Kobe's followup ACTH. I'll let you all know how it goes.

    Thanks for the support!
    Last edited by FoxFire; 09-22-2018 at 12:35 PM.
    Glen, Kobe's dad.

    (pronounced Kobay)

  4. #34
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    I'm not sure if anyone posted that Vetoryl has to be given with a meal to be properly absorbed, so in case not, I just did! Keep us updated!

  5. #35
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Thanks Lori,

    Yes I do recall reading that, so Kobe has been taking Vetoryl with his breakfast.

    Today is his 4th consecutive dose. I do believe he's been perking up a little bit more each day. And I'm pretty sure it's not just my imagination.

    Today he showed a bit more of the energy and excitement he used to have when I'd return home. Not yet where he was, but a noticeable improvement. He is still sleeping more than usual, but I think even that has improved a bit. We went on a fairly lengthy walk this evening and while it is still slower going than months ago, there were times when he was actually out ahead of me and making me have to pick up MY pace to keep up. How long before I'll need to jog or run to keep up with him again I wonder. (Although to a degree I have to imagine some slowing down is just his getting older. I don't expect him to have puppy energy).

    Yesterday his water consumption was the lowest since I've been recording it. Only 2400 mL (81.1 oz) . The day before he was 3300 mL. Prior to the Vetoryl he was usually over 3000 mL (101.4 oz) and as high as 4200 mL (142 oz)! He didn't spend forever lapping up water yesterday, or today either. Though it has been cooler the last couple of days, so.... maybe that is part of it.

    His stool has run the gamut over the last few days (even during a single day) from normal, to soft, and this evening while returning from our walk he had a small quantity of runny stool. Not sure what to make of that. Maybe just all the walking got his bowels moving quicker than usual.

    I'll let you all know how he progresses.
    Glen, Kobe's dad.

    (pronounced Kobay)

  6. #36
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    So glad to read that you are seeing improvement...YAAA Go Kobe!!!!! If Kobe's follow up ACTH test results are good and the diarrhea is still looming you could add some plain canned pumpkin to his food to see if it would firm it up.

  7. #37
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hello Cushpup friends.

    Sorry for the lack of updates. Kobe just had his ACTH test last Wednesday, and I didn't get the results until Friday.

    I'm sorry I don't have the detailed test results sitting in front of me as I need to pick them up at the vet (they don't e-mail them for some reason). However the vet did call me on Friday, and said that Kobe's ACTH results, I believe 4 hours (maybe it was 6, I don't remember now) after his morning 60mg dose of Vetoryl was 3.0 and he ought to be in the range of 1.5 to 9.0 . So he's definitely in the good range, though near the low end. He will have another test at the 30 day mark.

    The vet is concerned that prior to his test he could be going even lower, perhaps too low, given my observations that he does get even more lethargic soon after he's been dosed (which is a bit hard to tell since he's already lethargic with the Cushings), and then perks up later in the day. She said she called Dechra and had a long conversation with them about Kobe. They said it should be fine to keep him on 60mg though it would be worth trying him on dosing 30mg twice daily, to keep his cortisol levels more even throughout the day.

    I'm wondering what the community's thoughts are on this, and has anyone had better or worse results with twice daily dosing?

    If I switch to 30mg twice daily Kobe will need the ACTH test again at 2 and 4 weeks out from the dosing change. I decided to get Care Credit as his expenses mount. Also since I thought in case he does need surgery. Though in speaking with the vet it was decided not to go that route for the time being.

    As for other observations, Kobe's drinking has continued to reduce to the point that he only drank 1.7 L (57 oz) yesterday. Now I'm beginning to wonder what's too low! Heh. He hasn't had any more accidents in the house EXCEPT for the same day he was at the vet for his ACTH test. I was unable to monitor how much he drank that day. Later that evening he peed near the back door again. Maybe whatever they give him for ACTH did something as well.

    His appetite is still good. Still too good. Though there are days where he takes longer to decide if he'll eat his dry kibble. He was always used to getting some wet mixed in just to get him to be interested in it, but since the Cushing's kicked in he would inhale it without anything mixed in. He always wants snacks though. Unfortunately he put on more weight at his last vet visit, so I (and the kids who like to sneak him cheese knowing how much he loves it) have to be more disciplined in giving him snacks.

    I actually found fat free cheese, which as you can imagine is pretty nasty. Ha! In fact, I didn't think there was ANY cheese Kobe wouldn't scarf down like a starved Velociraptor, but alas he refused to touch the stuff! Oh well. He likes low fat cheese, so he'll only get it wrapped around his medication.

    His energy level seems to be up and down. Seems about every other day that he's willing to go on longer walks. He is more willing to go up and down the stairs than he had been. Jumps up on the bed more. And greets people at the door again. Still he does sleep A LOT still. I'm hoping his energy returns in time, and particularly if I can get some weight off him. The vet said he could be experiencing more aches and pains now that there isn't so much cortisol in his system which will mask those aches and pains. She believes he could be experiencing some arthritis and asked me if I'd like her to prescribe some medication for it to see if it helped. I decided to hold off on that for now.

    She did give me some medicated wipes for his paws which are still a bit red and swollen. Hopefully those will help.

    Also she prescribed him some Pro-biotics to sprinkle on his food once daily. The pumpkin did help Lori, thanks! He hasn't had any more diarrhea. But his stool has still been a bit softer and mushier as the day goes on than is ideal. We'll see how adding the pro-biotics helps.

    So, I think that's about it. Hope everyone else and their cushpups are doing well. Haven't had a chance to read the forum lately, but I'm going to get to that in a bit.
    Glen, Kobe's dad.

    (pronounced Kobay)

  8. #38
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hi Glen,

    Definitely get those ACTH stim results so we can be absolutely sure what Kobe's cortisol levels are. Now, if his post is 3.0 ug/dl than that is really good, however, if it seems that Kobe does get lethargic right after his dose of 60 mg of Vetoryl splitting it into 30 mg doses and giving it twice a day could be better as this would help keep his cortisol on a more even keel. When a cushdog has diabetes it is strongly urged to administer Vetoryl twice a day for that reason so even though Kobe doesn't have diabetes the twice a day regimen, I think, could be beneficial.

    Regarding the arthritis, sometimes this is unmasked when a cushdog starts treatment because, as the vet stated, that abundance of cortisol is now lowered. Some of our members have tried Adequan shots for their arthritic dog and it seems to help. Fish oil, especially wild salmon oil, has anti-inflammatory properties. I found this article to be informative regarding canine arthritis and treatments: http://www.whole-dog-journal.com/iss...s_15910-1.html

    We also have a thread where natural anti-inflammatories are discussed: Joint support supplement

    Here's a link with info regarding Adequan: http://www.fda.gov/AnimalVeterinary/.../ucm116139.htm

    I'm also including this link to an article, regarding arthritis, on the Dogaware site that lists medical and other alternative therapies: http://dogaware.com/health/arthritis.html

    Glad his appetite is still good and that he seems to be doing well, I also hope the Pro-biotics help with his stool.

    Lori

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