Page 1 of 5 123 ... LastLast
Results 1 to 10 of 41

Thread: Cody diagnosed with cushings

  1. #1
    Join Date
    Dec 2018
    Posts
    20

    Question Cody diagnosed with cushings

    Hi my name is Julie. My dog Cody is a 12 year old bichon and was just diagnosed yesterday with cushings. I've been reading posts here and they have given me more questions for the doctor so I put a call into her today and am also going to the vet this afternoon to pick up the last two bloodwork results from the two previous regular bloodwork and cushings tests to post. I am going to ask if the cushings is adrenal or pituitary but I have a feeling she doesn't really know cause we haven't done an ultrasound but I will ask. The reason she suspected the cushings was because he had elevated liver enzymes in his annual bloodwork a year ago. He got tested with 2 different tests for cushings and it didn't come back as a definite positive plus he wasn't showing any other signs except drinking a lot but that could have been because of the COPD medication he's on. He still had elevated enzymes this year so she did another cushings test and she said that he has it. He does seem more hungry now, still drinks a lot, has a bit of thinning hair on his back and his belly looks grey instead of pink. He has other medical issues as well. He had 2 bouts of pancreatitus but not recently. He has bladder stones, a rectal hernia (not large), a heart murmur and the COPD cough. The bladder stones and hernia aren't bothering him so we are just watching them. When I talked to the vet yesterday she was good at describing the pros and cons of treatment and we decided to bring him back in 3 months and do an xray to see how his heart is and a blood panel because after she told me about the treatment and the possible side effects including one patient that died because her gland totally shut down and she was in between blood tests and they didn't know until it was too late TOTALLY freaked me out! He is my baby and the thought of the medicine possibly ending his life versus just doing nothing right now because he's still energetic and doesn't seem to be bothered by it much worries me. But it sounds like if I do nothing he could get diabetes and a host of other issues that if he gets to that point putting him on the medicine will be too late to fix. I'm so confused ☹. Anyway I will post again when I get a copy of the bloodwork. Thanks for reading and any comments would be appreciated.

  2. #2
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,095

    Default Re: Cody diagnosed with cushings

    Hi Julie,

    Welcome to you and Cody!

    I am probably not the best one for you to hear from first off because of my experience with my little Trinket. But I will share her story anyway along with her sister's so you gain a better understanding of just how difficult it is to accurately diagnose canine Cushing's especially in the face of other health issues. Trink also had COPD as well as anal gland disease, colitis, allergies, was blind, and a few other issues when she was diagnosed with Cushing's. Her tail was getting the tell-tale appearance of a rat tail, her appetite was increasing, she was peeing and drinking more, labs were off a bit, and her ACTH was literally off the charts when it was done the first time. But because of all the other things she was dealing with I questioned the diagnosis of Cushing's. The dog who introduced me to the Cushing's world was her sister, Squirt, and when she was first tested Squirt tested positive on all the tests she had - LDDS, HDDS, ACTH, and UTK panel. But when we did the abdominal ultrasound a tumor was found on her spleen. Once that tumor was removed her cortisol returned to normal levels - the stress from the tumor had caused false-positives on ALL those tests. So Squirt's journey made me overly cautious about Cushing's diagnoses anytime another health issue was in play and Trinket certainly had other issues. However I also didn't want to add to her woes IF Cushing's was in fact present so I chose to use Lysodren. It helped with her signs. However I continued to question the diagnosis because the monitoring ACTHs never went back to normal - they remained high tho not off the charts like in the beginning. During Trinket's last weeks none of her vets could tell me what was causing the things she was going thru then so when she passed I had a necropsy done (autopsy for animals). That proved what I had always suspected - she never had Cushing's. Her adrenal glands were normal and they would not have been had she actually had Cushing's.

    So I strongly advise that you have that ultrasound done before you start treating Cushing's AND that you not rush into starting treatment until you are convinced, NOT your vet convinced but YOU, that she does have the disease. Cushing's is a slow progressing condition, taking years to do damage but treating a dog who does not have Cushing's can quickly cause serious problems. Thankfully that did not play a role in my Trinket's death or I'm not sure I could function from carrying that quilt. Her death was unrelated to her medications or known conditions. So do.not.rush. Take your time, get that ultrasound, learn all you can about the disease, ask us and your vet every question you can think of, LISTEN TO YOUR GUT and then decide if treating is indeed the right path for your precious baby. The odds are you have plenty of time, use it. A few weeks or even months won't matter more than likely but rushing into treatment could.

    I'm glad you found us and am sure others will be along soon to share their thoughts with you as well. Know you are part of our little family here now and we will do anything we can to help you and Cody along your journey.
    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
    Dec 2018
    Posts
    20

    Default Re: Cody diagnosed with cushings

    Thank you for replying. I agree that jumping into starting treatment is not what I want to do at this time. Now that I have his medical records I am thinking of getting a 2nd opinion from a specialist and having an ultrasound done. I feel better knowing that what I thought is in line with your thinking too. Here are the test results:
    10/28/16 (first test done after bloodwork showed high liver enzymes)
    ACTH STIMULATION TEST
    PRE 8.2
    POST 21.9

    7/20/17
    DEXAMETHASONE SUPPRESSION TEST
    Pre 4.3
    Post 4 hr. .2
    Post 8 hr <.2

    4/17/18 - Senior profile Blood test
    High ranges are for
    MCH 26.7 (Not sure what that is)
    ALT 180
    ALP 877

    10/29/18 Alk Phosphate test
    ALT 158
    ALL 996

    REDID ABOVE TEST ON 12/6/18 after putting him on milk thistle didnt really help

    ALT 197
    ALP 966

    12/18/18 ACTH STIMULATION TEST
    PRE 4.7
    POST 25.4

    What do you think about CushAway? I talked to the vet and she said it would be ok to try.

  4. #4
    Join Date
    Apr 2008
    Location
    Tennessee
    Posts
    6,568

    Default Re: Cody diagnosed with cushings

    Thank you for posting those test results. It sure looks like a clear progression of cushing's to me and suspect that if you were to repeat the LDDS today, it would most likely be positive. FYI, MCH is an abbreviation for mean corpuscular hemoglobin and 26.7 pg is an extremely mild elevation most likely caused by fat in the blood or hemolysis caused by a not so wonderful blood draw. No doubt your vet is not concerned with that number. There is no way for your vet to know whether Cody has pituitary cushing's or an adrenal tumor. An abdominal ultrasound is the most favored test to make that determination. Based on the information you have provided it does look like Cody is symptomatic and may benefit from treatment. We've been around here for many, many years and have followed more case studies than most general practice vets will see in a lifetime or three. LOL Your vet's story about having a dog die from a fatal addisonian crisis is extremely rare and without knowing complete details such as dose, timing and results of the acth stimulation tests, I would not automatically assume that the drug was the sole cause of that unfortunate dog's demise. If proper dosing and monitoring protocols are adhered too, risk of adverse effects are greatly mitigated and in a lot of cases completely eliminated. I would hate for you to opt out of treatment because the only information you have about the drug is a horrific story about one dog's very unusual circumstance. To answer your question about CushAway, this is an online remedy that may help dogs with mild symptoms but at some point, symptoms will increase and eventually overcome the effects of any of these types of "alternative" treatment. None of the companies selling these products have done any clinical trials that would prove the safety and efficacy of their products and rely solely on customer reviews as their so-called proof. Ironically, I have seen a few rave reviews over the years posted by a few of our members who reached out to us when an online product was doing nothing for their dog. If it were my dog, I would save my money for an abdominal ultrasound. Given that Cody has other issues going on, I personally think asking for a referral to an internal medicine specialist is an excellent idea. The specialist can do the ultrasound and validate the diagnosis. A specialist can also provide a great deal of insight into Vetoryl as they likely prescribe that drug every day of the week. I'm glad you found us and please keep us posted.

    Glynda

  5. #5
    Join Date
    Dec 2018
    Posts
    20

    Default Re: Cody diagnosed with cushings

    Thank you so much for your feedback. As soon as the holidays are over I will be making some calls to get Cody into to seeing a specialist. I looked at your lists online and it says there is one about 45 minutes from me in Murrieta, Ca. so I will try there.

  6. #6
    Join Date
    Apr 2008
    Location
    Tennessee
    Posts
    6,568

    Default Re: Cody diagnosed with cushings

    I am happy to hear that you will be getting a consult with a specialist. I am from So Cal and miss having so many specialists within an hour's drive. I remember when there was nothing in Murrieta and the 15 freeway didn't exist and you took Rt 395 to get there. When I was a kid, the 60 nor the 10 freeways existed and you had take Mission Blvd all the way to L.A. We did have cars back then though. LOL Anyway, I did a search and found you have an internal medicine specialist in Murrieta. There are a lot more of them within 45 minutes but then, 45 minutes in So Cal may be five miles or fifty on a good day. I've provided a link to my search below. Happy Holidays and I'll be anxiously awaiting your update after the consult. Of course, don't hesitate to keep us posted or ask questions in the meantime.

    http://find.vetspecialists.com/searc...4ARj-3Unfku1BI

  7. #7
    Join Date
    Dec 2018
    Posts
    20

    Default Re: Cody diagnosed with cushings

    So I took Cody to the specialist in Murrieta to get a consult and an ultrasound. After checking him out, looking at the records from his regular vet and the ultrasound she said in her opinion he should get treatment. She said his gallbladder looked sludgy and his liver and both adrenal glands are enlarged but there are no tumors on any other organs. She said she believed it was pituatary. She said she would start him on a very conservative dose of Trilostane if we decided to treat it. She also said that 2 weeks after we start he will come back for a test than if the dose is ok once a month for 2 months. If he seems to be doing well she said she would do the Pre-Vetoryl Cortisol monitoring like they do in England to monitor his progress. She also recommended doing an echocardiograph to check on his heart murmur and possibly consider removing his bladder stones because one of them is an inch large and his bladder lining looks irritated but only after his cushings is stabilized. There is also something on his liver that they may biopsy when they do the bladder surgery. So much to digest. She is supposed to send the results to my vet and give her a call. Also they did a urinalysis and a cystitus profile to see if maybe the inflammation in the bladder was due to a bacterial infection. I should know by the end of the week.

  8. #8
    Join Date
    Apr 2009
    Location
    York, PA.
    Posts
    10,648

    Default Re: Cody diagnosed with cushings

    Her plan sounds pretty good to me. What is the Vetoryl dose she wants to start him on? And did she tell you that it is vital to give the Vetoryl with a meal so that it is properly absorbed? Also with Vetoryl, a dosage increase is not recommend until the dog has been on treatment for a month because cortisol can continue to drift downwards for the first 30 days of treatment.

    I'm so glad that you took your Cody to see an IMS, and to me, it looks like she knows what she is doing.

    Lori

  9. #9
    Join Date
    Dec 2018
    Posts
    20

    Default Re: Cody diagnosed with cushings

    She did not tell me the dosage but when I talk to my vet (After she talks to the specialist) I will find out. Thanks for the other information too. I will make sure to convey that to the vet as well if she doesn't tell me herself.

  10. #10
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,095

    Default Re: Cody diagnosed with cushings

    So you are aware - the recommended starting dose is 1mg per pound. So a 10 lb dog should start with 10 mg. The old starting dose was 3mg per lb and dogs were getting very sick so Dechra lowered it to 1mg/lb a year or so ago. Not all vets are aware of the change but now you are so you can be on guard just in case.
    "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.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •