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Thread: Brit has crossed The Bridge - new to cushing

  1. #1
    Join Date
    Jan 2019
    Posts
    6

    Unhappy Brit has crossed The Bridge - new to cushing

    Hi,
    My 10 year old boxer has just diagnose with cushing. She had a skin rash that was infected. they put her in antibiotics.(has not taken any in the last 2 days). Now she will not eat or drink. she is scheduled to start he cushing meds next week. has anyone else experience this . any help would be appreciated.

    jim

  2. #2
    Join Date
    Jun 2013
    Location
    Canada
    Posts
    1,077

    Default Re: new to cushing

    I am an old poster on this forum, and no expert, however there will be someone along soon to help you out. The first thing they are going to ask is how was your boxer diagnosed? What tests were performed? They will want to see copies of the tests. It is a good idea to provide them here, as my pup was diagnosed, and with the test results I posted here found out he did not have cushings... and the meds they prescribed sent him into an Addisonian crisis. Please wait for someone with loads of experience to get back to you before you start anything. In our experience we have found multiple times dogs are misdiagnosed believe it or not and that a lot of vets just are not very qualified when it comes to cushings. If you can get copies of the tests performed and post them here, that would be a great start.
    Last edited by spdd; 01-24-2019 at 12:14 PM. Reason: spelling
    Judi & "mah boy" Keesh

  3. #3
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,126

    Default Re: new to cushing

    Hi and welcome to you and your Boxer baby!

    Ok, we are gonna play 20 Questions!

    What antibiotics was she given? Did they tell you what kind of skin infection she had? Did she see a derm vet or her GP vet for that diagnosis? Was a skin punch performed to diagnosis the infection?

    Now for questions about her Cushing's diagnosis -

    What tests were given to diagnose the Cushing's - LDDS, ACTH, abdominal ultrasound?
    What signs did you see at home that concerned you - increased appetite, peeing a lot more, drinking a lot more, panting for no reason, hair loss or failure to regrow hair, pot belly?
    How much does your baby girl weigh?
    What drug did her vet prescribe to treat the Cushing's and at what dose?

    The answers to these questions will help us help you much better so the more you can tell us the more meaningful feedback we can offer. If you do not have the test results call the vet and ask for copies of all the recent testing - the actual results not the invoice that simply says what was done. We want to see the actual numbers.

    If she is not eating DO NOT start any treatment for Cushing's. Both drugs used to treat Cushing's are fat soluble meaning the must be given with a meal to be absorbed and used by the body. In addition, loss of appetite is one of the signs that the cortisol has dropped too low which is a life threatening situation. It is a general "rule" to never ever give either Lysodren (Mitotane) or Vetoryl (Trilostane) to a dog who is not well. Food she can go without for a few days but water is crucial. If she is still not drinking anything by morning, get her into the vet asap. You might try making her some plain chicken or beef broth (no seasonings at all), let it cool, and see if she will take that.

    Please keep us informed on how she is doing today.
    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.

  4. #4
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,130

    Default Re: new to cushing

    Hi Jim, and welcome to you and your girl. I noticed that you had started a second, duplicate thread. So I have removed that duplicate from view, and am posting this quick note so as to “bump up” your original thread to the top of the index page ;-).

    We’re so glad you’ve joined us, and we look forward to learning more about your girl!

    Marianne

  5. #5
    Join Date
    Jan 2019
    Posts
    6

    Default Re: new to cushing

    Here is what I have so far. not actual results(will get tomorrow).

    1/9 vet visit they did the following test Skin Cytology w/tape test gave her cephalexin 500mg for 14 days.

    performed pet wellness blood work

    intestinal parasite check.

    1/18 urine protein ctreat ratio

    lo dose dex supp test. this is what they used to tell me she has cushing I am getting Trilostane 70 mg liquid form because it is tough to give her pills.

    she was eating all the time the last several years after we got her fixed. never a big drinker, the reason I made the appointment was because her activity level was dropping. it is very low now. she was 90lb in may but her on weigh management food and she is now 75lb.

    tried to post a picture of the rash, i could not do it

  6. #6
    Join Date
    Apr 2009
    Location
    York, PA.
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    10,656

    Default Re: new to cushing

    Definitely get copies of those tests and post the results here, in that way we can get a better perspective of what is going on...thanks!

    Even though the Trilostane dose of 70 mg is within the recommended starting guidelines for your girl's weight of 75 lb, there is one study that suggest that larger dogs may need lower doses of Trilostane per pound than smaller dogs to control clinical symptoms, and we have witnessed this on the forum too. Here's a link to that study: https://www.ncbi.nlm.nih.gov/pubmed/22708554

    Regarding posting a picture of your sweet girl, here are instructions


    How do I use albums?

    As a member, you can create Albums of images that are linked to your public profile. Albums can be created by visiting the User Control Panel, and clicking on the 'Photos & Albums' link, and then clicking on 'Add Album'.

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    Profile albums are viewable only by you. However, you can use the images to customize your public profile (info)

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    All members who have access to your album images can comment on them, in a similar way to Visitor Messages (more info). You can delete any image comments from your albums, and report inappropriate messages to moderators.

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    Lori

  7. #7
    Join Date
    Jan 2019
    Posts
    6

    Default Re: new to cushing

    Quote Originally Posted by Squirt's Mom View Post
    Hi and welcome to you and your Boxer baby!

    Ok, we are gonna play 20 Questions!

    What antibiotics was she given? Did they tell you what kind of skin infection she had? Did she see a derm vet or her GP vet for that diagnosis? Was a skin punch performed to diagnosis the infection?

    Now for questions about her Cushing's diagnosis -

    What tests were given to diagnose the Cushing's - LDDS, ACTH, abdominal ultrasound?
    What signs did you see at home that concerned you - increased appetite, peeing a lot more, drinking a lot more, panting for no reason, hair loss or failure to regrow hair, pot belly?
    How much does your baby girl weigh?
    What drug did her vet prescribe to treat the Cushing's and at what dose?

    The answers to these questions will help us help you much better so the more you can tell us the more meaningful feedback we can offer. If you do not have the test results call the vet and ask for copies of all the recent testing - the actual results not the invoice that simply says what was done. We want to see the actual numbers.

    If she is not eating DO NOT start any treatment for Cushing's. Both drugs used to treat Cushing's are fat soluble meaning the must be given with a meal to be absorbed and used by the body. In addition, loss of appetite is one of the signs that the cortisol has dropped too low which is a life threatening situation. It is a general "rule" to never ever give either Lysodren (Mitotane) or Vetoryl (Trilostane) to a dog who is not well. Food she can go without for a few days but water is crucial. If she is still not drinking anything by morning, get her into the vet asap. You might try making her some plain chicken or beef broth (no seasonings at all), let it cool, and see if she will take that.

    Please keep us informed on how she is doing today.
    Hugs,
    Leslie

    here is what I got

    CORT baseline cortisol 8.9

    CORT 4 hour post low dose dex 7.8

    CORT 8 hour post low dose dex 8.2

  8. #8
    Join Date
    Apr 2009
    Location
    York, PA.
    Posts
    10,656

    Default Re: new to cushing

    The picture you sent to our gmail, which I've included here, really looks like she has Calcinosis cutis (CC) and if so, it can be difficult to get under control, one main thing is that the cortisol needs to be under 5 ug/dl. I do recommend that you get a biopsy done on the area to confirm Calcinosis cutis.
    Attached Images Attached Images

  9. #9
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,130

    Default Re: new to cushing

    Hello again from me. I do agree with Lori that the photo strongly appears to be calcinosis cutis. For some reason, it seems that boxers seem to be over-represented here in terms of exhibiting that particular Cushing’s symptom :-((((. And as Lori says, unfortunately it can be challenging to get under control unless cortisol levels remain at relatively low levels through the use of medication.

    As far as the current lack of appetite, it’s possible that the antibiotics were upsetting her stomach. Hopefully that problem will reverse once the antibiotics have ended.

    One thing I do want to note are your LDDS results:

    CORT baseline cortisol 8.9

    CORT 4 hour post low dose dex 7.8

    CORT 8 hour post low dose dex 8.2
    Has your vet explained that this pattern can occur in conjunction with either a pituitary or an adrenal tumor? If an adrenal tumor is the cause, surgery can offer a complete cure. However, this type of surgery is very expensive and also risky, so it may not be an option that you would even consider. However, I just wanted to let you know that these LDDS results do suggest that an adrenal tumor is a possibility. An abdominal ultrasound would likely provide you with more complete information in this regard.

    Marianne

  10. #10
    Join Date
    Jan 2019
    Posts
    6

    Default Re: new to cushing

    thanks for the info. Considering her age We are not going to do surgery. Vet called me to day and we are going to try prilosec 20mg. If thinks do not improve tomorrow we will take here to have an IV started to get her strength back before starting the cushing meds. she has been off antibiotics for 4 days now. the Calcinosis cutis just started 2 weeks ago. Thanks for everyones help.

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