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Thread: My havanese pup has been diagnosed with cushings

  1. #11
    Join Date
    Mar 2009
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    rural central ARK
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    Default Re: My havanese pup has been diagnosed with cushings

    Hi and welcome to you and Snoopy!

    It's been a few days now and I am curious if Snoop is still showing the same reaction following the Vetoryl? And - have you seen any loose stools or diarrhea, signs of nausea or vomiting? Is his appetite still good?

    I'm glad you found us and look forward to hearing about that ultrasound! That test gives us the biggest bang for the buck because not only can it go a long way in diagnosing Cushing's, and telling us which type, it lets us have a look at many other organs to boot!

    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.

  2. #12
    Join Date
    Jun 2019
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    10

    Default Re: My havanese pup has been diagnosed with cushings

    Hi Leslie,

    Sorry for the late reply.

    Snoopy is doing fine, other then that first hour or so when he started the Vetoryl where he looked very relaxed and not wanting to get up to follow me like he normally does, he has shown no other reaction to the Vetoryl, it's only been a week but he is already drinking less water, pretty much back to what he was drinking before the cushings, is this normal for his drinking to return to normal in just one week? His appetite has not changed though. I have been feeding him lots of steamed vegetables to satisfy his hunger without giving him too many calories, he seems to like it.

    My Vet doesn't have an ultrasound machine on site, so we had to schedule for a specialist to come in with the ultrasound equipment.
    His ultrasound is scheduled for this Tuesday.

    Hoping for the best and will update when I get the results.

    Thanks

  3. #13
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    York, PA.
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    Default Re: My havanese pup has been diagnosed with cushings

    It usually takes around 2 weeks to see improvements in thirst and hunger, but all dogs react differently so the decrease in drinking in one week wouldn't worry me too much. Glad he likes those steamed vegs, that ravenous appetite sure can get out of control!

    Good luck with the ultrasound and let us know the findings, please.

    Lori

  4. #14
    Join Date
    Apr 2009
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    Georgia
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    Default Re: My havanese pup has been diagnosed with cushings

    Good luck with the ultrasound from me, too! Also, my Cushing’s boy was one who showed improvement in his thirst/urination within just 2-3 days of starting the trilostane. So I know from personal experience that it’s possible to see changes within a very short amount of time ;-).

    We’ll be watching for your further updates,
    Marianne

  5. #15
    Join Date
    Jun 2019
    Posts
    10

    Default Re: My havanese pup has been diagnosed with cushings

    Hi All,

    I got good news to report, ultrasound results came looking positive for my little guy.

    The following is the ultrasound report for him

    Diagnostic Imaging Report Findings

    29 still B-mode and colour Doppler ultrasound images as well as 3 video clips are provided for evaluation.

    Liver/GB: The liver is subjectively increased in echogenicity. No abnormalities are detected.
    The gallbladder is mildly to moderately distended with small, hyperechoic foci adhered to the ventral gallbladder mucosa.
    The small foci are most consistent with mineralized sediment. Gallbladder wall thickness is normal.

    Spleen: Normal echogenicity and echotexture. No abnormalities seen.

    Left kidney: Measures slightly small right kidney 4.32 cm in length. No pylectasia, mineralization or other abnormalities are detected.

    Left adrenal: Mildly, uniformly enlarged for the size of the patient, measuring 7.1-7.4 mm. No nodules or masses are seen.

    Urinary bladder: No abnormal findings.

    Right kidney: No abnormal findings. 5.25 cm in length.

    Right adrenal: Mildly enlarged caudal pole, measuring 7.2-7.4 mm in thickness. No nodules or masses are seen.

    Stomach: No abnormal findings.

    Pancreas: No abnormal findings in the region of the right pancreas.

    Small intestines: Normal wall layering and thickness (3.7-3.8 mm for jejunum and 4.3 mm for duodenum). No abnormal findings.

    Colon: Normal wall layering and thickness (1.2 mm). No abnormal findings.

    Sublumbar region: No abnormal findings.

    Other: A solitary long access view of the heart is provided. No abnormalities are seen.

    Opinion & Recommendation
    Mild bilateral adrenomegaly. No adrenal nodules or masses are seen. Primary consideration is given to pituitary dependent hyperadrenocorticism given the bilateral adrenal changes.

    Mildly, diffusely hyperechoic liver, likely secondary to hyperadrenocorticism in light of the history. Other differentials including hepatopathies or hepatitis may be less likely.

    Left kidney measuring slightly smaller than the right kidney could be an incidental finding in the absence of elevated renal values on bloodwork. No pylectasia, mineralization or other evidence of renal disease is detected.

    Suspected mild mineralized gallbladder sediment adhered to the ventral gallbladder mucosa. This could be an incidental finding in the absence of gallbladder wall thickening or secondary to cholestasis.

    No additional abnormalities detected.

    My Vet believe that the abnormalities found are due to his cushings and don't believe he has any other conditions.
    I will be seeing my Vet next week for his first ACTH test, if anyone sees anything in his ultrasound report that I should ask my Vet about please let me know.

    Thanks
    --Frank
    Last edited by Snoop; 07-06-2019 at 12:21 AM.

  6. #16
    Join Date
    Apr 2009
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    Default Re: My havanese pup has been diagnosed with cushings

    The enlargement of the adrenal glands could be due to just the use of the Trilostane as it is known to have that effect on them.

  7. #17
    Join Date
    Feb 2019
    Location
    Spring Valley, Il
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    169

    Default Re: My havanese pup has been diagnosed with cushings

    Hi Frank,
    I know how much better you must feel since the ultrasound! As a pup mom who has been through two pups with gallbladder problems, I would recommend you ask your vet about “sludge” in the gallbladder. My angel schnauzer, Gracie, was diagnosed with a sludgy gallbladder when she was only seven and we managed it until her death in January of this year.

    Fast forward, now we have Annie who had an enlarged gallbladder with a complete mucocele blocking her bile duct which resulted in us rushing her to Chicago for emergency surgery in April. I’m not trying to scare you with Snoop—-please trust me.

    In June we had to take Annie to her eye doctor two hours away. She has cataracts which are stable at this point. However, in talking about Annie’s journey to this point, she made the comment “ I think gallbladder problems in dogs are under-diagnosed and mostly overlooked by most regular vets.”

    You might want to ask more questions about Snoops gallbladder numbers, ask about sludge, and anything else. I”m so thankful you were able to get this done for your boy. Blessings to you and Snoop. Karen
    Last edited by Katy1; 07-08-2019 at 11:38 AM.

  8. #18
    Join Date
    Jun 2019
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    10

    Default Re: My havanese pup has been diagnosed with cushings

    Thanks for the suggestion Karen, I will ask my Vet what the findings about snoopy's gallbladder mean.
    My Vet spoke to me about the ultrasound results before she sent me the report, so I didn't get a chance to see the report before speaking with her.
    Snoopy is scheduled for his first ACTH test this week so I will be seeing her this week.

    Frank

  9. #19
    Join Date
    Jun 2019
    Posts
    10

    Default Re: My havanese pup has been diagnosed with cushings

    Hi All,

    Got the results for my snoops ACTH test

    Pre 31 nmol/L
    Post 81 nmol/L

    My vet said snoops looks to be doing very well on his current treatment and suggest I can wait 60 days before his next test.
    Before the test my vet said 30 days but seeing that he's doing well, she said I can probably wait 60 days, Is that a good idea to wait that long considering where his current readings are?

    Also, he does have some sediment in his gallbladder, my Vet said its a small amount and that there is no blockage or anything like that and that it should clear up over time.
    If his blood test later on shows any abnormalities then we can look at it again at that time.

  10. #20
    Join Date
    Apr 2009
    Location
    Georgia
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    13,969

    Default Re: My havanese pup has been diagnosed with cushings

    Hello again, and thanks so much for all the additional info you’ve been giving us. Regarding the ACTH results, for the benefit of some of our other readers, I’m converting Snoopy’s results into the units that are most commonly reported here in the U.S.:

    Pre-ACTH: 1.12 ug/dL

    Post-ACTH: 2.93 ug/dL

    The “pre” number is just a hair low, but the “post” number is squarely within the desired therapeutic range for a dog taking trilostane, so that’s indeed great since that’s the primary number upon which dosing decisions are made. Since you’re asking our opinion about retesting, though, I’d advocate for testing again in another 30 days. In looking back through your thread, I’m thinking that this first monitoring test was taken after three weeks of treatment? If so, we still might expect that his cortisol level could continue to drift downward a bit more while still taking this same dose. For safety’s sake, I believe I’d want to see where it has “landed” by another month from now. If everything is still A-OK then, I’d think you could follow Dechra’s protocol and finally make the leap to wait for three months before testing again :-).

    Whatever you decide, please keep us in the loop. And congrats on all these good test results ;-).

    Marianne

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