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Thread: Dog not eating and has Cushing's

  1. #51

    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Quote Originally Posted by fkhan View Post
    I'm still waiting on her Thyroid test to come back, which was over a week ago. Given the immune suppression of cortisol in our dogs, I'm supplementing Pookie with Vit C twice a day. Since Cushing's has effected her liver and her kidneys were failing last month, I have her on Azodyl, SubQ's, Denamarin Advanced, and Vit B12 shots once a week. I also give Pookie fishoil, Pepcid, HMR lignans, Kidney Gold, and just started alternating Kidney Gold and Adrenal Harmony, and a little Ginkgo Biloba again. Since my vet hasn't recommended Trilostane, I have to be my own vet and see what works and doesn't work for Pookie. It's dangerous to experiment with our own dogs, but I feel leaving Cushing's untreated is not a good idea. At the least, I think VitC is needed if their immune system is being suppressed. Since Pookie is suspected of have been dealing with Pancreatitis, her CLP still shows a light positive, but the Vet said it could take time for that to resolve.
    Pookie is doing pretty good given the circumstances and her age. Since I'm still waiting on the Thyroid test and my vet doesn't know yet if we should start the Trilostane, I started adding back the Adrenal Harmony and Ginkgo Biloba at night. She was on this stuff for months before her episode of possibly Pancreatitis and elevated kidney values. Pookie gets SubQ's/3week, VitB12shot/1week, FishOil at night, Kidney Gold in day, Azodyl/day&night, Denamarin Advanced/morning, VitC/day and night, HMR Lignans/day&night, and Pepcid at night. Given her issues, I have to try and suppress that cortisol, but be careful about her kidneys and liver. I'm watching her clinical signs like a hawk when I can and will stop these supplements if I notice something out of the ordinary. I think the VitC is important, bec her immune system is being suppressed. Pookie could die any day now or live a year or longer. I really despise Cushing's. The strange thing is that one of her clinical signs for almost a year have been panting. She doesn't pant like she use to and that clinical sign is gone. I can take Pookie for walks again, but not far. She doesn't like chicken anymore, so ground beef made at home works as well as the Nutro Lamb and Duck trays. She eats baby carrots sometimes and she gets some peas, green beens, and brocolli sometimes too.

  2. #52

    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Just an update. Pookie is eating kibble again after a month. Not sure what to make of this, but kibble is not good for her Cushing's, but this isn't her main dish in the day, just a snack that's left out.

  3. #53
    Join Date
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    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Quote Originally Posted by fkhan View Post
    ... but kibble is not good for her Cushing's, ...

    Why is her kibble bad for the Cushing's?

  4. #54

    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    I thought kibble was bad, because it's not fresh. I could be wrong. Do you think it's ok for Cushing's dogs to eat kibble?

  5. #55
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    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Yes, kibble is fine. We do recommend that a high quality protein be listed as the first ingredient, however, if a dog is doing well on a certain dog food than it really doesn't have to be changed.

  6. #56

    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Just got a call from my vet and said her base cortisol level is now under the normal range at 1.7. Pookie was given a trazadone the day her blood was drawn. I don't know if Trazadone could be the cause or not. Now that her cortisol is low, we were thinking of waiting to start Vetoryl. Her clinical sign of Cushings for the past year have been panting and hair loss/skin pigmentation, increased appetite with a little thirst increase. Now after Pookie crashed/Pancreatitis over a month ago, her only clinical sign is hair loss/skin pigmentation. We decided to wait a week or two and run another ACTH stim test. I'm concerned now, because her cortisol level is low. All tests in the past year have shown High cortisol and the vet said it could just be a fluctuation that occured. Pookie has had consistent high levels over 3-4 tests and now low, which has me putting on the brakes.

  7. #57
    Join Date
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    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Hello again from me! I’m sorry it’s been such a long time since I last wrote on your thread, but I’ve been traveling and am just now having the chance to catch up again on the forum. After reviewing your recent posts, I agree with your decision to hold off on starting the Vetoryl at this time. Truly, I think there are too many question marks as to whether or not Pookie would benefit from the medication, even assuming that she truly has Cushing’s.

    A first cautionary note is that resting cortisol levels alone have no Cushing’s diagnostic value at all. They are simply too variable. For instance, stress itself can elevate a baseline cortisol level in even a healthy dog. Conversely, I would guess that a medication with sedating properties such as trazadone could artificially lower a baseline reading in a dog who otherwise might routinely run higher levels. For this reason, Cushing’s diagnostics require a more complete picture gained from either a LDDS test or an ACTH test, both of which you’ve had done in the past. Pookie did return a mildly elevated result on her LDDS, but that test is particularly vulnerable to “false positives” in the presence of other illnesses or systemic stress, of which it sounds as though Pookie has had quite a few medical issues going on. The ACTH is less vulnerable to false positives, and Pookie’s cortisol level fell within normal range on that test. If her repeat ACTH is still negative next week — coupled with the recent drop-off of the observable symptoms that prompted you to suspect Cushing’s in the first place — I would really question whether she actually suffers from the effects of elevated cortisol at all.

    Even if so, I do think you need to carefully weigh the advisability of giving Vetoryl to a dog with a history of serious renal dysfunction. If the kidneys are not working properly, the danger of a trilostane overdose is increased because the body is not capable of optimally flushing the drug out of the system. This can create a very dangerous, even life-threatening, situation.

    I know you are trying so hard to give Pookie the best quality of life that’s possible. I’m just fearful that given her age and medical history, the testing and risks associated with starting Vetoryl may make things harder for you both rather than easier. Her appetite may be depressed even further, she’ll require ongoing blood draws and vet visits, and her risk of overdosing may be heightened. If you do decide to proceed with treatment, we’ll do our very best to support and guide you. But in honesty, if Pookie were my own dog, I’d likely forego starting a potentially risky treatment requiring such rigorous follow up as Vetoryl, and instead try to keep her life as stressfree as possible with the foods, supplements, and homecare that brings her the greatest comfort. Either way, though, we’ll surely be anxious to know how things are going for you both.

    Marianne

  8. #58

    Default Re: Looking for Dr. on East Coast for Pituitary Tumor Removal

    Quote Originally Posted by labblab View Post
    Hello again from me! I’m sorry it’s been such a long time since I last wrote on your thread, but I’ve been traveling and am just now having the chance to catch up again on the forum. After reviewing your recent posts, I agree with your decision to hold off on starting the Vetoryl at this time. Truly, I think there are too many question marks as to whether or not Pookie would benefit from the medication, even assuming that she truly has Cushing’s.

    A first cautionary note is that resting cortisol levels alone have no Cushing’s diagnostic value at all. They are simply too variable. For instance, stress itself can elevate a baseline cortisol level in even a healthy dog. Conversely, I would guess that a medication with sedating properties such as trazadone could artificially lower a baseline reading in a dog who otherwise might routinely run higher levels. For this reason, Cushing’s diagnostics require a more complete picture gained from either a LDDS test or an ACTH test, both of which you’ve had done in the past. Pookie did return a mildly elevated result on her LDDS, but that test is particularly vulnerable to “false positives” in the presence of other illnesses or systemic stress, of which it sounds as though Pookie has had quite a few medical issues going on. The ACTH is less vulnerable to false positives, and Pookie’s cortisol level fell within normal range on that test. If her repeat ACTH is still negative next week — coupled with the recent drop-off of the observable symptoms that prompted you to suspect Cushing’s in the first place — I would really question whether she actually suffers from the effects of elevated cortisol at all.

    Even if so, I do think you need to carefully weigh the advisability of giving Vetoryl to a dog with a history of serious renal dysfunction. If the kidneys are not working properly, the danger of a trilostane overdose is increased because the body is not capable of optimally flushing the drug out of the system. This can create a very dangerous, even life-threatening, situation.

    I know you are trying so hard to give Pookie the best quality of life that’s possible. I’m just fearful that given her age and medical history, the testing and risks associated with starting Vetoryl may make things harder for you both rather than easier. Her appetite may be depressed even further, she’ll require ongoing blood draws and vet visits, and her risk of overdosing may be heightened. If you do decide to proceed with treatment, we’ll do our very best to support and guide you. But in honesty, if Pookie were my own dog, I’d likely forego starting a potentially risky treatment requiring such rigorous follow up as Vetoryl, and instead try to keep her life as stressfree as possible with the foods, supplements, and homecare that brings her the greatest comfort. Either way, though, we’ll surely be anxious to know how things are going for you both.

    Marianne
    Hi Marianne,

    Thank you for your feedback. My vet also suggest that if it were her dog, she wouldn't treat, but she said it was up to me. I am just worried about not treating and encountering another episode; pancreatitis, blood clots, etc if left untreated. I was told by my vet that even if we treat a cushpup, that they still have an increase in these types of episodes. This leads me not to treat. I will probably do another acth without trazodone in a week or two and see what it looks like. Thanks again!

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