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  1. #1
    Join Date
    Mar 2020
    Location
    Allen, Texas
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    Default New to Forum

    Hello Everyone! I am new to all this Cushings stuff. My dog, Jake, who is a Chiweenie at about 15 lbs, is 11 years old and he was just diagnosed with Cushings. He had the thirst, shaking, extra urinating, you know, all the classic symptoms. All of his counts were off the chart! I had been taking him to the vet because the vet found a mass on his liver/pancreas area and it was thought to be a tumor. Well, I started noticing little bumps and blood where he had been scratching all over his body. That is when we did the test for Cushings and it was positive. It was a relief and a fear, since it wasn't cancer, but it was indeed something. The vet shaved Jakes back and it looked like mold all over his back (so gross). So I got DMSO sauve to put on his bumps. Well, his bumps are breaking open and they are all bloody. Has anyone experienced this? That DMSO smells like garlic, it is so gross! Rubber gloves are hard to find these days!
    The vet put him on Vetoryl 30 mgs. We just started it yesterday. I'm hoping for better numbers when we go back! Any advice I can have on his bloody spots on his back? Has anyone experienced this?


  2. #2
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,227

    Default Re: New to Forum

    Hello and welcome to you and Jake! Weíre so glad youíve found us, but surely sorry for the problems youíre having. From your description, Iím guessing that Jake may be suffering from a skin condition named Calcinosis Cutis. It is one of the most unfortunate side effects of Cushingís due to the potential discomfort to the dog, and the patience it requires to treat it. The single most important issue is to significantly reduce the amount of circulating cortisol. Even once thatís achieved, it can still take time for the calcium deposits to work their way up through the skin. Secondary bacterial infections are common, so medicated shampoos and sprays are often recommended in addition to the DMSO. The only way to diagnose this condition for sure is through a skin biopsy. But if you Google it, you can find pictures that you can compare to Jake. Rather than writing more about CC here, Iíll go ahead and direct you to a specific thread thatís devoted to postings about it. Once youíve looked it over, you can come back here and we can pick up any additional questions you may have.

    https://www.k9cushings.com/forum/sho...eatment-thread

    Returning to the all-important issue of reducing the cortisol, Vetoryl is indeed an effective treatment and one thatís commonly used by our members here. However, Iím very concerned that your vet is starting Jake off with a dose of 30 mg. Given Jakeís weight, that is twice the dose that is currently recommended by researchers and specialists who commonly treat Cushingís patients. When the medication was first introduced, higher doses were commonly prescribed. However, experience has shown that dogs typically suffer fewer side effects and less risk of overdose if the medication is introduced at a lower dose and then increased as needed, rather than vice versa. Current recommendations are to start at initial doses that do not exceed a formula of 1 mg. per pound. In the U.S., Vetoryl is sold capsule strengths of both 5 mg. and 10 mg. It would be much safer for Jake if he was started on a lower dose than the 30 mg.

    Given Jakeís significant symptoms including his skin eruptions, your vet may be thinking that itís better to be more aggressive in terms of dosing. But the manufacturer specifically advises that initial dosing decisions be based solely on weight ó not on symptom severity. As I say, these dosing recommendations have evolved over time, and your vet may not be familiar with the changes. But hereís a post that you can print out to show him/her:

    https://www.k9cushings.com/forum/sho...=1251#post1251

    If Jake were my own dog, Iíd ask my vet to start off first with either a 10 mg. capsule, or a combination of a 10 mg. and 5 mg. capsule. After subsequent monitoring blood testing is performed, the decision may indeed be made to increase the dose. But truly, itís safer to start off lower to begin with.

    OK, Iíll close for now. But once again, welcome to you and your little boy!
    Marianne

  3. #3
    Join Date
    Mar 2020
    Location
    Allen, Texas
    Posts
    2

    Default Re: New to Forum

    Oh wow. I really appreciate your post. That was very informative. Yes, the vet did mention Calcinosis Cutis. I gave him a warm bath with oatmeal soap and he seemed to love it! I also put a bandage over the worst skin eruption so he wouldn't lick it and keep it moist. It looks to be working! He goes into the vet on the 27th for more blood work to see if his numbers are down. This sure is an expensive path we have had to take, but my boy is worth it! Thanks again for the welcome!

  4. #4
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,171

    Default Re: New to Forum

    Hi!

    Welcome to you and Jake!

    I cannot stress strongly enough how important the information Marianne gave you about the dosing is. This drug is VERY powerful and a dose that is too high can result in permanent adrenal gland damage, even death....and it can happen very quickly. If you have not stopped the 30mg you MUST do so today. Do not give Eli one more dose at 30mg, please, for his sake as well as yours. Call his vet and tell them to give you 10mg capsules and start him on that dose. Remember, they work for you not the other way around. This drug has gone thru many changes since its release in the mid-2000's and sadly some vets are still referring to text books that have the old dosing guidelines, resulting in very sick dogs if they are lucky, in broken-hearted parents if they are not. Dechra, the manufacturer, says it is best to start as low as possible and gradually increase if needed based on signs and ACTHs. If this vet will not listen and do as Eli requires, find a new vet. Waiting a while to start treatment won't cause nearly as much harm as giving this drug at too high a dose, which 30 mg is.

    You mention a tumor on the liver or pancreas? Am I understanding that right? If that is the case, then any positive results on any testing for Cushing's is highly suspect making it even more important that you stop giving the 30mg Vetoryl. My first cush pup tested positive on the LDDS, HDDS, ACTH, and UTK panel but when the ultrasound was done a tumor was found on her spleen. Once that tumor was removed her cortisol returned to normal. The tumor had caused the cortisol to rise in a natural response to the stress the tumor was causing. My second dog who tested positive had a host of other health issues. Her cortisol was so high it couldn't be measured. Her necropsy (animal autopsy) proved she never had Cushing's at all. Her cortisol was extremely elevated due to all the other things going on in her little body. Cortisol is a fight or flight hormone and will rise in response to any stressor, internal or external. So IF Eli does have a tumor then I am not at all convinced he actually has Cushing's. However if this is CC on his skin then I feel a little better about the diagnosis. CC is almost always caused by Cushing's, or steroid use, but can be caused by other things. A derm vet could make that determination if needed.

    Your most important take-away from my post is to STOP the 30mg Vetoryl and get the 10mg from either this vet or a new vet plus get clarification on the tumor. Eli is counting on you since he can't speak for himself.

    I'm glad you found us and look forward to learning more as time passes about you as well as your sweet baby boy.
    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.

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