Re: Cushings and Hypothyroidism
Hi Tracy,
Welcome to you and Cowboy!
Yes, Cushing's can cause a condition called Euthyroid Sick Syndrome which usually clears up once the cortisol is in a more normal range. If the pup is truly hypothyroid then taking meds for both conditions is fine - the do not counteract with each other. Weight gain is caused by Cushing's as well as low thyroid so that cannot be used to determine the effectiveness of the thyroid treatment. Only a thyroid assay can tell you if the med is helping or now. The pot belly is a hallmark sign of Cushing's.
I am a bit concerned about the dose of Vetoryl Cowboy has started on in spite of the continuing signs you are seeing. The starting dose for dogs of his weight is 0.05mg/lb. Recent studies have shown that larger dogs (60 lbs+) are very often much more sensitive to this drug than smaller dogs and need a much smaller starting dose as a result. However you don't mention any of the signs of over dose - loss of appetite, loose stools/diarrhea, nausea/vomiting, or lethargy - so I am not panicked just yet. The concern is that the cortisol can suddenly drop too low so please keep an eye on your sweet boy for the signs I mentioned. If you see ANY of them, stop the Vetoryl immediately and call the vet for another ACTH and electrolyte check. Low cortisol is a life threaten situation so don't take any chances. Cowboy is six days into treatment so you could see signs of improvement or danger at any time so watch him closely the next few days.
I am assuming he is scheduled for either an ACTH or PVC monitoring test next week? This should be done 10-14 days after starting treatment, another at 30 days after starting treatment, then every 90 days thereafter IF the results are within range and signs are improved. This testing schedule starts all over at the 2 week mark with any dose change. So if he is not scheduled, please call his vet Mon and get this set up. Ask which test the vet will be using - ACTH or PVC - to monitor as they are handled differently and you will need to do different things before the test is given. So you want to be sure which one is used so you know what you are supposed to do.
Would you mind getting a copy of all the testing done to diagnose the Cushing's - the ACTH you mentioned plus any labs that show things like BUN, CHOL, ALP plus the test called the CBC? They should be glad to give them to you. (It is the perfect time to start the habit of asking for test result from now on so you can keep them in a file at home.) If you would post the abnormal results, too high or too low, from those tests it would help us to give you more meaningful feedback. I am also a bit concerned about the diagnosis because you say these signs started suddenly. Cushing's does not come on suddenly but very slowly, snail's pace slow, over years. In fact most people just think their dog is getting older and don't realize a disease is present. Cushing's is one of, if not THE, most difficult canine disease to correctly diagnose because so many other conditions share the same signs and can cause false positives on the tests for Cushing's. This happened to two of my babies - misdiagnosed because of other conditions/health issues that were present. A tumor on the spleen in one and multiple issues including COPD in the other. So the fact that you say this started suddenly causes me to wonder about the diagnosis. Was an abdominal ultrasound done? If not I highly recommend having this done if at all feasible. You want it performed on a high resolution machine which most GP vets don't have so you may need a referral to get this test done. It is well worth it tho as it will tell you a great deal about his organs and will also help determine if Cowboy has Cushing's and if so which form - adrenal or pituitary.
I'm glad you found us and look forward to seeing those test results soon!
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.