Border Terrier with Cushings had a possible stroke or brain tumor?-Ollie has passed

[mgcuws]

Hi All -
My Border Terrier Ollie is 13 1/2 and has been living with Cushings Disease and Water Diabetes for about 6 years now. He takes Vetoryl and Desmopressin 2x daily and has been very well managed by his great doctor in NYC for years now. Yesterday, however, he had some kind of seizure after lunch with his head tilted down and was turning in weird circles and his legs gave out. It only lasted about 3-5 minutes and he was pretty calm. He got back up and ate and was fairly normal. But then he had a much worse episode where he was pacing and turning and disoriented and walking in weird circles. His legs kept giving out as well.

We're living in the middle of nowhere because of Covid this year, but we drove two hours to the emergency vet hospital. They weren't super helpful. It could be a brain tumor or a stroke but the vet wasn't sure at his age and with all of his underlying issues if it was worth doing the MRI since we probably can't do anything for either. I'm heading back to NYC Monday and have an appointment with our vet there but does anyone have any experience with older dogs and either strokes/brain tumors?

The old guy is up and walking, eating and resting a lot today but no seizures. His back legs have given out a few times. It's all a bit heartbreaking. I'd always thought it would be his kidneys that would go, but I"m not sure how much time he has left now given whatever is going on. He's a really anxious dog and I'm not sure I want to subject him to a lot of unnecessary vet/hospital visits.

I haven't posted before - but I have read a lot of the forums over the year. It's been a great resource and I appreciate the community.

[Squirt's Mom]

Hi, we are glad you and Ollie introduced yourselves!

At first I thought it might be Vestibular Disease but that typically sticks around for a while once it shows up, not coming and going in episodes like you have described. So my thoughts are the same as yours now - either a seizure disorder or something with the brain itself. In the pituitary form of Cushing's the tumor on the pituitary gland typically remains microscopic causing nothing more than the usual cush signs. However, in rare cases that tumor starts to grow becoming a macroadenoma, or macro for short. It causes neurological signs just as any tumor on the brain can. There are other types of brain tumors of course but as far as I know the only way to determine if this is what is going on is either a CT scan or MRI. If you weren't going to treat via radiation or surgery then I'm not sure I would go to the expense of either of those tests unless simply knowing is that important. One thing to consider is the Vetoryl - cortisol is a natural anti-inflammatory and with macros it is usually best to stop the Vetoryl and let the cortisol rise which will help slow the growth. Otherwise lowering the cortisol allows the tumor to grow more rapidly. I am going to give you a link on the forum that was started by a member in 2011 whose baby developed a macro. Others added their stories over the years in order to help those who came after and faced this same diagnosis. You can read thru and see if anything in these stories fits with Ollie.

I would also try to get him in to see a vet who can talk to you about seizure vs macro as soon as possible. Hopefully with the vaccine being given to more and more of us things will loosen up soon. I have a dog who has focal seizures but her episodes display as a feral dog - she doesn't recognize anyone or anything as opposed to what we typically think of happening with seizures. Another of my babies had one episode that could have been a seizure in which she when limp, fell to the floor and seemed disoriented for a few seconds. She was a little out of it for a few minutes after. But it happened only that once thankfully.

You can use the search feature on the forum to look for "seizure" and "macro" too which should take you to threads and/or posts where these topics are discussed. Here is that link on macros:

https://www.k9cushings.com/forum/sho...-Macroadenomas

I'm glad you decided to talk to us and look forward to learning more. Please stay in touch and let us know how your sweet baby boy is doing.
Hugs,
Leslie

[labblab]

Hello and welcome from me, too. Leslie has done a great job of covering the bases re: the possibility of an enlarging pituitary tumor, so I don’t really have anything to add in that regard. If you do take look at the macrotumor link that she gave you, you’ll see my story there about my experiences with my own Cushpup.

In addition, I do have experience with seizure disorder in my non-Cushpup Lab girl. She started exhibiting grand mal seizures of unexplained origin around the age of six. During an episode, she would suddenly get very agitated and uncoordinated, trying to run around in circles but finally falling to her side and “paddling” with her legs. I would guess each episode would last maybe 3-5 minutes. We decided against the brain imaging, too, and instead tried her on an experimental course of phenobarbital. Miraculously, she responded with a minimum of side effects and total remission of her seizures. We were very, very lucky. She stayed on the phenobarb for the rest of her life, and lived until age 12.

Phenobarb is one of the older anti-seizure meds — several newer ones are in use now. I’m thinking that your vet may recommend just giving some medication a try, too, rather than launching into involved diagnostics at this stage. Regardless of what ends up being recommended, though, please do come back and let us know, OK?

Marianne

[mgcuws]

Thank you both for these amazing responses. It's so helpful and I look forward to reading more about Macro tumors which sounds like it could be a real possibility. I, too, had wondered about Vestibular Disease but his recovery has been so quick that I don't think that's the case.

I hadn't realized that about the Vetoryl possibly causing the tumor to grow more quickly, so I'll ask my vet about that. I had a dog with epilepsy in the past, so I've been through that as well - this seems very different.

He's got so much life in him- I'm always amazed how he bounces back at times I think it's impossible. Hopefully there will be some good days ahead. I appreciate the support - and help. Will keep you posted!

Michele

[labblab]

Hi again, Michele! Definitely do take a look at that macroadenoma thread in order to see if any of it corresponds with what you’re experiencing now with Ollie. In terms of treatment, one paradox you will see is that Cushpups with suspected macros are sometimes given both trilostane and prednisone, simultaneously. The explanation is given in that thread, so I won’t take the time to rewrite it here. I think the jury may still be out as to whether or not trilostane actually hastens tumor growth significantly. I’m afraid I haven’t been following recent research in that regard closely. But either way, allowing a higher level of circulating steroids can reduce the swelling and inflammation of the tissue of the brain that the tumor may be affecting. So either stopping the trilostane, or combining the trilo with prednisone are both strategies that we’ve seen employed.

Good luck with your vet visit, though, and maybe some other possibilities will emerge, both in terms of causation and treatment. I surely hope you’ll be able to find a way to make Ollie as comfortable as possible, no matter what is going on.

Marianne

[mgcuws]

Hi Marianne,
I have been reading through the thread (I had to drive back to NYC this morning so I had a lot of distractions getting ready

I do think this is probably a good explanation of what's happening with Ollie. I don't know how I confused him being on Vetoryl when he's really on Trilostane. The medication he's on is still managing his Cushings and Water Diabetes fairly well, but I'll have to ask the doctor about what it means if he's got a tumor.

Oddly he hasn't had another episode and he's a lot stronger again, his hind legs are holding him up pretty well, though he does appear weaker to me and he's still looking for more water than usual. Did any of you notice there there were bouts when things seemed a bit better? The vet seemed to imply that with this kind of thing it would just depend on when the seizures came so frequently that he was suffering and we'd know it was time to free him from his pain. He's already 13.5 and so I don't see the point of putting him through all of the tests to find out exactly what it is as there really isn't much to do at this point from what I've read except keep him happy as possible so we call all enjoy the time he remains with us.

It was a bit heartbreaking reading through the Macro thread. It's like I know what's coming, but it's so hard. I haven't cried this much in a long time. It's nice to have some good time with him now though and I'll appreciate every moment.

Thanks to everyone on this forum - it's really been the best resource for Cushings information I've found. It's a tricky disease and vets often don't have the time to really explain to you what to expect. Although, I'e been fortunate to have very good ones.

I'll keep you posted.

Michele

[Harley PoMMom]

Tons of loving hugs being sent your way. ♥

[labblab]

Oh Michele, we’ll be holding Ollie and all your family in our hearts during the coming days. I’m so glad you’ve had that special week together — it’ll be a time to treasure in your memory forever. I send you continuing hugs, too. Just remember we’re always here, walking right alongside you. And all our Cush-angels will be lined up to greet Ollie at the moment he passes, whenever that may turn out to be. He will never be alone, either.

Do take care, and please give Ollie a giant loving hug from us all, too. He is such a good, dear boy. Forever.
Marianne

[Harley PoMMom]

I have nothing to add, I just wanted to send you and sweet Ollie some huge loving hugs. Please do keep us updated and talk to us as much as you want, we are here for you and Ollie.

More hugs, Lori

[mgcuws]

Thank you!