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Thread: Suni

  1. #1
    Join Date
    May 2009
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    632

    Default Suni

    Hello everyone! I just had a feeling a few years ago that I would be back someday looking for information and support from this special group, and sure enough, here I am!

    Suni's story is a long one, so I will just cut to the chase and fill in details later. She is 12 years old and the beat of my heart. She is unofficially diagnosed with cushings. I say unofficially, I mean I have been in denial and not pursued a diagnosis because I was certain I couldn't subject her to the treatment, however, my vet said she is almost certain she has it. She has a collapsing trachea and difficulty breathing sometime; she has a bad cataract in one eye that is going to cause her the loss of that eye; she has cherry eye in the other one that has been corrected, but wasn't successful, so we keep drops in it to keep down infection; she has the onset of arthritis; persistent gallbladder sludge; is overweight and is very cautious about her surroundings, naturally. That's pretty much an outline of my sweet girl, but she is still happy and all functions are great! Labs have been good except a high steadily increasing Alph. I am totally freaked out about her and am trying to, in the end, do what is best for her, not me. Would love to hear your opinions, advice and comments and most certainly, your support. I am looking forward to getting re-acquainted and meeting everyone. Thanks to all and thank you Marianne for being so gracious in helping me find my way back!

  2. #2
    Join Date
    Apr 2009
    Location
    Georgia
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    14,789

    Default Re: Suni

    Shelba, YAY, you made it back again today! I don’t know what’s been going wacky with your log-in, but I’m very grateful that you’re here again now.

    I’ll come back later on to add my thoughts about sweet Suni’s situation, but first I wanted to quickly re-introduce you to our membership. Folks, Shelba is one of the founders of the original message board that, over the years, ended up being reborn into K9C here. Without Shelba and our other founders, there would be no K9C today. It was her sweet girl, Misty, who bravely battled Cushing’s and who helped blaze the trail for all our Cushpups to follow. I’m so sorry to hear that Suni is having so many problems right now, but I know we’ll all do our best to repay the support that we were given by our original founders, and that has been continued by our K9C family throughout the years.

    Thank you, Shelba, and now let’s put our heads together and see what we can figure out in order to help Miss Suni!

    Bye for now, but I shall return ;-).
    Marianne

  3. #3
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    Apr 2009
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    Georgia
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    Default Re: Suni

    OK, here I am back again :-). Once again, I’m so sorry that little Suni is struggling at all right now, but let’s go ahead and leap right into the Cushing’s question. After my years on the forum, I’ve really come to believe that a treatment decision for older dogs probably depends more on immediate quality of life as opposed to minimizing risks of slow systemic damage developing over time. In other words, is Cushing’s causing enough discomfort in an older dog to warrant beginning a medication regimen that requires close vet monitoring, frequent vet visits, and the possibility of medication side effects (not to minimize significant expense)?

    So let’s take a look at Suni’s situation. You really haven’t mentioned her being bothered by any of the classic observable uncomfortable Cushing’s symptoms such as excessive thirst and urination, ravenous appetite, panting, skin problems and hair loss, seeking out cool places, inability to jump up or climb steps, general lethargy, etc. Overall, you describe her as being a happy girl who is functioning pretty well. So in terms of observable comfort, it doesn’t sound as though you’d be gaining much in terms of treatment, even if Suni does actually have Cushing’s.

    Digging a bit deeper, though, we know that Cushing’s does leave dogs more vulnerable to infections, generally (her Cherry eye?), to the development of gallbladder mucoceles, and to tracheal collapse due to weakening of cartilage. So in Suni’s case, if she does have Cushing’s, I’m thinking that a decision to treat would depend less upon observable symptoms and more upon whether or not these internal problems could be reversed or improved — and how important that would or would not be given her age. One “negative” to treatment might be the worsening of her arthritis once a high level of circulating cortisol is lowered.

    Is your vet encouraging you to test Suni for Cushing’s and to pursue treatment? Having lived through treatment with Misty, what are your own thoughts or reservations? Although I don’t remember for certain, I’m guessing you were using Lysodren since Vetoryl was largely experimental back then. As you’ll see here, Vetoryl (Trilostane) is now being prescribed pretty much exclusively. But Lysodren would still remain an option, as well.

    Since Suni *doesn’t* seem to be exhibiting any of the classic observable Cushing’s symptoms, I’m not sure how likely it is that she actually does have the disease. Of course, one option is to go ahead and test, just to gain the information. But if you wouldn’t choose to treat, regardless, then testing does become much less important. So do let us know what you’re thinking right now, OK? And do feel free to ask us any current testing or treatment questions that come to your mind.

    Marianne

  4. #4
    Join Date
    May 2009
    Posts
    632

    Default Re: Suni

    Thanks Marianne!

    I will try and fill in all the blanks. Suni does have cushings symptoms....drinking more water, big appetite, weight gain, high alp, heat sensitive. To be thorough, she has always, since a puppy, peed a lot and often so didn't think much of that, has always had a good appetite, but the heat sensitive came after she accidently slipped out the door unknowingly while my husband was talking to someone. It was one of the hottest days we had and she was left out a couple hours before we missed her.
    When I started looking for her I realized she might be outside because she didn't come when called. I flung the door open and she was just standing there panting hard and looking like she was about to pass out. I rushed her in and started washing her down with cool water and put her in front of a fan. Kept this up for several minutes until she started breathing better. She slowly came around but has never been the same since. I spoke with the vet about it and she said she had heat exhaustion and if quick action hadn't been taken, she might have died. Scared the bejeebers out of us! it took a toll on her little body. She still gets hot and stressed real easy and pants hard when she gets stressed.

    This alone is hard on her collapsing trachea. Long story I know, but a major reason why I am reluctant to treat if she tests to have cushings. She has had regular ultrasounds because of her trachea and gall bladder and the adrenal glands have always looked normal, so another reason I haven't pursued testing. She is having more trouble jumping, but I believe it is due to arthritis. She has injured her legs over the years by jumping and has had to have medicine and bedrest several times.
    My vet has suggested cushings in the past, but I would shy away from pursuing it.

    The last visit 2 months ago, which was a check on her little eye to check pressure and how close enucleation was. Another reason. I am wondering if the eye drops she uses (different drops for each eye) could have an effect on her symptoms. Both have steroids in them. She has been using the one for cherry eye a long time, but the other one only a couple months. Need to ask about this. Should have already addressed that with the vet!.

    Let me interject right here so you won't think I am a really horrible mom, that the past 2 years have taken its toll on this old gal! Fell and broke a hip, doing well with therapy and developed blood clots in my lungs. Had to spend an additional 10 days in the hospital under pulmonologist care, then in January of this year, both my husband and I had Covid and it hit me pretty hard. After the appropriate waiting period, the dang first shot made me sick as a mule! I am still trying to recoup from all of the mess, so I hope you will cut me some slack when trying to read and understand my messy and unprofessional post! UGH!! I will be more than happy to answer anymore questions if there are any and will try to make sense of it. I'll do better, maybe....I think you probably understand though. Thanks!
    Last edited by sunimist; 05-12-2021 at 02:15 PM.

  5. #5
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    Mar 2009
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    Default Re: Suni

    Heavens! We all understand how life can get in the way at times so need to worry about being judged!

    At first I was going to disagree with Marianne about testing in spite of no signs but your second post has listed enough cush signs that testing would be warranted. As you know Cushing's is a sign-driven disease meaning the signs are important both for diagnosing and during treatment. HOWEVER, with the steroids on board that changes everything. Since she has been on one of them for a long time and just added a second drop with steroids that is more than likely where the cush signs are coming from.....the drops are causing Iatrogenic Cushing's caused by exposure to steroids. The first line of treatment for this form is to slowly wean the pup off of the steroids IF possible. Should you decide to test Suni you will want to use the ACTH VS the LDDS because Iatrogenic Cushing's can cause the adrenals to atrophy and not respond as expected on a suppression test. Here is a link from DMV360 that talks a bit about this form of Cushing's and testing for it:

    https://www.dvm360.com/view/hyperadr...sm-proceedings

    I would discuss whether another form of treatment for her eyes is available that is non-steroidal. That may not be an option but would be the first step in my book. I have asked about studies on treating Iatrogenic while keeping the dog on the steroids so hopefully someone will supply some more info for you 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.

  6. #6
    Join Date
    May 2009
    Posts
    632

    Default Re: Suni

    Thanks Leslie. It just came to mind that maybe the eyedrops could come into play. The older I get, the slower my mind works, if at all!! So I will speak with the vet and we will get the drops changed and see if that makes a diffrence. I checked and she has been using the eyedrops for cherry since 2018. They have dexamethasone in them. I can get the same thing with antibiotic Bacitracin that I think would be ok. I will definitely check with the vet.

    Just noodlin', but wonder if they would cause some of her other issues like with the high alp.

  7. #7
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    Apr 2009
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    Georgia
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    Default Re: Suni

    Bingo! At least some of Suni’s problems could indeed be the result of the longterm dexamethasone, I think including elevated ALP:

    https://vcahospitals.com/know-your-pet/dexamethasone

    https://www.sciencedirect.com/scienc...34528801905417

    I totally agree with Leslie that my first step now would be to try weaning Suni off the steroidal drops.

    (And omigish there’s nothing messy or unprofessional about your posts! I’m just so sorry you’ve been through such a wringer with health issues! But you’re doing a great job of describing what’s going on with Suni.)

  8. #8
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    Mar 2009
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    rural central ARK
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    Default Re: Suni

    Here's a link Glynda shared with me:

    https://pubmed.ncbi.nlm.nih.gov/6497127/

    So it seems that most if not all of what you are seeing both in terms of signs and lab work could be attributed to the eye drops.
    "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.

  9. #9
    Join Date
    May 2009
    Posts
    632

    Default Re: Suni

    OMG! Why didn't I think of this before!!? It is not being used now every day, but every 2-3 days. Would it still warrant a gradual withdrawal?

  10. #10
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    Mar 2009
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    rural central ARK
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    Default Re: Suni

    Yes since she has been on the steroid drops for long term. The adrenal glands can atrophy on steroid use and you want to give them time to regenerate so a s.l.o.w. wean is best. I would want to include her vet in this process too.
    "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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