Ugga-7yr old french bulldog (calcinosis cutis)(Ugga crossed the bridge)

[jackiev]

Hi. My name is Jackie and my boy, Ugga, was diagnosed with Cushings yesterday. He was diagnosed by a skin biopsy (he has calcinosis cutis). It really looked like he was having an allergic reaction and I had switched his food right around the same time so I just assumed that's what it was. At first he was just flaky. His hair as always been sparse around his ears and his sides so I didn't think that was anything to worry about (so stupid). His skin started turning really red and the flaky spots got big and raised and were spreading rapidly. Off to the vet we went. It happened pretty fast. He was drinking slightly more than normal but nothing dramatic by any means (that has changed dramatically in the last week, he's drinking A LOT now). He just looked awful. We did bloodwork and pretty much went right for the biopsy. Ugga has a worst-case scenario history at the vet clinic so this time we decided to be aggressive right off the bat (I really wish I had thought that way when his skin first started to look iffy). We put him on Cephalexin to help prevent a skin infection and waited for the results. His bloodwork came back really good. His liver enzymes were only mildly elevated (I'm sorry, I don't know the numbers and all the technical info but I'm sure I could get a copy of his lab results if needed) but everything else was right where it should be. So we waited for what seemed like a decade and found out he has Cushings. Our vet is waiting to talk to the pathologist on Monday before we decide on a medication. She is leaning toward Trilostane (I think that's what it's called) because that may be the safest option for Ugga. He's epileptic and takes phenobarbital and potassium bromide. I read that there are some tests you're supposed to have done to find out which type of Cushings you're dealing with and I don't think my vet is doing that. Do people begin treatment without knowing for sure? Maybe we have fewer options because of his other meds. I don't know. I hate that I know nothing about this. I'm hoping to learn as much as I can from all of you and your experience. I'm so sorry for rambling on and on, thanks for listening =).

[Cyn719]

Jackie and Ugga

Hello and welcome to the forum I am so glad you found us but so sorry for the reasons you are here. I want you feel very comfortable here. The members here are fantastic and very knowledgeable. They will be along shorty to help you. Please get copies of all bloodwork and tests that were done so you can post them. This will help the members give you advise. Also tell us everything you can about Ugga, his health and his weight. Hang in there. I know its alot to consume. Again you have come the the right place. We will always be here for you! Oh and never apologize about rambling on!! We are here to listen and help

Hugs xo

[Harley PoMMom]

Hi Jackie!

Welcome to you and Ugga! So sorry for the circumstances that brought you here but glad you found us as we will help in any way we can.

Sorry I only have a moment to post but I wanted to welcome you and provide these links to a few Threads where calcinosis cutis is discussed: http://www.k9cushings.com/forum/show...lcinosis+cutis

http://www.k9cushings.com/forum/show...lcinosis+cutis

http://www.k9cushings.com/forum/show...lcinosis+cutis

If you could get copies of all test/s that were done and post the abnormalities here, that would really help us to provide you with more meaningful feedback.

Love and hugs,
Lori

[jmac]

Hi Jackie, and welcome to you and Ugga!

I am sorry for the unfortunate circumstances that brought you here, but you have found a wonderful site! We can all remember the fear, sadness, and confusion that we felt when we heard the Cushing's diagnosis. Luckily, there are many kind, helpful, and knowledgeable people here who will help you with all of your questions. Someone will be along soon to help you.

When you have a chance, please get the names of the tests your vet did, as well as Ugga's test results and post them here. That will help us give you the best information possible. Cushing's is a bit confusing and typically more than one test is done to make a diagnosis. There is a test (LDDS) that can help to determine if it is pituitary or adrenal Cushing's, and someone else can give you more information about that. Many of us also had an ultrasound done on our dogs, so they could look at the adrenal glands.

As I said, you have come to the right place. Please feel free to ask all the questions you have. We are a very supportive group and you and Ugga will not be alone as you figure things out. There is also a wealth of information on this site that you can read in the meantime.

Rest assured, we will be with you and Ugga every step of the way on your Cushing's journey.

Julie & Hannah

[labblab]

Jackie, welcome to you and Ugga! As a Georgia girl, I have to ask whether you guys have any connection with the U. of GA mascot?

I am so sorry to hear about the calcinosis cutis, because I know it can be a great problem for people. But one thing we also know is that it is pretty much a definitive symptom of Cushing's. However, one reason why you may want to dig further in the effort to find out the type is because with Cushing's caused by a tumor of an adrenal gland, surgery can offer a total cure. The surgery is a major undertaking, though, and not every dog is considered a good candidate, especially if there are other big issues going on.

As far as Cushing's medication, one factor you may want to consider is that trilostane is probably not a great drug to use in combination with phenobarb. Here is part of a reply that I posted to another member who has an epileptic dog (Dechra is the manufacturer of Vetoryl, brandname trilostane):

OK, I just spoke with one of Dechra's technical reps, and what he told me pretty much coincides with what you were already thinking. Even though there is no documented interaction between trilostane and phenobarb (he is unaware of any clinical trials that specifically addressed that drug combination), dogs who are being treated with both drugs need to be monotored very diligently both in terms of liver function and also trilostane efficacy. He is aware of dogs that are currently being treated with both drugs, and no particular problems have surfaced thus far. But theoretically, phenobarb's effect on the liver could alter the way in which trilostane is metabolized by any given dog, leading to the potential for trilostane overdosing in the absence of appropriate dosing adjustments. Everything being equal, potassium bromide would probably be a preferable treatment choice for a dog suffering from both conditions.

I don't know whether you might want to try to shift Ugga to potassium bromide, exclusively. Or in the alternative, whether Lysodren might be a better choice altogether -- although off the top of my head, I'm not sure whether Lyosdren is a good combo with phenobarb, either. Strictly in terms of the calcinosis, Lyosdren may be the better choice. Here is another quote from Glynda, another staffer here:

...Calcinosis Cutis can be very difficult to resolve and you have already heard from our resident expert, Angela. As she mentioned, her Sabre treated with lysodren, which may be a better choice of treatment for dogs with calcinosis cutis. Dr. David Bruyette, one of our country's reknown veterinary endocrine specialist, stated in one of his lectures that his facility (VCA West Los Angeles) has not had good luck with resolving the calcinosis cutis in dogs being treated with Vetoryl (Trilostane). VCA West Los Angeles treats hundreds of dogs with cushing's so they have lots of experience under their belt. If your friend's vet is out of suggestions, you may want to ask her to ask the vet to contact Dr. Bruyette to discuss Vicki's case.

http://www.vcahospitals.com/west-los-angeles

Due to Ugga's multiple issues, a consultation with Dr. Bruyette might be really helpful to your vet. I have an epileptic dog on phenobarb, too, so I truly understand that you hate to rock the boat in any way in terms of additional treatments or medication changes!

I'm so glad you've found us, and we'll do everything we can to help you work things out for Ugga.
Marianne

[lulusmom]

Hi Jackie and welcome.

I'm glad to see that Marianne has provided you with some very important information. Unfortunately, Ugga is a complicated case. According to most well published endocrinologists, treatment without the common symptoms of cushing's is not recommended. Then one of those endocrinologists lectures and readily admits that he has had less that satisfactory results in resolving calcinosis cutis with Trilostane treatment. To compound matters, Ugga has epilepsy and for separate reasons, neither Trilostane or Lysodren is recommended if a dog is on phenobarbital. Marianne has already mentioned why Trilostane is not recommended so I will tell you that Lysodren (Mitotane) is listed as a drug whose absorption can be greatly altered by phenobarbital.

Calcinosis Cutis is scarey and it's not easy to get the upper hand on it so I would recommend that if your vet is not an internal medicine specialist or board certified dermatology specialist, you ask for a referral. An alternative would be to have your vet contact Dr. Bruyette and discuss Ugga's case with him.

We're here for you in any way we can and while we're always sorry for the circumstances that brings folks here, we're very glad that you found us. We've jumped on board and we're on the journey with you now.

Glynda

[Sabre's Mum]

Hi Jackie and Ugga ... welcome.

My Hungarian Vizsla - Sabre had calcinosis cutis and was treated with Lysodren. Lori has provided you with some links to the threads which have discussions on calcinosis cutis so I willl not repeat these but will add that if you have any further questions on how to manage the skin condition then please ask. It is difficult, but once cortisol levels are where they should be under treatment things become more managable.

I can't comment on the epilepsy and drugs as I have no experience in this but I would agree with the other members ... Dr Bruyette may be very helpful to contact to your vet in suggesting what options you may take.

All the best
Angela

[Harley PoMMom]

Potassium Bromide can be an alternative anti-seizure medication if pheno can not be used.

Here is a link to an article about other anti-seizure meds: Phenobarbital Alternatives for Dogs

[jackiev]

Thank you so much for the warm welcome. I'm sorry it's taken me so long to reply. I come here with every intention of answering posts and I just get caught up reading. I will make sure to get copies of Ugga's labs as we're going along, I think it's time to start a new file. I'm calling the vet this afternoon to discuss treatment (she has a phone consult with the dermatolopathologist who diagnosed Ugga). I will definitely talk to her about the possibility of weaning Ugga off the Phenobarbital (he takes Potassium Bromide also). It seems like we almost have to. I am very nervous about losing control of his Epilepsy while treating for Cushings. He has cluster seizures and his episodes go on for days. He's been seizure-free for 3 1/2 years!! I really, really, really hope we can find a "cocktail" that works for both. This is all pretty scary for us. Well, not so much for Ugga. He has no idea he's sick and is acting completely normal . I'm sure he's wondering what the deal is with all the salty water on mommy's cheeks =). As far as the calcinosis cutis and the meds, I have been reading that the Lysodren seems to be more effective but there was one case (out of the few that I could even find) where the dog was on Trilostane and it was effective. I think it took awhile (4 months) but that seems to be the case regardless. We'll have to see what the specialist says and go from there. I will definitely print out the information I've gotten here and have my vet take a look when we go in for suture removal. I'll tell her about Dr Bruyette as well. I do trust her implicitly and if something is over her head, she'll be the first to call for backup. Thank you for the support, we really appreciate it. I'll check in when we know what our next step is. Hugs to you and your furbabies =).

[marie adams]

Hi Jackie and Ugga,

Welcome!!! I see the experts have started asking questions and giving advice--they are the BEST!!! You are in good hands so ask as many questions as you like. If they do not have an answer they will research to find one for you.

Take care!!!