China--incontinence with Lysodren maintenance?

[britbula]

Hi everyone,
A little background: China, my 13 year old Rhodesian Ridgeback mix has been on and off Lysodren for the last 2 years. In April, she was on maintenance Lysodren but stopped eating. We took her off the lysodren and her appetite came back in a couple weeks. We tried keeping her off Lysodren to see how she'd do, and she was great for a few months. Recently she started to show a lot of signs of Cushings again, so we re-loaded her and she's now on maintenance dose of Lysodren. The loading went real well and her Stim test numbers were great after the load.

The whole time she was off the lysodren, she never had incontinence. While we were loading her, she didn't have any incontinence. However, since we've started her maintenance dose she has been incontinent--not just when she's sleeping. It seems to be getting worse. She weighs about 72 lbs, and she's taking 1375mg/week maintenance. Other than the incontinence, she is not showing any signs of cushings--she is acting better than she has in a long time.

Any thoughts on why the incontinence started after starting treatment??

[sunimist]

Hello! Welcome!

Just a thought, maybe your girl just has a UTI that could be treated with specific antibiotics. Has the vet checked for that? It sounds like she is doing great otherwise.

Please keep us posted. :)

Shelba and Suni

[Squirt's Mom]

Hello and welcome to you and China! :)

Wow! You are much tougher than me to tackle Cushing's on your own! Kudos to you! Especially since it seems your baby is doing quite well on Lyso. :D

My first...and only :o ....thought was also a UTI that perhaps rears its head when the cortisol is being controlled. One would think it would stick around all the time until the bacteria was killed of, but I guess it is possible the Lyso could have some bearing.

Ooo! Just had another thought (gonna be a good day! :p ) Cortisol is a natural anti-inflammatory so maybe your vet could look into the possibility that her bladder is inflamed for some reason but the cortisol keeps in under check when she is not on the Lyso.

Ok, that seems to be it for now but I do want you to know how happy I am that you and China have joined us and hope to learn much more about you both in the coming days. BTW, do you have a name we could use? "Hey you" gets kinda confusing at times as I'm apt to answer! :D

Hugs,
Leslie and the girls

[britbula]

I did call the vet and I'm waiting to hear back on whether I should bring her in ASAP for a urinalysis.

The other thing I forgot to mention earlier is that she has also had some hind-leg weakness that seemed to worsen when on the lysodren...again, something that I would have thought would have gotten better with treatment. Occasionally it seems like one of her back legs just 'gives out' on her. Sometimes when she's walking she kind-of drags her toes (her nails scrape on the ground).

Do you think the hind-end weakness and incontinence could be related?

I was on the other forum--caninecushings.net last year, and then it was gone! I was so happy to find this last night!! It's great to have some support again.

Thanks for your feedback!
Brittany

[gpgscott]

China is at the age that she could well be experiencing loss of muscle tone realated to reduction in hormones. She might also be hypo-thyroid, thyroid is an important hormone for many bodily functions.

I would want to know about thyroid if you do not already and you can ask about DES which is a synthetic hormone or Proin which is a drug which mimics a hormone to address the incontinence issue.

Best to you both, Your user is familiar, were you a member on the former site?

Scott

ETA, I thought your user and the name of your pup was familiar, glad you are back and hope we can help.

Scott

[britbula]

I talked to the vet yesterday afternoon, and she doesn't think it's a UTI because she isn't showing any urgency (she isn't having accidents, only leaking urine when she's lying down) or straining when she pees, and her pee is very clear and no odor. Our other dog is on Proin, so she recommended that I start China on it and if the incontinence doesn't improve in a few days, then we'll check for a UTI just to make sure. Well....

I gave her the Proin with her dinner last night. An hour after eating she vomited up all of her dinner, so I called the vet right away. The vet said to stop the Lysodren and Proin for the weekend and we'll see how she does. This morning she ate all of her breakfast right away, has her energy and personality back, and seems to be OK again (and, no incontinence last night or this morning so far). I don't really think she was getting too much Lysodren because she isn't showing any other signs like decreased appetite, diarrhea, listlessness, etc. The vet doesn't think the Proin would make her vomit, but who knows? Maybe China just had an upset tummy last night and it wasn't actually caused by the meds. I'm just glad she's doing better this morning!

[Squirt's Mom]

Hi Brittany,

I, too, thought you and China sounded familiar! So glad to have you back home with us! :D

Since it has been a while, could you post China's history with her tests for us? List the results along with the units of measurement and normal ranges for that lab from her first test to the most recent. That would help us get a better idea of what may be going on with her now.

I find it very strange how she reacts to the Lyso...of course, I find many things very strange. :p

You are on top of it, girl! Calling the vet immediately after she vomited the Proin! Way to go!! :cool::cool::D:cool::cool:

Hopefully, she will have a good weekend and you, too!
Hugs,
Leslie and the girls

[gpgscott]

Hi Brittany,

I really do not like the Proin. I prefer the DES because I think there is less chance for side effects. I would ask the Dr. to explain the difference.

Please let us know.

Scott

[britbula]

Leslie-I don't have all of China's test results, but here's a brief synopsis: When we first loaded her 2 years ago, I thought she had reached the end of induction (in only 2 days) because her eating slowed down. However, the stim test showed she was very close, but not quite there. Rather than continue with the load, we started her on maintenance because she was so close. She acted and felt much better, but her follow-up stim tests were still always a little high, so we gradually kept increasing her maintenance doseage. Then, back in April she quit eating all-together (at that time she was on 375mg per day, but weighed closer to 80 lbs). We stopped the lysodren and her appetite came back after a week or so. She wasn't showing any cushings symptoms, so I kept her off Lysodren for a few months. The symptoms recently started to come back (and her weight dropped to ~ 70 lbs), so I re-loaded. This time it took about 4 1/2 days before her eating and drinking slowed and when we did the stim test she was right where we wanted her ('flat lined' I think is what the doctor called it). So, since then she has been on 250mg 4 days/week and 125 mg 3 days/week (total of 1375mg per week and she weighs 72 lbs). She was doing so well except for the incontinence and then the vomiting last night! This morning she was VERY slow eating her breakfast (but did finish it all), so maybe she was getting a little too much lysodren again. She is incontinent again tonight--leaking when she lies down. I should probably do another stim on Monday, but they are so expensive! By the way, our vet office has a great relationship with the University of Wisconsin Vet School and China was seen by the vet school last year. Our vets consult with them on a regular basis for advice on treatment, so I am very confident in the care China is receiving...she just continues to stump us with weird symptoms!!

Scott: Our other dog was on DES for a while and it worked great, but our vet here does not stock it (because they also take care of large animals I think?), so I would have to mail order it. I tried the Proin because of the convenience of being able to get it at the vet office, and it has worked great for our her. However, China is MUCH more sensitive to medications/food/etc., so maybe I should try the DES once we rule out the UTI. I think I will ask for a urinalysis on Monday. Also, she had her thyroid tested in April when she quit eating and everything came back normal.

Thank you for all your input!

[tobybarnum]

HI, My dog Toby has exactly the same issues on the maintenance dose of Lysodren. My vet has checked for UTI, but negative. He is leaking when resting or sleeping, even shortly after a walk. He also seems to have worsening hind end weakness, and I also had expected that to improve with Lysodren. Please keep in touch! My vet is puzzled, but I have a hard time believing that the incontinence is unrelated to Lysodren. Perhaps it is due to a change in hormone levels?
I too am anxious for answers.
Best, Dawn

[lulusmom]

Dawn, this member has not logged on for almost two years so I have copied your post to your own thread so that members can provide feedback.

Glynda