New member/maybe cushings (Annie) 6 y/o bulldog

[goatheaven]

Hi, I found this group looking for answers and info about Cushings. We are getting my 6 year old bulldog tested Tuesday. She has had recurrent UTI's for the past 7 months, corneal ulcers, then constant paw licking, excess thirst and appetite along with hair loss and lethargy. She was treated with steroids(skin) and Tacrolimus(eyes), and Simplicef (UTI's). The steroids seemed to work at first then it lessened with each injection. We had all the skin scrapings, etc and ruled out thyroid and addison's now we're looking at allergies or cushing's. Hope I get answers soon. Thanks, Laura

[haf549]

Hi Laura:

Welcome to the forum. I just wanted to post a quick welcome note so you know that someone has been looking. Because of Christmas, things will be a bit slow here, but the others should be along soon to play 20 questions with you.

Heidi

[Squirt's Mom]

Hi Laura,

Welcome to you and your baby! :)

Boy! What a Christmas present, huh? But it's not as bad as it may sound, I promise.

Fair warning, we will play 20 Questions with you for a bit but it is only so we can learn more about her. The more we know the more meaningful insight we can offer. So here we go for the first round. :p How long ago was she on the steroids, for how long did she take them, and when was her last injection? How much does she weigh? What is she eating? Has she been diagnosed with anything definite, if so, what? Is she on any other meds, supplements, herbs, etc. now other than those you mentioned? If so, how much and how often? Has she been tested for diabetes, both kinds? Have you had enough for now? OK...one more...what is her name? ;)

When you see the vet Tue., ask for copies of all the test results she has had done, the actual results. It is a good thing to keep a file on her at home just in case you ever have to see a different vet for any reason, like on vacation. Plus you will be better able to answer our questions. :p When you get the copies, come post those results here, just the ones that are abnormal - too high, too low. Be sure to include the units of measurement (ug/dl, mnol/L, etc) and the normal ranges for that lab. These will help us a great deal in helping her.

You don't have to take this journey alone. We will be with you all the way, here to help in any way we can. Read up in our Resource section and the threads here, and ask lots of questions. We will do our best to help you understand. It will seem like Greek at first, but that's ok. Just keep plowing along and in no time, you will find yourself grasping this stuff. Hey, if I can, anyone can! :D

Hope you and yours are having a Merry Christmas in spite of this news!

Hang in there!
Hugs,
Leslie and the girls - always

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

[Harley PoMMom]

Hi Laura,

Welome to you and your girl from me and my boy Harley. What's your precious girl's name? I'm going to warn you with new members we ask alot of questions, only because we need to know as much as we can about you furbaby so we can give you the best possible feedback.

There is a type of cushings called Iatrogenic Cushings, that is when cushings is induced in a pup when steriods, prednisone, or even corticosteroid eye drops are used for a period of time. When these medications are stopped, the cushing symptoms cease. If a pup is tested while on these meds, the pup will test positive for cushings and one does not know if it is the meds or if it is cushings. This is a false positive.

Has she been tested for diabetes? Diabetes shares some of the same symptoms of cushings, ie...excessive thirst, excessive urination, lethargy.

Was a CBC and/or Chemistry blood panel done on her, and if so, could you post the results that are marked "abnormal" with the reference ranges and the units of measurements. Usually cushpups have elevated ALP and Cholesterol, but all pups are different. :eek::) None of them read the rule book and follow the directions. :rolleyes: Was an ultrasound done on her? if so, could you post the results of that. Is she on any herbs or supplements? How much does she weigh? What specific tests were done on her to rule out the thyroid and Addison? Could you post those results here with the units of measurements and reference ranges.

I don't know alot about the skin allergies, but one of our Moderators, Debbie, does, and I am sure she will be along to give advice about that, she is also a lab tech with over 29 year experience so she will be able to assist with the lab results when you get them to us.

Hang in there Laura, I know this journey can be a scary and frightening one, but you have found a caring and warm family now and we will help you in any way we can.

Hugs,
Lori

[goatheaven]

Thanks everyone, I'll have more news Tuesday. My Bulldog's name is Annie. She has had 4 UTI's since last April. That was the first sign of illness. Vets in my area don't really test they just guess and medicate so now we are going to a vet 2 hours one way hoping for better care. She has been on many antibiotics for the UTI's but they keep coming back. I didn't even know she had one this time but the new vet insisted on a urine culture and discovered it. She really shows no symptoms. The eye problems started in May. She was on the following eye meds for ulcers: vetropolycin, atropine, gemtamicin sulfate, neopolydox and now tacrolimus. Her hair loss and paw licking started around July and she would have her feet red, swollen and bleeding. Not sure what test the vet did but some blood test ruled out thyroid and addison's he said. I know one of her urinalysis test showed protein in the urine, and cocci bacteria. The vet also stated she had high liver enzymes. In July she received a steroid shot, improved some and then 5 weeks later she was sick again and worse. Another steroid shot them improvement then 4 weeks later sick again and worse. The last shot given provide relief for less than 2 weeks and we were in a mess. Is it possible, steroids caused these reactions? She is on a homecooked diet of meat, and vegetables, no grains or potatoes. She was getting a vitamin supplement, coconut oil, digestive enzyme, and probiotic but I stopped all of those in case of allergies. She does use Comfortis for flea protection and Interceptor for heartworm protection. She was never sick until she was 5 years old. Thanks for your help, Laura

[Harley PoMMom]

How long has Annie been on the Comfortis?

Hugs,
Lori

[goatheaven]

She did not start comfortis till about the same time she developed problems. I asked the vet about it and of course he said no way Comfortis is safe.

[Harley PoMMom]

If you google Comfortis it brings alot of hits. Here is one:

Comfortis flea treatment causes vomiting and death in dogs

http://www.examiner.com/x-14505-Atlanta-Pet-Health-Examiner~y2009m8d13-Comfortis-flea-treatment-causes-vomiting-and-death-in-dogs

[Harley PoMMom]

Here's another really good article. This is just a quote from it.

http://www.veterinarypartner.com/Content.plx?P=A&A=2768&S=1&SourceID=52


Spinosad (Comfortis)

June 24, 2008: According to the FDA's enter for Veterinary Medicine (CVM), dogs receiving the drug Comfortis (spinosad) concurrently with high, extra-label doses of ivermectin are having adverse reactions in some cases. The regulatory agency warned that it has received adverse reaction reports that are consistent with ivermectin toxicity. Ivermectin is the main medication in many heartworm preventives. CVM advises veterinarians that extra-label doses of ivermectin in conjunction with comfortis may cause adverse reactions. The safety warning also comes from Elanco Animal Health, which manufactures Comfortis, a monthly oral, chewable tablet used for the prevention and treatment of flea infestations on dogs. The company is addressing the issue: see http://elms.xh1.lilly.com/10788_03_tech_Bulletin.pdf for more information.


The most common adverse reaction recorded during clinical trials was vomiting. Other adverse reactions were decreased
appetite, lethargy or decreased activity, diarrhea, cough, increased thirst, vocalization, increased appetite, redness of the
skin, hyperactivity and excessive salivation

http://elms.xh1.lilly.com/10788_03_tech_Bulletin.pdf

[littleone1]

Hi Laura,

Corky and I would also like to say hi and welcome you and Annie.

You have found a wonderful group of people that have so much to offer.

I hope that everything will go well for Annie.

Terri

[Franklin'sMum]

Hi Laura

Welcome to you and Annie, from me and my little one Franklin :). We look forward to learning more about your girl.

Jane and Franklin xx
________
Magic flight (http://mflbvaporizer.com)

[lulusmom]

Hi Laura and welcome to you and Annie.

I had a dear friend with a beloved female Bulldog named Tank who was plagued with much of the same conditions your Annie has. Because of all the skin folds, these guys are prone to urinary tract infections, dermatitis, pyoderma and staph infections. Chronic dry eye, conjunctivitis and resultant corneal ulcers is common also due to the extra skin and folds around the eyes. Believe it or not the uti’s in Bulldogs are usually the result of bacteria that develops in the folds around the vulva. My friend was meticulous in keeping Tank’s skin clean but even with her best efforts, she was constantly battling these problems. I didn’t remember Tank having problems with her feet and loss of coat but I Googled Bulldog health issues and apparently interdigital dermatitis/pyoderma is another condition that lists the Bulldog as being predisposed. Flank alopecia, demodicosis and general loss of coat due to skin problems are also common in the breed.

Cushing’s is a difficult disease to diagnose and while I’m not a medical professional, it’s my layman cushmom’s opinion that it will be even more difficult to confirm a cushing’s diagnosis as all of Annie’s symptoms could be the result of a genetic predisposition to multiple conditions. Unfortunately, the symptoms are much the same as those associated with cushing’s and these other conditions can cause false positive results on diagnostic tests as well as a lot of the blood chemistry and urinalysis abnormalities normally associated with cushing’s. Additionally, and as already mentioned by Lori, any steroidal drugs used to treat Annie can cause iatrogenic cushing’s, which could explain her increased drinking peeing and eating. If Annie had cushing’s, she would be producing excessive amounts of the adrenal steroid called cortisol and since cortisol suppresses inflammation, the cushing’s would, in essence, be treating her infections. Given that Annie’s condition improved with the steroid injections and got worse without them leads me to believe that her issues are more likely a result of conditions other than cushing’s.

Taking everything into consideration, I think your vet is on a slippery slope and is going to have to be very conscientious in his/her diagnostic protocol. For instance, even if an acth stimulation test was positive for cushing’s, additional testing would most definitely be needed to confirm a diagnosis. Most experienced vets would include an abdominal ultrasound to confirm evidence of hyperadrenal activity as well as its effect on the liver.

You mentioned that your vet has ruled out addison’s. In order to have done this, he/she would have done an acth stimulation test. This is the gold standard in testing for addison’s and it is also a diagnostic test for cushing’s. Others have already asked that you post the results of tests but we are always particularly interested in the results of the acth stimulation test as well as abdominal ultrasound findings.

It sounds as though you two have been through the proverbial wringer and my heart goes out to you. I’m so sorry that you had the need to find us but I’m sure glad that you did. We are here to help you in any way we can so don’t be afraid to ask questions and by all means, don’t feel uncomfortable about providing too much information. As you can see, I have no problem with being longwinded. :o The more information you can give us, the better we can provide you with more appropriate feedback.

Looking forward to hearing more about your Sweet Annie.

Glynda

P.S. If you live in So California, I have a great vet for you. English Bulldog owners and breeders drive 100's of miles to go to this guy because nobody knows the breed better. I very rarely see an English Bulldog but that's all you see at Dr. Butchko's clinic. It is an extremely busy practice with a line out the door. I've been there twice and was astounded both times by the sheer number of Bulldogs. Aside from my ex-husband, I've never heard so much snorting going on in one place. :D

[goatheaven]

Do you think we should not perform the tests for Cushings and just treat the allergies since it could give us wrong information. I have read that treating a dog for Cushing's who doesn't have it could be bad. Advice please? She just finished 21 days of Simplicef and she still is licking her paws and has red, inflamed feet along with hair loss. Thanks, Laura

[Harley PoMMom]

Hi Laura,

Cushings is a slow progressing disease, so you have time to get a proper diagnosis, a proper diagnosis is vital to a proper treatment plan.

Treating a pup that does NOT have cushings with Trilostane or Lysodren can be Lethal to the pup. You do NOT treat your pup with either one of these meds unless you are absolutely sure your pup has cushings.

Hugs,
Lori

[lulusmom]

Hi Laura,

You should never give the serious meds used to treat cushing's to a dog unless a diagnosis has been confirmed by way of numerous tests. In Annie's case, even if she had cushing's, her skin conditions could get worse if cortisol was reduced with treatment. If your vet still thinks Annie has cushing's, you might consider having him/her give you a referral to an internal medicine specialist (IMS). An IMS is the most knowledgable and experienced with cushing's and other endocrine disorders. My cushdogs have multiple conditions and treat solely with an IMS for all of the ailments. Is your vet a dermatologist specialist?

Glynda

[goatheaven]

No, he is not. Our other vets just wanted to treat her with steroids which did not help, only temporarily. We live in a very rural area without great vet treatments. We are driving 2 hours one way to see this vet. So frustrating. I think I am not going to have the test done because of her other issues. I am just so confused as to what to do. It is also hard scheduling visits with this doctor due to my work schedule. Thanks, Laura

[lulusmom]

Hi again,

I do understand the difficulties in driving great distances and juggling vet appointments with your work schedule. Our IMS is not local and in So California, 60 miles might as well be 150 miles. There are veterinary teaching hospital across the U.S. that have excellent diagnostic labs and clinicians and their fees are normally much less than a specialist. For instance the University of Georgia has a dermatology department and their map gives directions to their hospital from three different states. Sometimes the extra time and money spent on consulting with a specialist will ultimately save time and money as well as get to the root of our babies' problems. It sounds as though Annie is uncomfortable and we'd sure like to help you both through this. We have members all over the U.S. so if you let us know what area you are in, somebody may be able to provide you with a vet or facility that is doable for you.

Glynda

[goatheaven]

We are located in South Carolina, an hour and a half away from Myrtle Beach. Thanks, Laura

[Harley PoMMom]

Hi Laura,

You may also find an board certified Veterinary Specialist in Your Area
by going to this web page and typing in the necessary info.

http://www.acvim.org/websites/acvim/index.php?p=3

Hugs,
Lori

[Squirt's Mom]

Hi Laura,

I just wanted to second what has been said about the Cushing's testing. It would be a waste of money as the tests would likely be skewed, an additional stress on Annie at the moment which she doesn't need, and just add to the confusion.

Do not, please do not, start any treatment on Annie with either Trilostane (Vetoryl) or Lysodren (Mitotane). These drugs are powerful and can be lethal if not properly used; where Annie is in the diagnostic process in no way supports a Cushing's diagnosis so these meds could cause more harm than good.

Hang in there!
Hugs,
Leslie and the girls - always

[labblab]

Hi Laura,

By any chance, are you within "reach" of Mt. Pleasant? Apparently there are both dermatology and internal medicine specialists there. Here is a link to a page from a Mt. Pleasant dermatology practice that also lists local internal medicine specialists, as well:

http://southeastvetderm.com/specialist/

Your local vet would need to refer you to any of these specialists. But I agree with the folks above -- in the long run, I think you may save time and money by consulting with some specialists in order to arrive at a definite diagnosis for Annie. She sounds so uncomfortable that I know you are anxious to get her some help. If it were me, I believe I would start with an internal medicine specialist. But I was pleased to see this dermatology practice, as well. Because the internist may quickly decide that Annie would be best served by consulting with the dermatologist, as well (or instead of...).

It may be the case that the internist will still want to perform the Cushing's testing (with the benefit of an ultrasound). But I think you can feel greater confidence that an internist will be mindful of the bigger diagnostic "picture," and will have a better sense of the appropriateness of any given diagnostic.

After having written all of this, you may be miles away from Mt. Pleasant...:( But I at least wanted to give you this info.

Marianne

[goatheaven]

Thanks Mariann, I am going to Mt. pleasant now and the eye specialist Dr. Cook is the one who treats Annie's eye issues. I don't know if they will refer us but I'll see. Thanks, Laura

[Harley PoMMom]

South Carolina Code of Regulations
(Unannotated)
Current through State Register Volume 32, Issue 9, effective September 26, 2008.


ARTICLE 5.
PROFESSIONAL CONDUCT


120-5.2. Code of Conduct.

Every veterinarian has a responsibility to provide services which would include long-term hospitalization, surgery, radiology and emergency services when it is necessary to relieve suffering, save life and provide for the welfare of animals. Inasmuch as the veterinarian cannot always provide this full range of veterinary services, he/she has an obligation to make referrals to or otherwise join with colleagues in the area to see that such services are provided.

http://www.scstatehouse.gov/coderegs/c120.htm

[gpgscott]

You have at the least two excellent clinics in Charleston, SC. One in Mt. Pleasant, Dr. Jamison, and a clinic on Montague Ave, in North Charleston. The Dr. who saw my little one there has left, but the practice remains.

Dr. Jameson is very kind and highly credentialed, I know longer know any of the Drs. at the other practice but am certain they are fine Drs.

Please let us know.

Scott

The practice in Charleston is Coastal Carolina Veterinary Internal Medicine, their phone is 843-747-1507

Dr. Jameson's phone is 843-849-9473, I believe he would see you without a referral.

[goatheaven]

Thanks for the information everyone. Well we had an ACTH test done Tues 29th and a urinalysis done to check for UTI . As of today Sun we still have not heard any results. Will post once I know. Thanks, Laura

[Squirt's Mom]

Hi Laura,

I'm sure the holidays have slowed everything down. Hopefully you will have those results this coming week and the suspense will be over....well for that part any way! ;) One never gets bored with Cushing's! :p

How had Annie been acting? Signs getting any stronger? Is her discomfort increasing? I hope not. Bless her heart....and yours!

Hugs,
Leslie and the girls - always

[goatheaven]

Well actually her skin seems better. She still licks her feet constantly sometimes. She never had many of the symptoms except for infections skin and urinary, hair loss. Of course being a bulldog she's always thirsty and pants. That's kind of the breed. The vet think she just has allergies but something is causing eye ulcerations and UTI's along with skin issues. She doesn't itch really mostly licks. However, she reacts mostly when she get over excited or nervous and at night before bed. I hope we get news soon. Thanks, Laura