new to site and scared! (Piggy newly diagnosed, just started Lysodren)

[piglet]

hi, my name is melissa and my babys name is piggy. she has just been diagnosed with cushings. she took her first dose of lysoderm today. i was so scared to give it to her, my husband had too. we just brought her home from the hospital yesterday. she had been having trouble breathin and i had been taking her to the dr. for the last 3 weeks. he had given her antibiotics and some other medicine that didnt help. she was getting worse so i took her back. they kept her that time and put her in an oxygen incubator and then she started breathing better. he kept her for 2 days and run a lot of tests on her to see what the problem was. she also looked real swollen and her tummy was big and tight. The 1st thing they found was a huge cyst on her kidney. They said they had never seen 1 that big. The next thing was her liver. It was enlarged. Then they found out she has cushings. He said it was bad. the reading was above 50 so he put her on numerous meds for her liver, kidneys and the cushings. he started her out on a low dose and said if that didnt work, we could adjust up. It is 1/8 of a 500mg tablet. Iread up on it and it scared me to death, but i knew she had to have it if she has a chance to get better. she also takes thyroid meds and has for most of her life. i guess i am just scared and looking for some hope. this dog is my life and has been since she was 5 weeks old. I am a wreck and i cant even function. If someone has went through this, please help me to get through it. Thanks, distressed in texas

[Carol G]

Hi Melissa,

There will be others replying soon who are much more knowledgeable than I am. But, I wanted to tell you that there definitely is hope and there will be people on this forum that will help you through it.

Carol

[papaoats]

Hi

I am new to this as well, signed up here last week and everyone has been GREAT! I find people here so aware and helpful. They will respond to you soon enough. I am going through this process "new" as you are. what has helped me is reading all the new member links.
I also bought a couple of books which have helped me as far as diet for Kidney/Liver issues.

I understand and respect how much you love your piggy! Hang in there...

[Harley PoMMom]

Hi Melissa,

Welcome to you and Piggy from me and my boy Harley! Now, first lets just take a very deep breath...ok. :) Honey, cushings can be a confusing, scary, and frustrating disease to deal with but now you have a family, us, that will help you and Piggy along on your journey.

Cushings is also a slow progressing disease so it takes years for it to do major damage to a pup. Now in order for us to really help you and Piggy we need to know alot about sweet Piggy, so we are going to be asking tons of questions, so here are some from me.

What breed of dog is Piggy? How much does she weigh? What symptoms led you or the vet to test for cushings in the first place? What tests were done on Piggy to confirm her cushings? Do you have copies of any of the tests that were done on Piggy, if so, could you post the results with their reference ranges and units here. Is she on any herbs or supplements? Does she have any other medical issues? Was diabetes and hypothyroidism ruled out? Has she had an ultrasound done that showed the adrenals enlarged?

I know I have thrown alot of questions at you to answer but the more information we know about Piggy the more meaningful the feedback will be.

Please hang in there, my boy Harley is on Lysodren also, as long as you have a GP or IMS who is cushings savy and you are reading and learning everything you can about cushings yourself, you'll do fine, ok.

Here are some links that I think you'll find interesting:

Helpful Resources for Owners of Cushing's Dogs
http://www.k9cushings.com/forum/forumdisplay.php?f=10

Lysodren loading Instructions and related tips
http://www.k9cushings.com/forum/showthread.php?t=181

Remember you are not alone anymore, we are here for you and Piggy always.

Love and hugs,
Lori

[frijole]

Welcome from me also! It sounds like Piggy has been through alot. Can you please back track and tell us how this all started? It sounds as if she has alot going on and it would be helpful. Some of the things you mentioned are not signs of cushings so I want to understand her symptoms, when they started, other issues she has etc.

Deep breaths.. we are here to help.
Kim:D

[littleone1]

Hi Melissa,

I'm so sorry that Piggy is going through this.

I know how you feel, as we all do. Last year, Corky was also hospitalized twice due to respiratory problems, and had to be put in a crate that had liquid oxygen. I was then given Torbutrol to give him if he started having problems breathing. He has been on thyroid medication since 2003. He has an enlarged liver with a mass on it. Originally, they found a mass on his right kidney that was later diagnosed as an adrenal tumor.

Corky is not taking any additional meds for his liver or kidney. Once they started treating him with Trilostane for his Cushings, Corky hasn't had any more respiratory problems, and is doing very well. He's been on Trilo for about 3 1/2 months.

Please don't give up on your furbaby, as the treatment for Cushings, whether it be Trilo or Lyso, really does help.

The Corkster is really doing good.

As others have said, Cushings is a slow progressing disease. There is definitely hope amd improvemet, as others, along with me, have seen.

I'm wishing all of you the best.

You have found a wonderful group or very caring, supportive, and knowledge people. They have really helped me get through this.

Terri

[Casey's Mom]

You are okay and in good hands. Take a deep breath and read all that you can on this site to help you. You will also get some good advice and lots of questions so the people here can help,

Love and hugs,

[piglet]

Hi everyone. thanks to everyone for caring. first of all, piggy is a pug/boston terrier mix. She weighs 20 lbs. She has been on thyroid pills for about 7 years but other than that has always been healthy and had regular checkups. I took her to the vet about 3 wks. ago for breathing problems. It sounds like she is congested and has a stopped up nose. He listened to her lungs and gave her some antibiotics because he said she had a little problem with congestion going on. He said the meds he gave her would take care of it and to bring her back in 8 days when she finished her meds. I gave them all to her and she didnt get any better. In fact her breathing got worse and i took her back. He said that it was probably allergies and x rayed her and gave her allergy medicine. xrays showed good lungs and a slightly enlarged heart and liver. I brought her home and she continued to sound like she was stopped up and started panting a lot. I took her back and they put her in the hospital under oxygen and did an ultrasound on her and a blood workup and an actl test. Ultrasound showed a quarter sized cyst on her kidney and they said they had never seen 1 that big. actl test came back showing cushings. high level over 50. blood panel was pretty good. bun levels slightly elevated at 3. Liver enzymes slightly elevated. I dont have the tests with me but when i take her back i will get them. She had the pot belly. They got a lot of fluid off of her in the hospital. She looks better. What is strange is she hasnt acted like she even feels bad through all of this. She tires easily and is always hungry and thirsty but other than that she acts fine. Her thyroid test came back normal so she is on the right dose there. She seems to be doing ok so far with the meds and the lysodren that he put her on but it is only the 2nd day and he has her on a small dose. He said that we may have to adjust it up. How will i know if it works? Iam about ready to have a nervous breakdown. This is just overwhelming. Ididnt expect all of this. Ijust hope that i am doing the right thing because i just want her to get better. It just scares me giving her this medicine but i know i have to so i do. She is not on any herbs or anything. She is on A/D Diet. Any support or guidance will be greatly appreciated. thanks for the support and caring.

[gpgscott]

Hi Melissa and welcome to you and Piggy.

Accumulation of fluid or ascities, is not a Cushinging's symptom that I am aware. It points to heart/liver issues.

I am very concerned that a proper diagnosis has not been carried out.

I am going to place links to our Resources area and hoping others check in on this soon.

Scott

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

[Harley PoMMom]

Hi Melissa,

Cortisol is a stress hormone, one of the "fight or flight" hormones, so if Piggy was really stressed the day she had her ACTH test, this could of skewed her results, also any non-adrenal illnesses will cause false positives results on ACTH tests. Not one test can confirm Cushings or the type of Cushings that is why one needs a IMS or GP who is Cushings savy. Strong symptoms are a huge part of making the diagnosis, and a Cushing's savy vet will not initiate any treatment without strong symptoms and a proper diagnosis.

My boy Harley has many of the Cushings symptoms and I still had many tests done on him to confirm his Cushings before starting any kind of treatment. Melissa, honey, now I'm not trying to scare you, but if I were you I would find an IMS right now and make sure that Piggy is diagnosed correctly. Lysodren can be lethal if given to a pup that does not have Cushings.

Love and hugs,
Lori

[frijole]

I agree... and that is why I asked about what other illnesses Piggy has... I'm not sold on the diagnosis of cushings given what information we have. That is why knowing the tests and results helps us help. Please get the info as soon as you can... and I wouldn't be giving lysodren until I was more comfortable with the diagnosis.

Not meaning to scare you - it's just that we see alot of cases where dogs are not diagnosed properly... it is a tough disease to diagnose, especially for vets who don't run across it very often.

Glad you found us. We'll help you through this. Kim

[gpgscott]

Melissa,

I am going out on a limb here and suggest you contact your Dr. before giving another dose of Lysodren with the intent to cease administration until you have a clear understanding of diagnosis.

You need to have clear indications of Cushing's, not only with symptoms but bloodwork. Please ask for and post the results of Cushing's determinate testing. These would be ACTH stim, (including full adrenal panel) LDDS, HDDS, and UC:CR. The results of any of these tests are important in a proper diagnosis of Cushing's.

If Piggy has Cushing's, denial of Lysodren will not be immediately harmful to him. If he does not, Lysodren is very bad for him.

Please let us know, very best to you both.

Scott

[lulusmom]

Hi Melissa and welcome from me too.

I tend to sound disjointed sometimes in my response to members so to put things in a more organized fashion that you can follow, I've placed my comments in blue below within the body of your last post.


Hi everyone. thanks to everyone for caring. first of all, piggy is a pug/boston terrier mix. She weighs 20 lbs. She has been on thyroid pills for about 7 years but other than that has always been healthy and had regular checkups.

Boston Terriers are listed as a breed that seems to be more predisposed to cushing's and Piggy's mature age is also the norm in cushing's; however, my littlest cushdog was only three years old.

I noted later in your post that Piggy is now on Lysodren. If the diagnosis is correct, a dog weighing 20lbs. should be on a loading dose of approximately 100mg twice a day to 225mg twice a day. You mentioned that your vet has her on 1/8th of a tablet. This is equal to 62.5mg. Is she getting this once a day or twice day. If once a day, I doubt that it will do anything. At twice a day, if it does work, it's liable to take forever. You also mentioned that your vet said that if it doesn't work, you can up the dose. Did your vet explain how you should determine if the dose is not working? I'm asking because s/he is definitely not following established protocol so that's a red flag for me that says that s/he may not have much, if any, experience in treating cushdogs.

I was terrified like you and I had horrible experience with our old gp vet and it wasn't until I took my dog to an internal medicine specialist that she was properly diagnosed and prescribed treatment with Lysodren. The IM was very concientious and did a great job of explaining how Lysodren works and why it is so important to monitor my dog during the loading phase. I was good and scared and followed instructions to the letter and kept in close contact with him daily. Lulu loaded successfully without any problems. That was a few years before I became a member here and I found that the IM pretty much echoed the Lysodren loading instructions that can be found in our Resources section. I'm providing a direct link to that paper and highly recommend that you read it.

http://www.k9cushings.com/forum/showthread.php?t=181

I took her to the vet about 3 wks. ago for breathing problems. It sounds like she is congested and has a stopped up nose. He listened to her lungs and gave her some antibiotics because he said she had a little problem with congestion going on. He said the meds he gave her would take care of it and to bring her back in 8 days when she finished her meds. I gave them all to her and she didnt get any better. In fact her breathing got worse and i took her back. He said that it was probably allergies and x rayed her and gave her allergy medicine. xrays showed good lungs and a slightly enlarged heart and liver. I brought her home and she continued to sound like she was stopped up and started panting a lot.

Panting is a symptom commonly associated with cushing's. The panting can be caused by a combination of things; muscle wasting of the laryngeal muscle has been mentioned and redistribution of fat to the thoracic area and enlarged liver, both of which puts pressure on the diaphram. I think the short snouted (brachycephalic) breeds like Piggy tend to snort and snore more than most breeds anyway but these tend to become more pronounced with cushing's.

I took her back and they put her in the hospital under oxygen and did an ultrasound on her and a blood workup and an actl test. Ultrasound showed a quarter sized cyst on her kidney and they said they had never seen 1 that big. actl test came back showing cushings. high level over 50. blood panel was pretty good. bun levels slightly elevated at 3. Liver enzymes slightly elevated.

Elevated bun and liver enzymes are common abnormalities in cushing's and a post acth stim result of 50 ug/dl is quite high; however, as Lori has mentioned, nonadrenal illness and stress can cause false positives. For me, false positive would be less likely with a post stim of 50, especially if the pre number is in the normal range of 1 - 6 ug/dl.

I dont have the tests with me but when i take her back i will get them. She had the pot belly. They got a lot of fluid off of her in the hospital. She looks better. What is strange is she hasnt acted like she even feels bad through all of this. She tires easily and is always hungry and thirsty but other than that she acts fine.

Most dogs with cushing's don't act sick and usually aren't in any pain unless the disease has gone uncontrolled for a very long time and severe infection or organ failure occurs. This takes a very long time. I read a medical text that said that most dogs have cushing's one to six years before being diagnosed. It is much more important to take whatever time is necessary to make sure that a proper diagnosis has been made before starting treatement. I am not saying that Piggy was misdiagnosed but without the benefit of the test results, we are always concerned.

Did your vet do a urinalysis? The vast majority of dogs with cushing's cannot concentrate their urine which is why they pee so much and drink huge volumes of water to keep up with all that peeing. If they didn't drink, they would quickly dehydrate which can be life threatening. Most experienced vets will always do a urinalysis to check the urine specific gravity which is almost always low in a cushdog. Hopefully your vet checked for this so please post those results as well.

Her thyroid test came back normal so she is on the right dose there. She seems to be doing ok so far with the meds and the lysodren that he put her on but it is only the 2nd day and he has her on a small dose. He said that we may have to adjust it up. How will i know if it works? Iam about ready to have a nervous breakdown. This is just overwhelming. I didnt expect all of this. Ijust hope that i am doing the right thing because i just want her to get better. It just scares me giving her this medicine but i know i have to so i do. She is not on any herbs or anything. She is on A/D Diet. Any support or guidance will be greatly appreciated. thanks for the support and caring.

Just take a deep breath, try to relax and know that we’re here to help you through this. The more information you can give us, starting with the results of testing done to diagnose Piggy, the more appropriate feedback we can give you. We’ve all been traumatized to some degree when our dogs were first diagnosed and there is a common thread between us all. We’ve all come to realize that the more we know about the disease and the treatment we’ve chosen for our babies, the calmer we become and better able we are to become proactive participants in our dogs’ care. We are their only voice and the onus is on us to understand as much as we can about what our babies are going through so that we can make our voice heard. You’ll find that it’s much easier when you have a support system and you’ll find no better hand holders than right here. You two are family now and we’re here for you.

Please remember to review the Lysodren loading instructions. Not sure if anybody asked but did your vet give you prednisone to use in case Piggy should show signs that cortisol has dropped too low? Those signs would be extreme lethargy, inappettance, diarrhea, vomiting, etc.? Regardless of the small dose that Piggy is getting, having prednisone on hand is not an option, it is a necessity.

Glynda

[piglet]

hi lori, the vet told me that she would be stressed a little but when he got the results back of the ACTH test, he said that it was off the chart. i wish i wouldve gotten a copy of it. i will when i take her back. there were 2 graphs on it and the top 1 was green. within normal range, but the bottom 1 was red. he said it only goes to 50 and hers was beyond that. she seems to be tolerating all of meds pretty well so far. she is on baytril, famotidine, lysodren, thyroid, ursodiol, and lactulose. he also said that she had a little bit of sludge in her gall bladder so he is cleaning that out. i am just so worried about her. she seems to be doing pretty good though. she is alert and eats and drinks and plays and barks like she always did. she gets tired easy, but i just thought that was because she was getting older. the dr. said that she was big time cushinoid. he was pretty convinced of it when he seen that last test. he also thinks its adrenal because of the cyst on her kidney. he said if this med. doesnt work then he will have to put her on another one. i just hope it works. he is going to do another blood test on her when i take her back. he has her on a small dose of lysodren right now because he said that we can adjust up if we need to. he didnt want to give her too much of it right out of the gate. i am just praying that i am doing the right thing for her. i just want her to get better.

[piglet]

hi glynda, the vet didnt give me any prednisone because before we realized what all of this was, she had been on it for 10 days and her breathing problems were getting worse instead of better so we took her off of it. i am getting very confused because i dont know what to think now. he treats a lot of cushinoid dogs. the place is in a larger city that is about 45 min. from where i live. they dont have anything here. the clinic is a very well known and large clinic with a lot of patients. i just pray that he knows what he is doing. why would he put her on such a small dose? he was telling me the doses of it and it was the same thing that you told me but he still put her on this small dosage. she just takes 1 pill a day for now. he did a lot of tests on her when she was in the hospital and as soon as i can get copies of them, i will post them. i just want her to get better. i am so scared. the reason that i even knew anything about cushings disease is because i had a 17 yr. old boston terrier that died from it. i was stupid and didnt realize what it was until after she died. i just thought it was from old age and thats what these quacks around here told me too. i started looking up things after she died and there it was right in my face. i felt really bad then. when my piggy started showing signs, i just had this weird feeling that she had it and i guess i was right. i love her so much. she is so sweet.

[Squirt's Mom]

Hi Melissa,

A belated welcome to you and Piggy! :) Miss Piggy is one of my Squirt's nicknames...and she lives up to it! :D

Being terrified is perfectly normal at this stage of the game, in fact, I would be much more worried about you if you weren't scared out of your mind. Your fear is born of love, the love of a mom for her baby, and nothing is fiercer than a mom who feels her baby is threatened. The challenge for us humans is to channel that fear into a positive avenue. It is really frowned on for us humans to attack things using our teeth and nails, even when it is certainly deserved! :p

When I was told that my Sweet Bebe had Cushing's, I was devastated, completely and utterly crushed. Squirt is my heart and soul dog, she is the light of my world and I cannot imagine losing her. So when they told me she was sick, OMG! I went totally bonkers! :eek::eek: My emotions were out of control - grief, fear, anger, guilt, frustration, confusion - and all I could think of was this disease. I researched, and researched but the more I read and heard the less I understood. Of course, my little mind was short-circuiting constantly so when someone said up, I heard down, they said blue, I heard red. :rolleyes: I cried for weeks on end; she would walk in the room and I would start bawling, grab her up and hug on her til she was wiggling to get away from me! It was really sad. :o

Then I found this group and these wonderful people. They took me in and gently led me along until I could start to understand just a tiny bit. They have continued to teach me, lead me, and support me to this day. We are here to do the same for you and Piggy.

We aren't vets, but we do live with Cushing's on a daily basis, and the collective knowledge here is astounding. Not only about Cushing's but many other conditions as well. And it's yours for the asking. :)

In reading through your thread, you have been given some great suggestions but there are two that really stand out to me. First, and most important, stop giving the Lysodren for now; second, get copies of all those tests Piggy has had done to diagnose everything, not just the Cushing's diagnosis, tho that is most critical. Cushing's is a slow progressing condition so you should have time to take a tiny step back and let us help you before you continue with the Lyso.

My Squirt is one that had a non-adrenal illness (a tumor on her spleen) that caused ALL the Cushing's tests to come back positive for pituitary Cushing's. But once that tumor was out, she no longer tests positive for pituitary Cushing's. Her docs now say that initial diagnosis of PDH is highly questionable. If we had started her on Lysodren or Trilostane, she could very easily be gone because she didn't really need them even tho the tests said she did. So, please, stop the Lyso, just for now. Let us see those test results first and then we will be able to give you some meaningful insight.

You and Piggy are family now. Ya'll don't have to take one more step on this journey alone; we will be with you the whole way. In fact, you might start to look forward to having us NOT with you in the future...but we will just hunt you down and hound you. :p I am so glad you found us and look forward to learning more as time passes.

Hugs,
Leslie and the girls - always

[lulusmom]

Hi again,

I'm glad that you will be getting copies of all the test results so that we can figure out exactly what medical issues, in addition to cushing's, exists. If Piggy has multiple issues, your vet may be fearful of giving her the recommended dose of Lysodren. If, as you say, your vet suspects an adrenal tumor, then the extremely small dose that you are giving Piggy will most probably be a waste of time and money, not to mention your poor frayed nerves. Adrenal tumors are extremely resistant to Lysodren and most often, much greater doses are required. An experienced vet dealing with an adrenal tumor would start a loading dose of no less than 50mg per kg and work up from there. Often times it takes 75mg per kg to 100mg per kg to erode the adrenal glands sufficiently to stim the flow of adrenal hormones. To determine Piggy's weight in kg you would divide her weight in pounds by 2.2. (20/2.2 = 9.09kg).

If your vet feels that Piggy's health is so compromised as to not be able to follow proper treatment protocol, s/he should either be consulting with an internal medicine specialist about her case or provide you with a referral to one. If you are driving to a big city, there is undoubtedly an internal medicine specialist in the area. If you tell us what city that is, we may have members that can give you a recommendation. You can also try to find one yourself by doing a search, using the link below:

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

When dogs have multiple conditions, it really is a good idea to consult with an internal medicine specialist. This becomes even more important for pet owners who are new to the disease and are having to place blind faith in their gp vet and pray that the recommended treatment is what is best for their pet. I am convinced that thanks to my ignoramous gp vet, my first cushdog was not diagnosed for over a year after she started displaying symptoms. My second cushdog was a shelter rescue who had horrific infections and every symptom in the book. It was obvious that he had had the disease for a very long time. You wouldn't know they were the same dogs today so please don't panic and think that cushing's is going to take your Piggy away.

Alison, one of our learned administrators, reminded me that Boston Terriers are one of the breeds that are genetically predisposed to heart conditions. A swollen abdomen is certainly not unusual in heart disease and it can appear rather quickly as fluids accumulate in the body as opposed to the pot belly that gradually appears with cushing's due to muscle wasting and redeposition of fat. I don't see any heart meds in the list of drugs that Piggy is taking now so that makes me question whether Piggy has a heart condition. Hopefully not.

I could go on but my boss expects some work out of me today so I better go for now.

Glynda

[piglet]

hi, he said that her heart was slightly enlarged, but not enough to be doing anything like this. he showed me the xrays. he thinks that she has a resp. infection. i dont know what to think anymore. i am just sick trying to figure it all out. that is why she is taking the baytril he said. also, i dont understand why she acts like nothing is wrong if she is sick. ??? are they supposed to act like that? she hasnt had a fever at all either everytime i have taken her to the vet.

[lulusmom]

My dog, Jojo, had a slightly enlarged heart at the time he was diagnosed with cushing's and he was definitely a mess but nontheless, he loaded at the full 50mg per kg. If Piggy is not acting sick at all, then I am really, really confused as to why your vet is so afraid to prescribe an effective dose of Lysodren. I am also dismayed that he did not give you any Prednisone so the red flags are popping up which indicates to me that your vet may not have that much experience with cushing's . I'm hoping that the test results you will be posting will give us a clue as to his dosing rationale.

This is frustrating for us too because we want to cram a ton of knowledge and experience into your head today so that you can relax a little and not feel so overwhelmed by all of this. I'm sure that your head is already swimming with so much stuff that you think it's going to explode. Am I right? The truth is that it takes a lot of time to wrap your head around this darn disease and it takes some of us with no retentive powers a lot longer. The good news is that this is a disease that progresses at less than a snail's pace so taking our time to understand things before making crucial decisions for our dogs is not a problem. Sooo, why not take a step back, enjoy the fact that Piggy is acting like her cute little self, get those test results and post them here, finish the Baytril as prescribed and then revisit the cushing's once you've had a chance to digest a lot of the stuff we've thrown at you as well as everything your vet has told you. Sound like a plan?

If you don't understand what your vet is telling you, make him explain it to you in detail, even if he has to draw you pictures. I always jot down any questions I may have for our next vet visit. I always carry a notepad to jot down the answers and if I don't understand what he tells me, I make him draw me a diagram if need be. I may pay a bit more for an internal medicine specialist but I get my money's worth by golly. :D

Glynda

[littleone1]

Hi Melissa,

I know how you feel and how overwhelmed you are at the present time.

Corky's right side of his heart has been enlarged for quite some time, along with a heart murmur. He also has multiple issues. But in spite of everything, he never acted like anything was bothering him until the clinical signs of cushings appeared, which slowed him down. Even though with everything he has going on at the present time, once he started on the Trilo, he is back to his normal self. Corky hasn't had any fevers either.

This can be frustrating and worrisome, but everyone is here to help. They really helped me get through this. We are definitely are a family and we look out for everyone.

[frijole]

Melissa, I was a total wreck when my dog was first diagnosed. I didn't understand anything anyone was trying to tell me. My vet was clueless but I didn't know it yet.

My dog is now over 16 yrs old! She has used lysodren for over 3 yrs now. So please know that cushings is totally treatable - but you have to treat it properly and your vet needs experience.

I found these people here and they helped me thru it. I read like a maniac and when I was overwhelmed and confused I asked questions. It hit me that I had to quit crying and worrying because my dog could sense the fear in me and it made her nervous. So I focused on getting up to speed on the disease and making sure I did it right.

Again, the people here explained that the dose my dog would have gone on was not right. Had I not found this group I would not have my dog today. I switched vets.

I am not saying your vet is wrong because I don't have enough information. It is important that we know the exact tests (there could have been more than one) that were done to diagnose Piggy. And the results of those tests - they will be numbers.

My only concern right now is that your dog might not have cushings, yet she is on lysodren. This is not good. Only those test results will get us moving in the direction of being able to help.

Can you give us the results of the blood panel? You said mostly normal, slightly elevated liver enzymes. Do you have a copy of it? Can you post those numbers? Most cushings dogs have fairly high liver enzymes... and if your dog had an acth of over 50 I would have to believe they would be very elevated. If you have those numbers as well as anything else that was not normal, please post them for us to look at.

And in the meantime - take some deep breaths. We are here to help. Please do not be afraid to ask us questions. We have all been there and understand. Meanwhile, give Piggy a big hug. Kim

[piglet]

i have test results. ACTH 1 HR {cortrosyn} cortisol baseline is: 4.27 cortisol, 1 hr. post ACTH is: >50.0 Thyroid panel 02: T4 is: 1.82 Free T4 is :13.97 Endogenous TSH is: 0.321 . these are the results that they sent me. they didnt fax me the blood panel tests. she just told me that the liver enzymes were slightly elevated. i will get her entire file when i take her back. i talked to the dr. and i made him explain everything to me and i asked him a lot of questions about everything and i feel a little bit better about the situation. {not much, but a little.}

[mypuppy]

Hi Melissa,
First and foremost, I am so very sorry you and your pup have to go through this horrible time of uncertainty for your pup. I was there not too long ago, almost 5 months ago to be precise. As you, I was overwhelmed, devastated, mortified believing my precious baby's life was going to be cut short due to this Cushing's condition. I cried, unconsolably, 24/7 for weeks on end. I finally got my act together, did the research which lead me to this wonderful forum and outrageous group of people who have helped me through evey step of the way to where I am today. Today, I can sincerely say, because of these loving, caring people me and my precious pup are in such a better place. A healthier, happier place. Melissa, obviously we can't compare our pups because they are all unique and have different concerns, but I can honestly say that if and when you get the proper and final diagnosis, and if such leads to Cushings, there is definitely a light at the end of the rainbow, and lot's of hope for your baby. I know because I began treatment with trilostane on my pup, and well although we had a bit of a setback due to dosing issues, I am now enjoying her to the fullest--she's my happy, loving, energetic puppy again. As you, she's my life also. How can they not be. They are the most special creatures put on this good earth, and they make us better and more loving people for them. Hang in there, as easy as it is said on this end, but please don't lose all hope. Everyone here will lead you to the proper channels in order for you to get all the answers you need in order to proceed with your pup's diagnosis and treatment. Chin up, okay. Welcome to our family regardless of the circumstances. We luv ya and Piggy....xo Jeanette

[piglet]

thank you so much for your words of kindness and hope. i need all i can get right now. i am trying to be strong so that i can help her. she sees me crying and upset and that stresses her out more. she knows when i am upset. when i cry she cries so i am trying hard to keep it together. i feel like she is doing a little better. she isnt wanting to eat everything she sees and she isnt drinking like crazy so just maybe something is working. i have been feeding her a/d and she likes it. she is acting like she should and dragging her toys out all over the house so just pray that that is a good sign. thanks for caring. i dont feel so alone now. there are some wonderful people on here. i am glad i found this site.

[littleone1]

Hi Melissa,

I'm glad that you are starting to see some inprovement in Piggy. I hope this continues.

I'm also glad that you feel a little better.

Sending healing thoughts and prayers that everything will continue to improve.

[Franklin'sMum]

Hi Melissa,

I just want to echo Jeanette, and say that the people on this site are truly incredible, and have also a lot more of my sanity than I otherwise would have.
Hoping Piggy continues to show improvement,

Jane and Franklin xx
________
Uggs (http://uggstoreshop.com/)

[piglet]

hi everyone. i never heard from anyone after i posted the results that i had. i stopped the lysodren after 4 days. pigs breathing became better and now it is back to the same as before. it sounds like her nose is stopped up. i am wondering if i should start the lysodren again. will it be ok to since i stopped it. we had a major snowstorm and there was no way i could get to amarillo to the vets. everything was shut down and all the roads were closed. i got scared that something would happen. i am so stressed out, i dont know what to do anymore. she acts like herself, its just the breathing issue. she is still taking all of her other meds that he gave her. i just dont know whether to start giving her the medicine again or what. some one please help

[Roxee's Dad]

Hi Melissa,

I just wanted to bump this up. It would help if you posted the normal ranges for the test performed and I would guess members are waiting for the blood panel test results as well. :)

Piggy test reults so far:

ACTH
Baseline 4.27 (ref. range-0.1-6)
1 hour draw (post) >50 (ref. range >20)

Thyroid Panel
T4- 1.82 (ref. range is 1.7-3.6)
Free T4 - 13.97 (ref range is 8-33)

Endogenous TSH - 0.321 (ref. range is 0.1-0.4)



i have test results. ACTH 1 HR {cortrosyn} cortisol baseline is: 4.27 cortisol, 1 hr. post ACTH is: >50.0 Thyroid panel 02: T4 is: 1.82 Free T4 is :13.97 Endogenous TSH is: 0.321 . these are the results that they sent me. they didnt fax me the blood panel tests. she just told me that the liver enzymes were slightly elevated. i will get her entire file when i take her back. i talked to the dr. and i made him explain everything to me and i asked him a lot of questions about everything and i feel a little bit better about the situation. {not much, but a little.}

[piglet]

cortisol, baseline - result 4.27 ref. range-0.1-6 cortisol, 1 hr post ACTH ->50 REF. RANGE >20 T4 - ref. range is 1.7-3.6 free T4 ref range is 8-33 endogenous TSH ref. range is 0.1-0.4.

[Squirt's Mom]

Hi Melissa,

The ACTH numbers do show a high elevation in cortisol but, like others, I would like to see the CBC results to get a better idea of what is going on with Piggy. There can be numerous causes for elevated cortisol so that alone based on one Cushing's specific test is not really enough to feel secure in a Cushing's diagnosis.

I think you were wise to stop the Lyso and are doing the right thing in holding off a bit especially since you can't get to the vet easily right now. So just take it easy for now and keep holding the Lyso for a bit.

Hugs,
Leslie and the girls - always

[frijole]

Melissa, I know we asked you to post the test numbers and you posted numbers for the acth test and thyroid tests. Was there a complete blood panel (CBC) done? This is the one with lots of letters and numbers on it. Usually it is done first - to determine what is going on.

If these are the only tests done then yes the cortisol is high but it doesn't mean it is cushings. Other things, including pain or stress can cause the cortisol to go high. That is why we are saying Piggy might not have cushings.

So going back to my original question - knowing what was abnormal on a blood panel would help us guide you. If one hasn't been done then I would certainly have one done.

Thanks for getting us these numbers. The thyroid tests were all within normal ranges if I read them right.

Kim

[Harley PoMMom]

Hi Melissa,

I agree with everything Leslie has said and I want to add one more thing...when one starts treatment, they must always have prednisone on hand. From reading your thread I see that you do not have prednisone on hand. So since you don't have the prednisone to give to Piggy if she had an emergency situation then the Lysodren should not be given.

Love and hugs,
Lori

[StarDeb55]

Melissa, Glynda asked several questions in one of her earlier posts concerning how you were administering the lysodren. I have reviewed your thread & don't see where you have answered these questions. This information will help us a lot to give you better feedback on what may be going on with Piggy.

You mentioned that your vet's instructions were to give 1/8 tablet, is this daily, twice per day, or just a couple of times per week? Did your vet instruct you to give the lysodren for a specific number of days then bring Piggy back for a repeat ACTH, or did the vet tell you to continue with lysodren until Piggy showed signs of loading? Did the vet explain to you what loading signs are? As Glynda explained earlier, you are giving an extremely low dose for a pup of Piggy's size, so there is a possibility that one of 2 things will happen; nothing will occur as the dose is so low, there will be insufficient adrenal cortex erosion to bring the cortisol down, or loading will take forever.

When you stop lysodren administration no matter what dose you are giving, adrenal glands will begin to regenerate the adrenal cortex which is the tissue the produces the cortisol. Some dogs can regenerate this tissue quite rapidly, others regenerate quite slowly. Frankly, I would not give any more lysodren until you can get to the vet, ask your vet for a clear, concise explanation of what is going on with Piggy. Ask the vet why he/she has chose to administer such a low, probably ineffective dose. Ask if any other general labwork was done including a complete blood count, super chemistry panel, or senior wellness panel, & a urinalysis. If general labwork was done, ask the vet to explain all of the abnormal results to you, & their significance. Please get copies of all Cushing's diagnostic testing, & general labwork to post the numbers for us. On the general labwork, please post only the abnormal, along with the reporting units, & normal ranges. There are certain common abnormalities on general labwork that the great majority of cushpups show, so that is why we would like to see these results. Just to let you know, I'm a medical lab technologist with nearly 30 years experience, so I can help you understand these numbers.

As others have already said, Cushing's progresses at literally a snail's pace, taking years to do its damage to a pup's internal organs. You have the time to make sure you have a confirmed diagnosis, to learn about the disease for yourself, & what to expect. The best thing you can do is educate yourself about the disease & its treatment as you are Piggy's only voice & advocate. Please don't be afraid to ask your vet these questions, just tell them you want to understand what is going on, so you can make the best informed decision you can on Piggy's behalf. A Cush savvy vet knows that the pups who have the best outcomes are the pups whose owners take an active role in their treatment, with the vet & owners working as a team on behalf of the pup.

Looking forward to hearing more.

Debbie

[piglet]

hi, i will get the rest of the tests when i take her back this week. i know that they did a blood panel on her. i have been reading up on this a lot and really i am more concerned with her breathing right now. she is almost done with all of her meds that he gave her. i am going to have that other test done when i take her back to determine what kind of cushings it is. if she doesnt have it will it show that? could all of this be caused from the cyst they found on her kidney? they are going to give her another ultrasound to measure it also. i just didnt feel good about giving her that lysodren yet. maybe i am just scared because he told me that she definately had cushings. i was just giving her 1/8 pill 1x a day on the lysodren. does cushings make them sound like they are stopped up all the time? her breathing got better for a few days and then it went back to the way it was before so i dont get it. i will post all of the results as soon as i get the rest of them. thanks for all your help. melissa

[haf549]

Mellissa:

When Kira was first diagnosed she was having some breathing problems. It really scared me to hear her at night, because she was having such a bad time. She was almost gasping for air. That was one of the big reasons I took her to the vet. At one point, they thought it was congestive heart failure. We did all kinds of test and after much elimination, we came up with the cushings diagnosis. This was over a period of almost a month. Even after I started her on the trilostane, the breathing wasn't really getting any better. About 2 months after it all started, she was finally diagnosed with a respiratory infection. After a week on anti-biotics, it got better and she's been fine since. Cushings just tends to put the blinders on us to other possibilities. I doubt the breathing issues are related to Cushings.

Heidi

[Squirt's Mom]

Hi Melissa,

In cush pups, sometimes the liver will get so large before treatment that it pushes up against the lungs making it hard for them to breath. This will cause the pup the breath more rapidly than before, the panting you read about with Cushing's. Cush pups also have a hard time dealing with warmer temperatures so they pant in an attempt to cool themselves down a bit. This is the only type of breathing "issues" that I recall being connected to Cushing's. What you have described with Piggy is not something I recognize as part of Cushing's.

With a Pug/Boston mix, Piggy more than likely has a smush-face....very short snout. This type of facial structure is more prone to allergies because their filter is so short so you might want to rule out that possibility for Piggy.

As for the kidney mass, yes that could be responsible for the results you have on the ACTH but we really need to see the blood test results. Maybe you missed this earlier so I will copy it here for you -


My Squirt is one that had a non-adrenal illness (a tumor on her spleen) that caused ALL the Cushing's tests to come back positive for pituitary Cushing's. But once that tumor was out, she no longer tests positive for pituitary Cushing's. Her docs now say that initial diagnosis of PDH is highly questionable. If we had started her on Lysodren or Trilostane, she could very easily be gone because she didn't really need them even tho the tests said she did.

Melissa, now is the time to read and ask questions. If we say something you don't understand, please please please ask about it. Like maybe the phrase "non-adrenal illness"; what does that mean? Cushing's is a disease that involves the adrenal glands, so it is an adrenal illness. The tumor on Piggy's kidney and the tumor on Squirt's spleen are "non-adrenal" because the adrenal glands are/were not involved like they are in Cushing's. So to answer your question about the kidney cyst they found - yes, it could be the reason the ACTH came back like it did and why the cortisol is reading so high. The mass on Piggy's kidney could be why her cortisol is elevated.

If it were me, I would be taking Piggy to a new vet and starting over. It really doesn't sound as if the current one knows much about treating Cushing's, the Cushing's diagnosis and treatment for Piggy are very iffy to me, and for them to ignore a mass on the kidney is irresponsible IMHO.

Keep your chin up!
Hugs,
Leslie and the girls - always

[littleone1]

Hi Melissa,

I totally understand how you feel about Piggy's breathing problems. As I mentioned in a previous post, Corky had to be hospitalized twice last year due to breathing and respiratory problems. Last summer his breathing was so bad, that he sometimes would only walk around the block, which took him forever. He also has allergies. His breathing not only sounded like he was congested all of the time, but when he would lay down, he almost sounded like a foghorn (for lack of better words to describe it). I even taped his breathing for his IMS. This went on for a few months.

There was the possibllity that he had an elongated soft palate, which was that way from birth. Due to other issues, it could have interfered with his breathing. As others have mentioned, the liver is enlarged in furbabies with Cushings, and it could be causing pressure which interferes with their breathing.

Since Corky started on his Trilostane treatment, his breathing is now great. He's back to running, walking fast, and walking long distances.

I'm so glad that I went to an IMS. As Leslie said, you might want to find a vet or IMS that really knows about Cushings.

Terri

[piglet]

hi, they said it was a resp. illness at first and treated her with all these meds and antibiotics. it didnt go away so then they said it was allergies and gave her an antihistamine {which i didnt give to her} they said her trachea tube was good when they did xrays so thats not it. she is still taking an antibiotic with all this other med. they are giving her. she is taking baytril. what has me puzzled is sometimes it gets better and sometimes she cant even hardly breath through her nose at all. sometimes it sounds like congestion or something in her chest or rib area when she is breathing and other times you cant hear anything in there. ??? all i know is all this is driving me nuts. i have already spent 1300.00 in the last 3 weeks trying to find out what is wrong with her and i still feel like i dont know anymore than i did to start with except that something is wrong with her and she has a cyst on her kidney. i dont even know if that is cancerous or anything about it except that it is a large one. ??? i was looking for a different dr. in the phone book but i cant find any specialists around here and whose to say if i take her to another one they will know any more than this one. i am just so frustrated and confused right now i dont know what to do. i am tired of giving her all this medicine. she has been on 12 different meds. in the last 3 weeks and i dont even know if any of its helping or if they even know why they are giving it to her. ??? i just feel helpless. i dont know how to help her and i cant stand it when something is wrong with her and i cant even help her.

[Franklin'sMum]

Hi Melissa,


i was looking for a different dr. in the phone book but i cant find any specialists around here and whose to say if i take her to another one they will know any more than this one. i am just so frustrated and confused right now i dont know what to do.

When Franklin's vet was being guided by a "specialist" who works at the diagnostic lab and is a CAT specialist (nothing against cats, but they are different to dogs) and whose only experience turned out to be she had read a treatment article from 2003 :eek::mad: I (with some prodding from these wonderful folk here) sought a different vet with more Cushings experience. I went through the phone book, and had a verbal questionaire for who ever I spoke with. The receptionist often knows if there are any Cushings patients, and which doc is treating them. Ask when the vet has no appointment scheduled, phone back then to grill them over the phone to find out their experience, what drugs they're more familiar with, and what testing they do, etc.

The day before Franklin's appt. was when we got a referral to the vet hospital, where his current specialist works, she has many cush patients, and her own pup is a cush/diabetic little girl.

However, as others have said, the mass on the kidney may be responsible for Piggy's high cortisol, and Piggy may not have Cushings at all. Please do consider getting another opinion for her.

Jane and Franklin xx
________
Fix Ps3 (http://fixps3.info/)

[StarDeb55]

Melissa, with Piggy having been actively treated for some type of infection over these past several weeks, along with the mass on her kidney, this gives me major concern about the validity of a Cushing's diagnosis. Any of these problems which we refer to as a non-adrenal illness could very well elevate the cortisol.

Rather than continuing on with your current vet, I strongly suggest you get Piggy to a specialist to get this all sorted out for you, including the breathing problems, & kidney mass. An internal medicine specialist is really the only type of vet who is going to be able to get to the bottom of all of this. I have done some research for you, & found 2 options for a specialist. There is one internal medicine specialist in Oklahoma City which I believe is about 4 1/2 hours away for you. This is the only link I could find for the hospital as it appears the clinic does not have a website. You would have to check with this clinic to see if they require a referral from your local vet.

http://web2.userinstinct.com/35770300-hollands-veterinary-referral-hospital.htm

The other option is the vet school at Oklahoma State which I believe would be about 5 1/2 hours away. I have looked at the listings for specialist in Oklahoma, & the vet school has something like 5 IMS vets on staff. A vet school might be the better choice as it actually may be somewhat less expensive than a private practice vet. You would also need to see if OSU requires a referral. If you can tell us what is your closest major city in Texas after Amarillo, we can take a look to see if there are any other specialists in that area.

I know you are worried to death, but rather than continuing to use your financial resources for Piggy's treatment that is not giving you the answers you need, PLEASE CONSIDER SEEING A SPECIALIST. We are more than happy to help in any way we can, but try to take a deep breath, & give us the answers we need, if you possibly can.

Debbie

[StarDeb55]

Melissa, I have been doing some more checking for internal medicine specialists in Texas, & have found quite a number of them in Dallas. There is no place closer to you in Texas. I was hoping Lubbock might have one, but apparently they do not. It looks to me like your best bet is the specialist I found in Oklahoma City or the vet school at Oklahoma State.

Hope this helps.

Debbie

[labblab]

Dear Melissa,

I have not had the chance to post to you before this, so I am offering a very belated welcome :o. But I'm hoping that we'll hear back from you very soon so as to get an update on how Piggy is doing. Please do let us know.

With my best wishes,
Marianne