14 year old Golden with Cushings (Lysodren)

[baileysdad]

I have a golden who will be 14 years old in a couple of months. She was diagnosed with cushings disease about two years ago.

We have been treating her with lysodren (500 mg once weekly) and for the first year she did really well.

She still has her same great attitude, but I am worried about her. She has been losing weight, and her coat is very "ratty", no matter how much we care for it. She also has a sore of some kind on her front paw.

I have taken her twice in the past year to the vet for follow-up ACTH stim tests. I don't have the numbers (but will get them), but the vet said she was just a little over normal on the last one.

The second to last one - which was done about a year or so ago - was above normal, but there was a reason (which I can't remember) why he didn't think it was valid and not as concerned.

Again, the most recent was just over normal.

Having said that, she has lost weight. She is bony throughout the ribs. She still has a heck of an appetite and eats well. I put her on a high protein food (Blue Wilderness Formula) which is also calorically dense.

She cant do stairs anymore and is weak in the hindquarters. Since she was a pup, she has always laid down "spread eagle". She now has a hard time getting up.

I feel like the weight loss if from the cortisol. It's just my intuition.

Does it make sense to - with vet's permission/supervision - do another loading phase on a dog of this age? Do I trust labs over symptoms?

My girl has given me a wonderful long life and we're blessed for the almost 14 years we've had. I don't want to put her through tough times, but feel like she could be doing better.

Any thoughts?

[BestBuddy]

Hi and welcome,

I don't have any experience with Lysodren but many here have and will be along soon I am sure.

It is important to know what those ACTH numbers are because "normal" for a dog without cushings is not the same range as for a dog being treated.

Jenny

[StarDeb55]

How long has it been since the vet has done a physical exam on your girl? If it's been awhile, I think it's warranted to take her in. Weight loss is usually not normal with Cushing's, & if the Cushing's is under control, the muscle wasting should subside, & actually start improving.

Debbie

[baileysdad]

Thanks, guys.

I will call tomorrow to get those numbers and post them; I was unaware lysodren would "skew" the range.

And that is kind of my point...I don't think the cushing's is well controlled. My gut is telling me I have a healthy dog other than cushings.

My vet seems almost nonchalant. His attitude is the cushings will eventually take her anyways and the average lifespan after diagnosis is only a couple of years.

Assuming the numbers I post would lead most here to treat, I am willing to get another opinion from a different vet.

My question is would you put a 14 year old through another loading phase? She handled it well the first time around, would you do it again now?

[StarDeb55]

Lysodren doesn't actually skew the range on ACTH testing. There is one range for a normal, healthy pup, & a totally different range for our cushbabies. A cushbaby must have there cortisol kept at a lower level than a healthy dog in most circumstances.

When it comes to treating a senior, "been there, done that", so I can truly empathize. My little 15 yr. old Shih Tzu, Harley, was diagnosed at 13. Several times during the first year after diagnosis, I have had to reload him, once due to an internal med specialist who thought results that were extremely high on an ACTH were "ok", because he was not symptomatic. Within 2 weeks, Harley was drinking & peeing buckets, again, & an ACTH at that point had nearly doubled compared to the one that was "ok".

When it comes to this 2 year survival rate, ignore it, it's HOGWASH. My 1st boy, Barkley, was successfully treated with lysodren for nearly 8 years, crossing the bridge at 15.

One thing I can't see that we have asked you is what is your girl's current weight? Lysodren dosage is based on the following formula 25-50 mg/kg, & considering the average size of Golden's, 500 mg of lyso once a week seems like an extremely low dose which may be why you have lost control. It is also recommended that you split your maintenance dosing into at least 2-3x per week. For instance, Harley's maintenance dosage is 300 mg. weekly. That dosage is split into 3x per week at 100 mg. each dose.

Debbie

[frijole]

Hi! My little girl was diagnosed 4 yrs ago and she is almost 16 1/2 now!! Don't let any vet tell you a dog can't live with cushings. No way. If treated and cortisol levels are under control they can lead a very normal life.

If your dog is otherwise healthy I wouldn't hesitate to reload if needed. It'll make her feel better!

Yes, get the test results and share them. What is normal for a cush dog is not what is normal for a non-cush dog so we always check to make sure the interpretation is right.
he weakness in the hind legs is a good sign that the cortisol levels are up. My 2nd dog was just diagnosed with cushings (yea, bad luck !) and her symptoms came on real fast. I couldn't believe how she went from "spread eagle" to hardly being able to get up from the floor to stand up. Saddest thing.

So don't give up hope. I bet its just a matter of increasing the dose. What does your dog weigh? 500 mgs a week seems LOW for a Golden.

Looking forward to learning more about your girl. Kim

[baileysdad]

Thank ALL you guys for replying.

I will have results shortly and will share...

She has dropped as low as 55 pounds, her normal weight is 65; she's always been a small golden.

[frijole]

The recommended range for lysodren is 25 to 50 mgs of lysodren per kg of weight.

55 lbs = 25 kgs x 25 = 625 mgs of lysodren MINIMUM
65 lbs = 30 kgs x 25 = 750 mgs MINIMUM

Was your dog sensitive to lysodren when you loaded her (daily dosing at the beginning)? I am suspecting that this is the reason you are seeing the symptoms. Looking forward to the test numbers

Here is a link to info on lysodren that might help. Thanks!! Kim

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

PS the weight loss is a little strange as uncontrolled cushings usually means dogs are ravenous and heavy. have you had a blood panel done recently? wondering if there is something else going on.. or it could just be old age. my gal has lost a few pounds as well in her extreme senior years