Cushing's and hypothyroid

[galadriel]

Greetings! I ended up on this forum googling for hypothyroid, and arrived via this page:
http://www.k9cushings.com/forum/showthread.php?t=191

My Tessa has been diagnosed with Cushing's for about 2 years now, been on an inadequate amount of Lysodren during this time. She can't tolerate the dose she should be on; she gets about half. We've had to re-load her once. But she's severely arthritic, and she's been much more comfortable since she developed Cushing's, so hey; silver linings.

She's just been diagnosed hypothyroid too. She turned lethargic so completely and so suddenly that I thought it was her heart failing. She's absolutely miserable; she shakes when she tries to walk, and is too fatigued to even eat some days. She's started on Soloxine today.

Can anyone tell me how long it will be before she starts to respond to the meds? My poor baby is so pitiful.

Tessa is a black-and-white, short haired, 50 lb pound puppy. She's 13. She has spay incontinence and Horner's syndrome on top of the arthritis, Cushing's, and now hypothyroid. Wow...she sounds like a train wreck, but hopefully once she's dealing with the thyroid issue she'll be a happy bouncy girl again.

Thanks!

[StarDeb55]

There is a syndrome called sick euthyroid syndrome that is associated with uncontrolled or poorly controlled Cushing's which will show up on routine thyroid panels as hypo. If your vet did not do a free T4 by equilibrium dialysis to confirm the low result, Tessa may not be truly hypo Once the Cushing's is controlled, this problem will resolve itself. My vet & I have an understanding, now, that any time my Cushpup, Harley, shows as hypo on a routine thyroid panel, this is to be confirmed by the free T4. Everytime the confirmatory test has been done, Harley has been perfectly normal.

I would like to welcome both you & Tessa to our group! We have a tendency to ask a lot of questions of new members, but that just helps us to give you the best feedback possible from the group's collective experience. Could you tell us what symptoms led you to take Tessa to the vet when the Cushing's was originally diagnosed? Were both thyroid & diabetes ruled out at that point? I ask about these 2 things as their symptoms can overlap with Cushing's. Can you tell what test were done to diagnose the Cushing's, along with the actual results? Can you gives an idea about lysodren dosages, ACTH results with each dose, & Tessa's approximate weight during these periods? Can you tell us what dosage of lysodren you are presently giving weekly, number of times per week? What was her very last ACTH result? It's not suprising that Tessa feels better arthritis wise with her cortisol running a little higher. It's a natural anti-inflammatory. Have you tried any other medication to give her some relief for her arthritis such as Adequan injections/

Looking forward to hearing more. We are here to help in any way we can.

Debbie

[Harley PoMMom]

Hi and welcome from me and my boy Harley! Oh, you poor dear and your poor pup. :( My oh my you do have your hands full. I am in the midst of loading my boy, he too has a sensitive tummy so his Lysodren load had to be cut in half and given once a day, which means that this is going to be a looong load! :eek: so I can relate to your girls tummy issues and not eating. :(

We do tend to ask a lot of questions from our new members but that is so that our feedback can be as accurate as possible, the more we know about your girl the better we can help you help her, ok? So here goes my questions:

When was her last ACTH stim test and could you post her results?
What is her dose of Lysodren and what was her loading dose?
What tests were done to confirm Tessa's Cushing's?
Was a CBC/Chemistry blood panel done on her recently and if so could you post anything on there that is marked abnormal with the reference ranges and the units of measurements (mg/dl, g/dl).
Do you have prednisone on hand?

I don't know too much about thyroid issues but some members have gotten in touch with Dr. Jean Dodds about their pups even if they haven't sent their pups lab work to her, so I would suggest contacting her about Tessa.

Dr. Jean Dodds contact info can be found here:http://www.itsfortheanimals.com/HEMOPET.HTM

Looking forward to hearing more about Tessa, and remember you are not alone on this journey we are here for you and Tessa.

Love and hugs,
Lori

[littleone1]

Corky and I would also like to welcome you and Tessa to a very wonderful group of people.

I'm sorry that Tessa is experiencing these problems.

Corky was diagnosed with hypothyroidism about 10 years ago. He was just diagnosed with Cushings last year. Corky had started trembling when his thyroid level was too low. His dosage of Soloxine was increased until his thyroid level increased, and then it was reduced.

Corky was having these same issues. He also has arthritis. I give him baby aspirin along with 1/2 a tablet of Pepcid AC for his arthritis. I also recently purchased Bragg raw unfiltered apple cider vinegar which is suppose to be very helpful for arthritis.

Corky is taking Trilostane and not Lysodren, so I really don't have much knowledge about Lyso. I know that when he started taking the Trilo, I started to see improvement within a couple of days. His thyroid level increased within a months time. It's difficult to tell how long it will take the meds to work, as each individual furbaby is different.

I know it's heartbreaking to see our babies experiencing these problems. I hope that you will see improvement in Tessa, and that she will be able to do the things she use to do.

Terri and the Corkster

[galadriel]

Hey folks! Thanks for the welcome.

First off: yes, when her bloodwork came back with a low TSH, the vet ran a free T4 and based her prescription of Soloxine on those results. My vet is thorough and extremely competent, which is an excellent thing because I went through several who were...not...before I found this practice.

Oh boy. My Tessa baby has a loooong health history, but I can go into it.

At this time, she gets 20 mg Pepcid 2x/day; 50 mg Tramadol 2x/day; 1/2 a 1500mg tab of glucosamine 1x/day; 1/2 500 mg tab Lysodren every 3 days. She started on 1/2 of a 0.7 mg tab of Soloxine 2x/day this morning.

When she was about 6, she developed spay incontinence. She would leak urine when she was sleeping, but only then, and had no idea she was doing it. We put her on DES and it brought it easily under control.

When she was 8, she started pacing around whining under her breath, and then she started moving like she was in pain. I thought it was her back; the vet thought it was her hips, so we got both back and hips X-rayed. Hips were beautiful; low thoracic and lumbar spine was so arthritic the X-ray looked cloudy. Started her on Rimadyl and she was on that daily for years. I kept track of the way she was feeling, among other things, by whether or not she counter-surfed when I wasn't home ;) I never left anything up there that could hurt her, but could tell if she pulled anything down.

About two years ago, she started counter surfing all of the time, even when I stopped giving her Rimadyl because she didn't seem to need it. She started getting more comfortable jumping up on the couch, and jumped up on my rather high bed--something she hadn't done in years. Basically, the arthritis is GONE. (Well, no. It's still there, but she doesn't feel its effects.)

And she thought she was *starving*. Then she started with the polyuria/polydipsia. This was distinctly different from spay incontinence, as she was having accidents in the house while she was conscious, and very unhappy about them.

I'd just been looking into Cushing's/Addison's for one of my other dogs (who turned out not to have it, though he had a funky ACTH stim), and so I suggested we stim Tessa.

She had textbook pituitary Cushing's ACTH stim results. So we loaded her (2 tabs of Lysodren a day for 5 days) and re-stimed her, and the results of the 2nd stim were just about perfect. She went on a dose of 1 Lysodren tab 2x/week.

After about 6 months, the polyuria/polydipsia became a problem again. I experimented and determined that if I gave her 1/2 Lysodren tab every 3 days (no more, no less) it kept the polyuria/polydipsia under control. We re-stimed about this time, and she was still in a normal range, so we decided to just let it go and re-load if it became necessary. She gets a new stim about every 6 months.

Last fall I thought she had an eye infection. Vet diagnosed Horner's syndrome. It doesn't seem to affect her, just looks odd (one of her eyes looks kind of sunken and the 3rd eyelid doesn't always retract all the way).

She had a stim which led to a re-load and subsequent stim in March or April this year, and the post-loading stim was back to normal again.

About a month ago, we went out of town for a week. When we got back, Tessa was in really, really sad shape. She didn't want to go outside; she didn't bark at the birds and horses; she shook when she tried to walk; she seemed too fatigued to care about food; she didn't even drink as much.

I thought her arthritis might have gotten so bad that it was finally affecting her despite the Cushing's, so I tried taking her for a walk to see if she could work it off. I had her try to walk for about 15 minutes to see if she worked through it, and she gave it a valiant effort, but she just got worse, not better. I had to stop and let her rest several times before we could make it back home.

I thought it might be cortisol overload from the stress (excellent petsitter but she's still stressed when left). When Tessa is stressed, all her Cushing's symptoms go into overtime, poor girl. So I gave her a week to recover, hoping it was just that--but instead she got worse. So she went to the vet, where she got thoroughly checked out for pain, got X-rays of chest, and they ran a full "senior panel" of bloodwork. I was immensely relieved that it wasn't her heart or lungs.

The vet suggested trying Tramadol and Deramaxx to see if they improved things. They haven't.

Everything came back pretty much normal--liver a little off, but not unexpectedly--except thyroid. So they ran a free T4, and the results were definitely off. The vet did *tell* me the numbers, but I'm really bad with numbers unless I have them written down, so I was just going to get a printout of the test results for her records. I haven't been back to the vet; they ordered the Soloxine for me and then mailed it.

I am more of a health-problems train wreck than Tessa is, and she's one of 5 senior pets with health issues, so please forgive me if there's details lacking that you think need to be here. I've kinda got a lot on my plate.

~ ~ ~

Right now, what I really am hoping to know is how long it will take for the Soloxine to kick in. She got her first dose this morning. Is this something I should see results in days, weeks, months? What's my timeframe?

[Harley PoMMom]

Just a reminder: In order to complete your registration, you need to check your emailbox (or spam folder) for a communication from us. Once you respond to that email, your membership will be finalized, and anything that you post will become visable on the the forum immediately. Until that time, your replies must be manually "approved" by a staff member before they are visable to the public -- so there may be a bit of delay between the time that you write your replies and the time that you actually see them.

Love and hugs,
Lori

[galadriel]

Ah--I got the email and clicked the link, as soon as I registered. It told me that:
"Your account has been activated but you are currently in the moderation queue to be added to the forum."

[Harley PoMMom]

Right now, what I really am hoping to know is how long it will take for the Soloxine to kick in. She got her first dose this morning. Is this something I should see results in days, weeks, months? What's my timeframe?


Often an improvement in attitude and energy level is seen within the first week. Hair re-growth takes substantially longer (typically 4 months minimum) as the follicles must “reawaken” and then grow a hair long enough to create a visible coat change.

http://www.marvistavet.com/html/body_hypothyroidism.html

Hope this helps.

Love and hugs,
Lori