My little Triste - Cushings I am terrified

[ElleAR]

Hi everyone and thank you for this web site. My Triste has been gaining weight and a few other symptoms. I took her to my vet yesterday for a routine heart worm test and after consultation he ran a full blood panel. He just called and after discussion, he is convinced that it is Cushings. She is having another test on Monday.

I have been reading your threads and helpful information. I know today when he called, I was not prepared for exactly what to ask, and reacted in a shell shocked manner. Unfortunately, when I called back he was in surgery. So I am unsure exactly which test it is other than he will need her for about 3 hours and she cannot have food. I did spend time on the web and half the information terrified me.

Triste is a mixed breed of husky/shiatzu. She has a full husky body and very short legs. So she does have a strange appearance. I want to be prepared for Monday and find out as much information as I can.

Any guidance you can give me as to what exactly to ask or what I need to look for or consider would be sincerely appreciated.

Thank you again.
Elle

[apollo6]

Welcome you are not alone. You don't need to rush into anything just yet. These are some of the tests that should be done:
Full blood panel
ultrasound,
ACHT STIM TEST
Symptoms include, increased thirst, skin problems-liaisons, weakness in the hind legs, pot belly, increased appetite.
Sometimes there are no symptoms.
Find a veterinarian specialist with knowledge in endocrinology.
Before you even consider some form of treatment, you need to differentiate what kind of Cushing it is-PHD, Atypical, or adrenal. The senior members will ask what tests have been done and ask you to post the results.

[frijole]

Elle, We have all been there and please don't think cushing's is a death sentence ok? Meanwhile - if it is only 3 hrs he is probably doing an acth test. That is fine but I would ask him to do the LDDS (low dose dex suppression test), if not tomorrow - at another time to confirm the dx and try to determine which form of cushings it is - if in fact it is cushings.

I would also have him do a thyroid test to rule out/in hypothyroidism.

Sorry to run but I am at work ... will check in later. I just wanted to say that it will be alright so don't panic. Hugs, Kim

[Harley PoMMom]

Hi Elle,

Welcome to you and Triste from me and my boy Harley! I am sorry for the circumstance that brought you here but I am glad that you found this forum. I was so very frightened when my boy was dx'd with cushing's but these wonderful, loving and very knowledgeable people took my hand and guided me, which makes this disease less terrifying...knowledge is power!

If your vet is keeping Triste for 3 hours then the diagnostic test your vet might be doing is the ACTH stim test. You can read more about this test and other cushing's tests here: http://www.k9cushings.com/forum/showthread.php?t=227

What other symptoms does Triste display? Did she have a CBC/Chemistry blood panel done recently? If so, could you post anything on there that is marked abnormal with the reference ranges and the units of measurements (U/L, mg/dl).

Cushing's is a slow progressing disease so one does have the time to get their pup a proper diagnosis. A proper diagnosis is vital to a proper treatment plan.

Please know that we are here for you and Triste and we will help you in any way we can.

Here is a link to some interesting reading material to get you started!
Links to Cushings Websites (especially helpful for new members!)
http://www.k9cushings.com/forum/showthread.php?t=180

Love and hugs,
Lori

[ElleAR]

Thank you all for your responses. I think I am replying correctly if not apologes.

The vet did rule out thyroid problems and the only number that I wrote down was akaline phos was way above normal at 1800. She has been on a very restricted diet for her weight and she, I and her sis Onyx walk every day. Lately the walks are exhausting for her and she has gained weight not lost it. She is always starving and overweight, and my vet said she has a classic very distinctive pot belly that because of her short legs almost touches the ground.

I have been reading this website and your suggested links for a few hours, and I need to tell all of you thank you for your support. I think what terrifies me the most is reading about the treatments if needed. I am a prof and teaching two summer classes starting Monday, so there is no one to watch her but her adopted sisters, Onyx and Entchen. The thought of her being on strong meds and alone with any kind of reaction is scary. I have calmed down and realized we will get through this. More importantly, educating myself is crucial.

First thing in the morning, I will call the office and ask if to pick up a copy of the blood work for a working file and ask more about Monday's test. Thankfully I do have a very caring vet, who all three of my babies love, well Entch no so much, but I don't any kitties like their vet.

Thank you again
Elle

[ElleAR]

I also meant to add she is panting all the time and her back legs are weak and getting weaker.

Elle

[Harley PoMMom]

The one diagnostic tool that usually helps immensely is an ultrasound. This has to done on an optimal machine and read by a qualified person, and regretfully, both are usually not found in your regular vets office.

Ask your vet how many cushing pups he/she has treated, and with which medicine, Trilostane/Vetoryl or Lysodren/Mitotane, that he/she is more familiar/comfortable with treating.

Love and hugs,
Lori

[Harley PoMMom]

Excessive cortisol is hard on their system but is does take a long period of time to do damage.

Elevated ALP (akaline phos) is a liver enzyme which means the liver is working harder, this is very common in our cush-pups, maybe ask your vet about starting Triste on some liver support supplements like milk thistle or denamarin.

The excessive cortisol can cause muscle weakness, panting, thin skin, and it also makes their kidneys work harder which it turn makes them drink alot more, so one can never restrict a cush-pup or a pup suspected of cushing's disease of water.

Please ask all the questions you want and we will answer them the best we can, ok? ;):)

Love and hugs,
Lori

[addy]

Hi Elle,

We are all terrified when we first here the suspected diagnosis. I know I went through anger, fear, denial and non stop tears.

Having these wonderful people that are here in this forum support you and answer your questions will help all of the scary emotions.

Though I still have meltdowns, I get emotionally stronger everyday. You will too :)

We will be here for you!

Addy

[ElleAR]

Addy, Lori Thank you.

I have been reading about treatment methods both online and on our library. There appears to be so much conflicting information. What would be considered the least aggressive and invasive method. I would like to be able to discuss all of them with my Vet.

Thank you
Elle, Triste I know thanks you also.

[frijole]

Elle, The best treatment is dependent upon the type of cushings - there is more than one type. That is why I recommended having the LDDS test done as it can indicate which type a dog has. 85% of dogs have pituitary cushings. Another form is adrenal cushings. And there is atypical cushings.

The most commonly used drugs are lysodren and trilostane. Most go with whichever their vet is the most comfortable with.

I want to point out something important before you go to the vets. There is absolutely no rush to treat cushings. Most dogs go a long time before getting diagnosed. So go to the vets and go thru every single test you need to CONFIRM the diagnosis is accurate (it is often misdiagnosed), do your research on treatment options - discuss them with your vet. And when you are ready you can begin treatment.

This will give you plenty of time to read up and ask us tons of questions. We have a ton of experience here so you are not alone on this journey. Good luck! Kim

[StarDeb55]

Welcome to you & Triste! You have already been given some great advice so I will try not to repeat any of it. The one thing I don't see that anyone has mentioned is that since is part Husky, Nordic breeds are more prone to having elevations in some of this associated sex hormones produced in the adrenals. When this happens, it is termed Atypical Cushing's, rather than have just an ACTH done, it might be a could idea to have a full adrenal panel done at the Univ. of Tenn., Knoxville which will give you the cortisol levels, along with all 5 of the other hormones. Here is a link from our important information section which will give you more information about Atypical & the UTK full adrenal panel testing. Unfortunately, UTK is the only lab in the country that is doing the full adrenal panel, so your vet would have to draw the blood, process the sample & freeze it, then overnight the frozen sample to UTK. There is complete information about this testing on the link.

http://www.k9cushings.com/forum/showthread.php?t=198

Debbie

[addy]

Hi Elle,

I just wanted to check in with you and see how you are doing. Let us know if you have any questions or just need to talk.

Addy

[apollo6]

Dear Elle,
The senior members will ask you to post the results of the blood panel, they'll ask you which ones, you'll want to post the results and beside it the normal range. Looking to see if liver readings are high, see my thread: Apollo vetoryl-trilostane.
take a breath, you don't have to make any decisions right now, just get the tests and get support from us.
In my case I got the first red flag in Sept 2009, In January 2010 did an ultrasound, in May did an ACHT STIM, I went to a second vet because I did not like what the first said. I did not get Apollo on any medication until June 26, 2010. But this wasn't until I did a lot of research felt confident in the vet-try to see an INTERNAL MEDICINE specialist , familiar with cushing and specializing in endocrinology . In my case the hair loss started more then a year ago. Apollo is still here. I went through the same fears, denial about this. But I really wanted to make sure it was the right diagnose. We are here for you.
Sonja and Apollo

[Weeds]

Hi Elle, welcome to this great site...I'm fairly new also and some of the info on this site we never got from the vet, and we thought we were very informed. Our vet is great but learn from others here and ask questions, go to links and print them out and take to vet with you. Our Molly was diagnosed August 09 and with lots of challenges (had liver mass,cancer, surgery in March) but she is doing well on lysodren for the cushings. She is one brave 11yr beagle. It can be scary but it is not a life/death thing, its quality of life for your little Triste, and thats about all we loving parents can be, just like with kids doing the best we can for them :D
Take care and give Triste a kiss from us
Elaine, Paul and Molly beagle

[ElleAR]

I am not sure if I am posting quick reply or not. This site has been invaluable. I started my file, which I thank you for suggesting.

I travelled for 25 years and went back to school. Triste is my first companion. She saw me through Grad School, and although I love all three of my babies with all my heart she is. It is Cushings. We can take one more test to see if she can have surgery. She cannot. She is 10 years old. Last year, she had emergency surgery for the second time because she develops stones in her kidneys that are so large they do not pass throughher bladder, urethra (I may have the words wrong). Her first surgery they said, rare does not happen to female dogs. The second one they said no way - it was. She barely survived last year only because I pushed the
vet, not the same one I have today.

I have researched and researched all the information on the drugs available for possible treatment. I spoke to two Vets. They do not approve of my reaction. I have just been through 2 years of blank for my health. I had major reactions to all the drugs, but I could call my doctors, she can not. I can not do that to her. I have decided to try holistic alternatives.

I know that is out there. I know it is not a cure. I also know that my number one concern is quality of life and I want that for her. I want her to be here forever, but that is selfish. What matters is her and that every day is joyous. My Vet, who is very caring, says all we are doing if I choose this route is treating the symptoms. I know that.

There is a lot more I can say, but in truth I would ask for your prayers. I pray treating the symptoms and with holistic backup she will be comfortable. I also know that they told me holistic alternatives do not work. They did at least help me after all the drugs they pumped me with, and I continue with the alternatives today and I am healthy. I do not expect that for Triste, but I will try.

Elle and Triiste, and her sisters.

I apologize if there are mispellings. I am tired and won't download the spellcheck., but thank you again.

[Harley PoMMom]

We do understand your fear as we all were standing where you are now. Trilostane/Vetoryl and Lysodren/Mitotane are the life-saving drugs that are cushing's dogs need if they are going to survive this terrible disease. Please do not be afraid to give either one of these medicines to your Triste, most bad reactions are dosage related not drug related.

Another note, if Triste would have the UTK full adrenal panel done and the results would show that her intermediate/sex hormones were elevated and not her cortisol then she just has Atypical Cushings and this is a whole different treatment all together. Would you consider having this test done?

Will be keeping you and Triste in my thoughts and prayers.

Love and hugs,
Lori

[StarDeb55]

We are here to support you in whatever path you choose for Triste. I do want to tell you, as Lori has already stated, the 2 drugs that are used to treat are serious drugs but they are life-saving drugs for our pups. My 1st boy, Barkley, was successfully treated with lysodren for nearly 8 years, crossing the bridge at 15 years old. As long as you have a vet who is familiar with how either drug should be used, & is following proper protocols for the specific drug, there really shouldn't be any problem. It does need to be said, though, that there is a risk with any drug we or our pets take including something as simple as aspirin.

I wish both of you the best on your path.

Debbie

[Weeds]

Elle, I hear your love and concern for your dear Triste--do whatever you feel is right. We all do it and take each moment as a great gift. Quality is everything and I will pray for you, Triste and sisters. Love each other every day and I'll send a special prayer for Triste that she will be pain free in whatever treatment you decide.
Elaine and Molly beagle

[littleone1]

Hi Elle,

I totally understand how you feel.

I just want to let you know that Corky has an adrenal tumor, and he is not a good candidate for surgery because of his age and other medical issues. He is being treated with Trilostane, and has been taking it for a little over 9 months now. His quality of life has improved so much. He is back to his normal self. Before he started his treatment, he would only walk around the block, and that use to take him 15 minutes. He was use to walking 2 1/2-3 miles every morning, until he got the clinical signs for Cushings. Now, with his treatment, he is back to walking the distance he use to walk before. His clinical signs have gone away. Even though the medications are not a cure, they do help give our furbabies a much better quality of life.

Terri

[marie adams]

Hi Elle,

I would like to welcome you!! I was new to this disease in February. You do go round and round on which way is the best and believe me I wanted to go holistic, but what I read didn't support it like the traditional ways to treat. I had made my mind up it was going to be one of the mildest forms, but in the end I went with Lysodren because Maddie had almost all the symptoms and I wanted her quality of life to come back asap. It still has been a long road and I think we are finally getting there--a bit of a long story won't go into it.

Most of Maddie's symptoms have gone away. She still has the weakness in her hind legs and each day she seems to want to walk further. She has not had any bad reactions to the medicine at all. Her appetite is good not ravenous. I also switched to a raw and no grain diet. Just started her back on a dry diet which I mix with the raw--still no grains.

It is a hard decision to make--I do not like medicine myself, but you have to do what you think best. Am I glad I chose Lysodren? Yes, because I can see that it has worked for her and it was with all the help I receive here at this forum that made me feel comfortable with the decision. They have helped me through all of it.:)

Take care and ask all the questions--research is available which I am sure you can't get enough of.:D:D

[apollo6]

Dear Ella,
We are here to help. So ask what questions you need. I went through a lot of anger, fears, crying also. You are not alone.
Do the tests first: the full blood panel, the ultrasound will help also.
Sonja and Apollo
It took me a long time to finally decide on medication with Apollo. But first I did the tests, found out which one Apollo had, read up on Cushing and all the symptoms. This is a tricky disease.

[addy]

Hi Ella,

the decision you make today is what feels right for you and what you can deal with and cope with.

maybe down the road that will change and you may consider other treatment. that is okay too. you have to feel comfortable with the treatment you choose.

goodness knows, I change my mind sometimes daily:)

I too have been personally misdiagnosed more times than i care to remember, have been overdosed on drugs, oh, the medical community and I don't get along really well. I understand where you are coming from.

We are still here for you, always will be, no matter what.

Addy

[jrepac]

Hi Elle,

I can understand your concerns, as I share them somewhat regarding some of the current meds that are out there. You may want to try Anipryl (selegiline). Its efficacy is widely debated, but some pups do well on it. It can certainly help w/some of the symptoms. Plus, side effects are minimal. My Aussie is home alone a good part of the day, and I would feel the same way if I were giving her meds with high risk of side effects. Someone really needs to be around to observe them when they are being treated with lysodren or trilostane.

You can also combine anipryl/selegiline with your holistic rememdies, I tend to think. Get a prescription for the generic version from your vet (it's a lot cheaper than the brand name version) and Walmart can fill it for you.

I have been using it for quite some time now, in tandem w/various supplements (milk thistle, Sam-E, cranberry, melatonin, lignans, etc.) and we are doing AOK. It is worth a shot; after 2/3 weeks of treatment, you will be able to tell if your pup is responding to it, as symptoms will reduce/stabilize. If by one month, no change is observed, your vet will likely double the dose and go for another month to see if there is a response.


Good Luck to you!

Jeff

[apollo6]

Dear Elle,
First things first. Get the tests we suggested, then find out if and which one Trista has. I am going through the same fear. All I can say is I think Apollo had signs over 2 years ago. I am finally doing treatment. We are hear to help. Ask us questions. You don't have to make any decisions right away. I am somewhat holistic myself when it comes to treatment. It was my holistic vet , who suggested doing the tests for cushings. I did holistic for awhile, but Apollo got to a point where things were not getting better, and only after a lot of research, tests, and finding the right INTERNAL MEDICINE SPEALIST(IMS) with knowledge in cushing and Endocrinology, did I finally make a decision on treatment.
Sonja and Apollo

[addy]

Hi Elle,

Just thinking about you and hoping you are okay. How is Triste?



Addy
:)