Progression of Cushings?

[edsmum]

Hi. Am new to the forum, however have a border terrier who was diagnosed with pituitary cushings approx. 4 yrs ago. We have managed this with Vetoryl and a very strict diet as he also has significant liver damage and needs very low protein, low fat diet.

After we started treatment his improvement was marked and for a long time he has remained quite well, however he has deteriorated recently and I have a few questions. I would first say that he will be 14 at the end of the month so much of this could be due to aging alone.

He lost his hearing fairly suddenly and our vet says that this could be because the tumour is growing and putting pressure on the nerves controlling hearing. He also shakes at times; not epileptic, more like parkinsons type head and limb wobbles. He has become extremely senile sadly. The most recent change is his muscle tone on and stance of hind legs. His back end seems to be disappearing and he stands with his legs much more underneath him - I assume to compensate for muscle weakness?

Its a painful subject but I wondered if members of the forum could tell me how treated cushings progresses as their dog ages - should I expect a crisis where he goes off his legs completely?

I would be very grateful for any information.

Many thanks.

[labblab]

Hello and welcome to you and Ed, although I am so sorry to hear that he is not doing well right now. It must be very hard to see these changes, especially after he has been maintained well on his treatment during these past four years.

I only have a few moments to post right now, but do want to ask a couple of quick questions. First, can you tell us how much Ed weighs and also what his Vetoryl dosing history has been? And secondly, how recently has he had an ACTH monitoring test performed, and what were the results? Actually, however much you can tell us about his entire ACTH testing history will be very helpful. There could be several different causes for Ed's current problems, but probably the first and easiest one to rule out will be whether or not his cortisol level is falling within the desired therapeutic range.

So thanks in advance for that information, and I'm guessing that other members will also soon be by to welcome you and to ask some additional questions of their own. ;)

Marianne

[happydogs]

Hello EdsMum, and welcome. I'm so sorry to hear about your pup's problems. Cushings is difficult on its own, and combined with liver problems it's even harder.

My pup Randall also has Cushings. I can't comment on Vetoryl as he was treated with Lysodren. However, during maintenance phase, he was diagnosed with significant liver damage. We stopped the Lysodren immediately and put him on supportive supplements and drugs for his liver. We expected to have only a few weeks left with him. Well, it's been 7 months now and he is happy and active, and nearly himself again (although just recently diagnosed with kidney insufficiency). Randall was able to recover liver function to near-normal levels again.... so there is hope.

For the senility, has your vet suggested Anipryl / selegiline? This drug is actually used for the treatment of pituitary-dependent Cushings (most of the time, it doesn't work, which is why it's rarely used), but is also used for dogs who are experiencing cognitive dysfunction. I don't know if it can be used in conjunction with Vetoryl.

About the head / limb wobbles: maybe it's hepatic encephalopathy... The build-up of ammonia in the body (from severe liver disease) causes stuff like unsteadiness and tremors. Our dog was starting to show signs, and we put him on baytril, metronidazole (half dose, due to his liver issues) and lactulose. His unsteadiness went away within a week.

There's also something called "Dog Gone Pain". We tried it, on the advice of a holistic vet. I was skeptical it would do anything and had zero expectations, but it seems to work a little for pain relief. Strangely, it also seemed to help a bit with hind end weakness. It's no miracle, but it helped Randall get up a bit easier on slippery floors.

Acupuncture has also helped. It helped much more earlier on, but still makes our 15.5 year old puppy-like for a few days afterwards.

I'm sorry I can't be of more help... just thought I'd chime in with what worked for us. I'll be keeping you and your pup in our thoughts.

Angela and Randall

[littleone1]

Corky and I also want to welcome you and Ed.

I really don't have any advice to give you, as Corky has only been taking Trilo for a little over a year now.

There can be other causes for what you're seeing now. I hope you will be able to get some answers as to what is going on.

Terri