Atypical Cushings

[Lpeach1969]

My approx 13 year old cocker was diagnosed with atypical cushings. He was started on trilostane about 3 weeks ago and the excessive drinking and urinating has improved. I'm wondering if the weakness in his hind legs will get better as well? He can't go up steps anymore and has a very difficult time standing to be groomed.

[lulusmom]

Hi and welcome to the forum.

I noticed that you also posted to another member's thread and I have taken the liberty of copying that post here so that we all have the additional information on your dog.


It took a year and every test under the sun to diagnose my 13 year old cocker with atypical cushings. He had a urinalysis, urine culture, blood panel, xray, ultrasound, LDD, and finally the sex hormone panel from the University of TN. After the LDD came back negative I was in shock b/c I knew he had all the symptoms of cushings. The sex hormone panel was just over $400, but it finally gave me some answers. It was so worth it! He is now on trilostane once a day (for the mean time - several blood test need to be done to make sure the levels are regulated) and he is not drinking/urinating like he did and I can tell he feels better. Hopefully he will continue to improve. Just don't give up!

It would be terrific if you could gather up all of the tests that were done to diagnose your dog and post them here. I would be particularly interested in the abdominal ultrasound findings, abnormal blood chemistry and the UTK adrenal panel results.

It is highly unusual for a vet to prescribe a cortisol inhibiting drug to a dog who has normal cortisol so the test results will come in handy in trying to understand your vet's treatment of choice. If you have a copy of the UTK adrenal panel, you should have an additional page that sets forth the treatment options. Can you please tell us what those options are? For atypical cushings, treatment usually starts with melatonin and lignans, if the estradiol is elevated. If after two to three months these supplements are not effective in improving symptoms, it is usually recommended that a maintenance dose of Lysodren be added to the regimen. UTK does not recommend Trilostane for atypical dogs, or at least they didn't the last time I checked their website.

I'm sorry that you had to find us at all but I'm glad you made it here.

Glynda

[Squirt's Mom]

Hi and welcome to you and your baby! :)

My Squirt is also Atypical and has been on treatment with melatonin and lignans per Dr. Oliver at UTK for over 2 years now. As Glynda said, Trilostane is not usually recommended for pups with Atypical as it is known to raise some of the intermediates that cause this form in the first place. However, some vets will take this approach anyway.

If your baby has elevated cortisol as well as elevations in the intermediates, then he has true Cushing's, not Atypical. Atypical Cushing's does not have elevated cortisol; only elevations in one or more of the intermediate hormones - estradiol, aldosterone, progesterone, 17-hydroxyprogesterone, and androstenedione. The results on the UTK panel will let us know exactly which hormones you are dealing with and will allow us to provide more meaningful feedback. ;) So we always ask for test results in order to help you help your baby.

I am glad you found us and look forward to hearing back from you soon!

Hugs,
Leslie and the girls :D - always

[apollo6]

Welcome

My approx 13 year old cocker was diagnosed with atypical cushings. He was started on trilostane about 3 weeks ago and the excessive drinking and urinating has improved. I'm wondering if the weakness in his hind legs will get better as well? He can't go up steps anymore and has a very difficult time standing to be groomed.

The hind leg weakness is caused by muscle wasting. I have been told it can take months to see improvement. My Apollo started Trilostane in June 2010 and is still dealing with the weakness and stiff wobbly walk. It may be neurological or arthritis. Apollo is 12 years old.
Keep coming back.
Hugs Sonja and Apollo