seizures and cushings

[duchess]

We have an 11 year old, female, schnauzer who has recently been diagnosed with cushings disease. She began having seizures Jan 1 of this year, then was put on pheno and Valium for immediately after any seizures. She was pretty good until Easter, had some bad seizures, and then until October 30th when she had more seizures.

She hasn't lost hair, but is definitely drinking and urinating many, many times more than before and is incontinent and even has defecated in her pen. Her liver has enlarged and she looks almost like a Portuguese pig in her abdomen.

She seems to be regaining some control of urination and even seems to be returning to some of her previous learned habits.

My question is whether to put her on medication or, if she returns to "normal", we just let her live out her life...whatever that would be. We do have a male schnauzer, her half brother, who is confused by everything.

Any suggestions on anything? Thanks.

[Harley PoMMom]

Hi and welcome from me and my boy Harley. So sorry for the circumstances that brought you here but glad you found this forum. We will help you and your precious furbaby any way we can.

Cushing's is a difficult disease to diagnose and not one test can diagnose it 100%. Some other non-adrenal illnesses can mimic the same symptoms of Cushing's, like diabetes and hypothyroidism, that is why a through diagnosis is vital before starting a treatment of any kind.

Also according to Dr. Feldman, who is a renown Cushing's expert:


Diagnosis of dogs with signs of Cushing's syndrome that are receiving anticonvulsant medication can be confusing. Such medication (primidone, phenytoin, phenobarbital) can cause polydipsia, polyuria, polyphagia, lethargy, increased serum liver enzyme values, and abnormal plasma cortisol concentrations. The clinician must be cautious when establishing a diagnosis in dogs taking these medications.
http://www.io.com/~lolawson/cushings/articles/feldman4.pdf

polydipsia = excessive thirst.
polyuria = increased urination.
polyphagia = excessive hunger.


Could you tell us more about your girl's Cushing's diagnosis? What test/s were done to confirm her Cushing's diagnosis? Was an ultrasound done? Is she seeing an IMS or GP? Does she have any other health issues? How much does she weigh?

I am sorry for all the questions but the more we know about your sweet girl the better our feedback will be and this is the best way for us to help you help her, ok?

Looking forward to hearing more about your precious girl.

Love and hugs,
Lori

[lulusmom]

Hi and welcome to the forum.

I'm very sorry for the circumstances that prompted you to find us but I'm very happy you made your way here. We normally ask a lot of questions but when phenobarbital is involved, we will probably have even more questions. I will apologize ahead of time for answering your questions with more questions but the more information you can provide us about your girl, the better able we can provide you with more meaningful and helpful feedback. So let's get started.

Cushing's is a very graded disease and I would normally tell a member that you have lots of time to make sure the diagnosis is correct and to research the drugs before making your decision to treat. However, phenobarbital throws a monkey wrench into things on a lot of levels. This drug has a profound effect on the liver as does cushing's, so I would personally feel a bit more anxious about treating a properly diagnosed cushingoid dog on phenobarbital.

The long term side effects of phenobarbitol cause a lot of the same classical physical symptoms and blood chemistry abnormalities that are associated with cushing's. Excessive drinking, urination, voracious appetite, enlarged liver, elevated liver enzymes and lethargy can be seen in a cushingoid dog or an otherwise healthy dog on phenobarbital. Cushing's is one of the most difficult diseases to diagnose and add phenobarbital to the mix, it becomes even more difficult.

Can you please tell us which diagnostic test were done by your vet to confirm a cushing's diagnosis? It would be great if can please obtain copies of all of the testing and post the results here. We would be most interested in any acth stimulation tests, low dose dexamethesone suppression test (LDDS) and abdominal ultrasound findings. I'd like to note that the LDDS is considered the gold standard in diagnosing cushing's; however, that is not the case when a dog is receiving phenobarbital as false positive results are to be expected. The ACTH stimulation test would be preferred.

If you don't have copies of these tests, your vet should be happy to give them to you. A lot of us members keep folders with our dogs' medical records. This comes in pretty handy in case of emergencies that happen after hours. The attending vets on call appreciate have the medical history at their fingertips. They also come in handy for when we bug you to post test results. :D

Did your vet diagnose pituitary or adrenal cushing's? Some vets don't feel it's necessary if the pet owner is not contemplating surgery in the event it is adrenal; however, in your dog's case, I think it would be very important to make this determination as side effects of phenobarbital mimic cushing's. Taking a look at the adrenal glands via an abdominal ultrasound would certainly help make this differentiation.

There are two effective drugs for cushing's, lysodren and trilostane (Vetoryl). Unfortunately phenobarbital greatly effects the metabolism of lysodren so that drug is probably not an option. I'm not sure about the effects on trilostane but I know we have members here that will chime in and share their experience with you.

Almost done but I have one last question. Is your dog treating with a general practioner vet or an internal medicine specialist? Many of us have found that our gp vets were woefully inexperienced with cushing's and we've ended up consulting with an internal medicine specialist. I have two cushdogs with multiple conditions so I know they are in the best hands possible with their IMS. A gp vet can be the best vet in the world but unless s/he has diagnosed and treated a lot of cushingoid dogs, I would be very wary of his/her ability to treat my dogs and their conditions aren't as complicated as your dog's.

I am sure that others will be dropping by to welcome you and probably ask their own questions and share their own experiences. You've found the greatest bunch of supportive hand holders on the net and there is a ton of collective experience to be shared.

Glynda

P.S. I see that Lori beat me to the punch while I was typing like a snail so please excuse any duplication.

[littleone1]

Corky and I also want to welcome you.

I just wanted to chime in on the seizures. Corky started having seizures, but was never on any medication for them, except for his Soloxine for his hypothyroidism. I don't know if anyone mentioned this to you before, but it is very helpful to keep track of the dates and duration of the seizures. It also helps if you keep a journal as to anything that is different in their diet or stress level. Corky's seizures did get shorter in duration and time. So far he hasn't had a seizure in almost two years.

I hope you will be able to get answers to what is going on.

Terri

[duchess]

Well, thanks for all the concern for our little girl. I hadn't realized ( the vet never mentioned the possibility) that the pheno might cause problems. In fact, our son was home this weekend (he's a people doctor) and questioned why some other seizure medication wasn't tried. When I asked him about that, he said there are lots and lots of possibilities and he, too, worried about the pheno potentially being a major cause of the problems. So, you all were absolutely on track!!!

Anyway, we have had blood work and urinalysis done several times. This time, they measured the cortisol baseline (that's what the diagnosis of Cushings was based on) and did a pheno assay plus a urinalysis as well as something called "animal profile 1". I can't tell from the receipt exactly what the animal profile means. I guess we just trusted the vet.

However, an employee --and friend --cautioned us that the local vets might not know enough to diagnose cushings. Her dog also has cushings and is doing okay at 12 years old. A friend of hers, though, was told to medicate her dog and the medicine caused Addison's and the dog had to be euthanized because it was then having so many problems.

So, I think I'll call the vet and see if there is anything else to do for our little Duchess. Her full name is "Duchess of Daring Do" because she has always been such a sweetie and never hesitated to do anything we asked of her. Here's hoping she can make it through this crisis, too!

Thanks heaps and heaps from a Wisconsinite who loves schnauzers! :)

[frijole]

Hi there! I love schnauzers too as you can see. My gal Haley was treated successfully for cushing's for over 4 yrs. She passed in May at the ripe age of 16 1/2! So if you would find an experienced vet and get up to speed on the disease you can do the same thing! The people here saved my dog's life. No doubt about it. Had to fire my first vet too.

If you can tell us where you live we might be able to help you with a vet in your area. No pressure.. only if you are up to it. If not, here is a site that you can go to find specialists in your area:

http://www.k9cushings.com/forum/showthread.php?t=182

Kim

[Franklin'sMum]

Hello, Wisconsin :)

Welcome to the forum, but very sorry for Duchess' problems. I don't know if you're aware of this, but schnauzers are prone to hyperlipidemia (high triglycerides/ lipase and /or cholesterol) = fats in the blood.
According to Franklin's IMS, hyperlipidemia can cause neurological symptoms, such as seizures. It may be worthwhile to ask your vet or specialist about this.

Hope it helps,
Jane, Franklin and Bailey xxx

[duchess]

Guess I have some questions for our new friends.

Is the hyperlipidemia from a diet source? Several sites I've researched are concerned with the type of food the dogs are eating. We usually use either Kibbles and Bits or the new Beneful.

Also, we live near the heart of Wisconsin -- equidistant from Green Bay/Appleton/Wausau, Wisconsin.

Has anyone tried potassium bromide rather than phenobarbitol? One online site recommended it if the dog's liver is compromised. The only caveat was to NOT switch dog foods as the sodium level might vary between brands.

Thanks and Happy Thanksgiving to all.

[duchess]

Admin note: Merged with original thread so as to keep all of Duchess' history in one place.

Hi All,

I thought you would enjoy knowing that our duchess seems to be improving! She is still on the phenobarbitol for seizures; but over the last week, her lovely personality seems to be re-emerging AND, her stomach is much, much smaller. We are unsure whether the diagnosis of cushings might have been a mistake or if she is just lucky to be returning to a more normal pattern.

We're certainly not vets, but we are speculating that maybe she had been retaining water due to the seizures and has now finally gotten rid of that excess fluid. She is now drinking normally, eating normally, and even starting to play with her brother.

Wow. We don't know how long this will last, but we are happy schnauzer fans here!

[Bichonluver3]

YAHOO, DUCHESS! You go, girl. Thank you for some good news in a very sad couple of weeks for the Cushing's family.
Carrol & Chloe

[jrepac]

nice to hear some good news! Yay Duchess! :)

Jeff & Angel Mandy

[duchess]

I hope this is not the beginning of more problems; but, today, when our 2 miniature schnauzers returned from their "business" walk, Duke, our male 11 year old, had a seizure! He had had problems last January which coincided with Duchess' seizures, but his was attributed to the heart not pumping well after running which caused him to collapse. After a month of that, he just stopped having that particular problem. We thought we were on easy street then!

Today's event was totally different and definitely a seizure! He had the post-seizure shakes, confusion, and is now standing, staring at the wall. This is exactly the behaviour our Duchess displayed after seizures.

Of course, he has now had a Valium (called the Vet right away) to try to limit the damage. We might have to put him on the pheno, too, if this continues. We're crossing our fingers that this was a one-time thing and not the beginning of more bad news.

Sad, sad here!:(

[lulusmom]

I'm keeping my fingers crossed that this is an isolated episode for Duke. I do know how terrifying seizures are to watch. They say it is more painful for us pet owners than it is the dog but how do "they" know these things? I will say that my wee one, who has had two or three seizures in the last four or five years, came out of all of them like nothing happened. It was so weird. She was bouncing around and looking for treats just like usual. It has been quite some time since the last seizure so I'm hoping and praying that she never has another one. Please let us know what the vet has to say.

Glynda