Pancreatitis(sp?) and cushing - Joy has passed

[jessica]

Hi --- Joy is an older Schnauzer and was diagnosed with Cushings last spring after the short test and the 8 hour test. I requested treatment with Trilo. She takes 30 mg daily. Last Sunday evening she threw up her dinner. Then she was fine. I took her to be groomed and to get her Rabies shot of Monday. She shakes the entire way to the Vet. On the way home she started smacking her lips and by dinner she got very sick. I could tell that she was in pain by the way she walked. She threw up 7 times until midnight. She even threw up in her bed which I don't believe is common for dogs to do. The next day she stayed in bed sleeping all day. I had to manually stand her up to make sure she could walk. I talked to the vet who told me not feed her Tuesday night and to start small meals on Wednesday. It appears to me that she had an episode of pancreatitis.(sp?) I fed her rice and boiled chicken for a couple of days and now have purchased a low fat dog food. I've read that Cushings is a risk factor for Pancreatitis ---- Is that true? If it is true do you keep your dogs on low fat pet food to prevent Pancreatitis? Have you ever heard of a Rabies shot causing such a severe reaction? Since she vomited once the night before I didn't think the Rabies shot was the cause. There was also a dead squirrel in the back yard that she took a bite or two of. Can a squirrel cause illness? I have seen her catch and eat them before without getting sick. It's so difficult to watch any animal suffer and be unable to tell you what's hurting. Doesn't it sound to you like it was a pancreatitis episode that remedied itself when she was taken off food.

[mytil]

Hi,

I have just a second, but wanted to welcome to our site. My first question is when was the last ACTH test performed to check her cortisol levels. Also when this was done were her electrolytes checked?

I do not know if ingesting part of the squirrel has caused this because she was vomiting before she ate it.

Yes, a lot of cushpups do get pancreatitis, but so do overweight dogs. High fat diets can contribute to this.

Is there any other medication your girl is on?

Terry

[jessica]

I think we did the ACTH test in the fall -- her numbers were perfect. I'll get copies of her medical records next week to get the numbers. She is not on any other medicine. She is obese. I think she caught the squrrel just before she first vomited because it was already dead when I took her outside for the first time after she became ill (she ran over and took another bite) - that's how I knew about it. She's a little killer dog. I am caring for my bedridden mom in my home. Joy was her dog. Mom has dementia and always fed Joy all her food off her dinner plate --that's where the obesity came from. Now I've fallen in love with Joy as my own.

[Harley PoMMom]

Hi and welcome to you and Joy from me and my boy Harley.

Votiming can be attributed to the electrolytes being unbalanced and/or low cortisol, so if Joy were my pup I would have both of these checked.

The best test to diagnose pancreatitis in a dog is the Spec cPL. Here is a link with information about the Spec cPL test: http://www.idexx.com/view/xhtml/en_us/smallanimal/reference-laboratories/testmenu/innovative-tests/spec-cpl.jsf?SSOTOKEN=0
The Spec cPL is a fasting test, so Joy will not be able to have anything to eat for 12 hours before having this test.

How much does Joy weigh? Is she experiencing any diarrhea? Is she drinking and urinating normally?

We are here for you and we will help you in anyway we can.

Love and hugs,
Lori

[apollo6]

Hi
Welcome
Just a quick note. If Trilostane lowers coristone too low it can cause vomiting. In that case you would contact your vet immediately. But the fact about the squirrel may have been the cause. Also Pancreatitis is common in cushing babies. My Apollo has pancreatitis throughout his life. The trilostane helped stop it. If your baby has hind leg weakness it could be from muscle wasting. But you are doing the right stuff. The Rabi shots is a mixed bag for many of us. Cushing effects the immune system.
Hugs Sonja and Apollo.

[foxandhound]

1st of all, your dog catches squirrels? You have a lightening fast one there! And, unfortunately, while eating raw is a great diet for most of our pups, wild animals can have tons of bacteria, not to mention the added factor of decomposition in your yard. Most dogs will get just a little digestive upset after such a meal, but a Cushing or Pancreatic dog can get pretty sick. If you factor in possibly already not feeling well with receiving a vaccine, it can make for some vomitting. Dogs do react to vaccines more often than vets care to remember. All I can say is if you elect to vaccinate consider not vaccinating during possible times of illness, staggering the vaccines (not giving those silly all-in-1 shots), and maybe even doing some of them every 3 years or less. Again, these are just opinions and should be decided upon by you and your vet.

You didnt mention any stool problems, so this could be a Trilo dosage issue. Has the vomitting stopped?

I would talk to the vet about staying on a natural, even homecooked diet at this point. I wouldnt really be thrilled to keep a dog with that type of vomitting on a dry diet (kibble). A homemade diet with controled portions and ingredients could be better for keeping pancreatitis attacks at bay IMO. Of course, there are good canned and dry foods too that might suite you better. Really, there's always a solution in the diet world so fear not!

The hind leg weakness is a painful issue for most of us and as I understand the Trilo usually helps with that soon so keep an eye on it. You said you have been dosing since spring, so when was your last ACTH? Have you had the protein:creatinine ratio checked? If it's high, you might want to talk to your vet about BP medication for proteinuria and creating a moderate to lower protein diet, but quality homemade proteins (eggs, meats, sweet potatoes, veggies in proportions needed by your dog and determined by your vet/nutritionist). Please talk to your vet about this since my dog has some different problems. ;)

I am a newbie here and by now means as well versed as some of the others. I learned so much from them. You're in good hands here. Keep us updated. Lots of love!

[jessica]

I think she wieghts 20 lbs. She did not have diarrhea. The vomiting stopped at midnight last Monday evening. She was very weak Tuesday, but by Wednesday she was completely well. I haven't given her any high fat food since the incident. Now I'm afraid to give her regular food. I'll have to ask my moms sitter about her fluid intake because Joy stays in the back with them most of the time. Yes, she has had hind leg weakness for a couple of years. The Trilo didn't help it at all. The only real difference I see in Joy since starting the medication is that she is now very, very happy. I think she feels good for the first time in a long while. She was kind of ignored when I was going through all the trauma of moving my disabled parents into my home. Also, because she's a "killer dog" :-) I couldn't let her into my side of the house because I had my 14 year old cat (Babykitty). Baby died of cancer last March and since then Joy gets to come over, so she's really happy.

[jessica]

Goodness, I don't even like to cook for myself. I can't imagine cooking daily for Joy. However, when I think about it I guess I have cooked for her for the last week. She's been getting boiled chicken breast and rice. Yes, she must be fast. One time she brought me a beheaded squirrel. It was terrible. We found out after the fact that Joy came from a puppy mill that was closed by the authorities ----she's never been quite normal, but is very funny. I agree with you --- she'll never have another Rabies shot.

[frijole]

Hi! I'm a schnauzer mom and have dealt with cushings as well as other issues..

First off - the others are right - it could be that the trilo dosage is now too high and the cortisol levels went low. I'm surprised the vet didn't have you have it checked out right away.

Second - schnauzers are KNOWN for having pancreatitus. They cannot handle fatty foods. A schnauzer with cushing's is even more sensitive. My gal Haley got to the point where even one small bite of white chicken breast would make her vomit. She was just very sensitive to fat. So not only do you need to go with a VERY low fat diet, you need to eliminate all people food. Find something that works and don't switch because of sensitive stomach.

Some here do home cook but these diets are specially formulated and entail making sure that all vitamins are included in the diet and it sounds like you don't want to go that way which I can understand.

Hope this helps! Kim

[foxandhound]

Well, I didnt mean no vaccines ever, that really depends on where you live, how much she interacts with other animals, etc. But yea, during times of illness, it's questionable.

I'd be really intested to know if other cush dogs' moms and dads continue vaccinating? My dog is not fully cushings yet/her diagnosis is still in the air, so I dont know, but we have not vaccinated in 2 years and it may stay that way bc mine had a reaction. :(

[jessica]

I read that a kibble food must be less than 9 grams of fat and a canned food must be 4 grams or lower. Does anyone know of a low fat canned food that dogs like. Joy won't eat the one I purchased (Science diet). There must be one that taste good. I have to give her the trilo in the soft food.
I guess I'll start her back on the Trilo in the morning when the Vet's office is open. I'll let you know how she does. Kim - Does Haley hunt squirrels? Thanks to everyone for all the help.

[frijole]

:D Ahhhhh the memories of Haley's squirrel hunting. You would not know this of course but my dear Haley passed in May at the age of 16 1/2. She was treated for cushings for over 4 yrs and she did not die from cushing's.

But back in the day my girl chased squirrels. There was a black one that hung out in my backyard and talked to her (made noises) and it was a stitch. I live in Nebraska. We moved to Florida for 6 yrs and the squirrels there are skinny little things. She chased them there too but it was much easier to chase those little lizards. So she kind of made the switch. ;) The only time she caught a squirrel was in Florida. She did however manage to catch baby rabbits and birds to bring home. She also used to go to a nearby lake and bring me home dead fish. She and her sister Annie were very "giving" that way. LOL

Regarding tasty low fat food... your dog is not alone in hating Science Diet... I think only the vets like it. :D;) Cha-ching.

I had my girls on a product called Holystique from Solid Gold. All natural kibble - salmon and sweet potato I think it is. Their energy levels and skin were so much better after the switch. Petco has a large selection of very good foods and there are other low fat foods out there these days.

Don't waste any money on cushing's tests until after the tummy disorder is over because illness can skew the test results and no reason to throw your money away. No rush to treat cushing's so handle the other issue first.

Kim

[StarDeb55]

Jessica, I have not posted to you before, but thought I would let you know that this website may assist in your search for a good quality food.

dogfoodanalysis.com

Also, I won't Hill's anything to any of my pups, & haven't in years. It's really a pretty low quality food. In the lymphoma dog support group that I was in a number of years ago, the group used to refer to Hill's products as "Science Death".

Debbie

[Squirt's Mom]

Hi Jessica,


I read that a kibble food must be less than 9 grams of fat and a canned food must be 4 grams or lower.

The key in canine nutrition is that each dog is a bio-individual and as such each one is a unique system. Statements like the one above that you read need to be seen as guidelines at the most, NOT rules. So don't let statements you may read like this one drive you in trying to find the right diet for Joy.

Joy may do just fine on 5 gr of fat per meal. Another dog of the same breed, age, size, and health status may do great on 12 gr of fat per meal. Unfortunately, it is trial and error most of the time, even when the diet is designed by a nutritional consultant or nutritionist...which is the best approach IMHO especially for pups with health issues. They will take all things into consideration concerning Joy and her lifestyle but even then, some adjustment to ingredients, portions, etc. can be expected.

Choosing a commercial feed will work the same way. Buy small containers of feed as a trial and see how Joy does. Lamb, turkey and pork based feeds will have the higher fat contents in most feeds. Read the labels carefully for nutrient percentages and ingredients. You can find some good feed in PetCo and PetSmart these days as well as in pet food specialty stores. You will not find good feed at WalMart, Target, KMart, or the grocery stores. Some good feed brands are Solid Gold, Holistic Select, Fromm, Acana, Taste of the Wild, to name a few. (You will notice Science Diet is not included! ;) I will be happy to share their history with you if you are interested. It was at one time a VERY good feed.)

Hugs,
Leslie and the girls - always

[jessica]

Hi everyone - I've been reading your many links on cushings and have learned a lot in the last couple of days. However, I still have two questions: Remember Joy got very ill last Monday. She's now been well a week. I took her off the Trilo 7 days ago. Can I start her back on it now? I can't remember if I had to do anything special before starting her on the drug originally - I don't think I did, but I'm just checking with you first. My second question is I keep reading that after starting the treatment the cushings symptoms go away. Joy's haven't. The only change is that now she is very happy and seems to feel great. However, she still has hind leg weakness sometimes when she gets up, she still urinates all over my carpet and she still has a big belly. She also has big growths on her body. They are about the size of a half golf ball and they are soft. The Vet knows about them and isn't concerned. My next question doesn't concern cushings, but it does involve Joy's welfare. When she goes to the Vet's office (mostly to be groomed once every two months) she shakes so hard on the way it seems that she is going to have a stroke. She doesn't shake on the way home. Is it natural for dogs to shake like that when they are driving to the Vet? I am considering discontinuing the grooming. I guess I can hand clip her. What would you do? Thanks for your help.
Jessie

Moderator's Note: Jessie, I have merged your update on Joy into her original thread. Normally, we prefer to keep all posts on a pup limited to a single thread, as it makes it easier for other members to refer back to the pup" history when necessary.

[lulusmom]

Hi Jessica,

You mentioned that the last acth stim test was done in the fall and that the results were perfect. An acth stim test is only perfect if the numbers are within the desired therapeutic range and symptoms have resolved. According what you've written, Joy seems to be much happier but none of her symptoms have improved. That usually tells us one of two things; 1) cortisol is still too high and 2) if the pre and post stim are within range, Joy may be a dog that will need twice daily dosing. Trilostane has a short half life and it's enzyme blocking ability starts to wear off any time after 8 or 9 hours so without adequate control throughout the day, symptoms will not resolve. It will help us if you will please post the results of the last acth stim test. Can you also get your hands on the tests that were done to diagnose Joy and post them here?

I just made a trip to the groomers on Saturday and all six dogs went this time. As usual, most were shaking like crazy and also as usual, everybody was totally calm on the way home. It's that way no matter where we go, to Petsmart or Petco, to family visits, to the vet and the groomer. I think Joy is perfectly normal...or at least in comparison to my pups.

Glynda

[jessica]

Yes, I can probably get them next week. The vet told me today that Joy can stay on her normal food, but if the vomiting starts again we will have to take a different approach. He thinks that it may have been caused by the squirrel --- I sure hope that's all it was. However, I do want to try the foods many of you have suggested. I just don't feel it's as urgent as I thought it was. Glynda, when my babykitty was dying I thought how much easier it would have been to take a dog to the doctor. Of course, I was wrong. I can not image taking 6 shaking dogs all at one time. Does your car rock :-)

[Casey's Mom]

Welcome to the forum Jessica!!

I feed my dog Wellness Core Reduced fat kibble - very good quality and low fat at 9%. I mix this with my homemade recipe of brown rice, extra lean ground beef, green beans and sweet potato.

She did have high amalyse and lipase levels last summer which have been reduced through this diet. She never has had an episode of pancreatitis but I am feeding her this to prevent an attack as she is a cushings dog.

Welcome to you and the little squirrel killer - my dogs wish they could catch them!!

[jessica]

I am so sad and just want to understand what happened. Joy, my 11 1/2 year old schnauzer died within 24 hours last week. What happened??? She had been on Vetoryl for two years. Was last tested in April and her numbers looked good. Had a complete CBC in the last year --- all numbers looked good. For the last 6 months or longer she has eaten an unusual amount of dirt --- seemed compulsive with it. In the last year she has been growing more of those large soft tumors on her body. The Vet checked them, gave them a name and said they are harmless. Wednesday she just went outside twice to tinkle, that night she ate her dinner as usual, later that night she wasn't as happy and the top of her head felt hot to me. I didn't really think much about it. Thursday when I got home around 2:00 the sitter that I have stay with my bedridden mom told me Joy went outside and wouldn't come in. I went and found her under the Sago Palm. The sitter said that she threw up white foam 3 times before going out. I got her in and she was very hot and threw up one more time. No loose stools, not a lot of vomiting --- however, felt very bad and wouldn't eat or drink. I thought she had pancreatitis ( which she had once a year ago) so told the sitter to keep her off food and water for the day. (This is actually my moms dog -- she stays in the room with the sitter and my mom). Anyway, when I went to their room in the morning to check she was still very ill ---- so we were taking her right to the Vet. The sitter got to the house at 9:00 and she died 10 minutes later. She wasn't really in pain --- just seemed like a bad case of the flu. She would stretch for me to rub her tummy so I though that was a good sign. The Vet thinks that she died from complications of Cushings. He said she could have had cancer or an internal tumor that ruptured. This all happened so fast. What are the end stages of Cushings symptoms. Her's was supposed to be under control, but I have read that the medication really doesn't help the disease --- it just helps the symptoms. Does cushings kill. What does it do to a dogs body that would result in death. Do you think that one of those large external tumors could have also developed inside her body. What are those tumors? Thanks for your help. I am just so confused.

[StarDeb55]

Joy, I am so sorry to hear that Joy has passed. From your description of the masses, they sound like lipomas, fatty tumors, & they are usually harmless unless they grow too large & begin to press on something important. Did your vet ever aspirate one of them to confirm they were lipomas? If he did, the fluid that comes out of them will literally look like oil when you put several drops on a microscope slide.

Let me say that unless you were to have a necropsy done on Joy, trying to figure out what happened is going to be anyone's best guess, including your vet. I think pancreatitis is a definite possibility. It also sounds like her cortisol may have dropped too low, & affected her electrolytes, sodium & potassium. Low cortisol by itself may not be life-threatening, but when it affects the electrolyte balance, this is a potential life-threatening situation. Cushing's of itself is not a life threatening disease, but what happens is the long term overproduction of cortisol in the body begins to take a serious toll on other internal organs. Was Joy having the recommended ACTH testing done on a regular basis, along with her electrolyte levels? If you have the results of the last couple of these test, along with the dates they were done, & could post them, we might be able to offer some insight.

The following link discusses the complications of untreated Cushing's, but it may have some helpful information for you. I can, also, offer from personal experience that Cushing's is seldom the culprit when one of our furbutts crosses the bridge. My Barkley, who had been successfully treated with lysodren for nearly 8 years, crossed the bridge at 15 from lymphoma. I lost Harley, my 15 1/2 Shih Tzu, just about a year ago, from what we think was a fast growing osteosarcoma, bone cancer, in his jaw, that had already spread to his lungs by the time I discovered he was seriously ill. Cushing's plays havoc with the immune system in our pups, so in my boys cases, IMO, their immune systems were so trashed, it allowed these malignancies to begin growing.

I know this probably won't help much. Again, I am deeply sorry for your loss.

http://www.k9cushings.com/forum/showthread.php?t=195

Debbie

[jessica]

Thanks Debbie -- those were interesting articles. I feel guilty because I think that if she had been under my care I would have noticed warning signs --- but she was very loyal to my bedridden mom and stayed in her room with the sitters 90% of the time. Mom has dementia so she has no idea what happened. I wonder about a UTI because she only went out twice the day before --- however, it seems like there would have been signs of urgency ----???? I took her for a walk last week and she urinated fine. I have one thought. The sitters said she ate way too much dirt for a normal dog. Just last week a sitter put bricks in the planter that she feasted from ----so she went under the Sago Palm. I didn't know about this until her death, but Sago's are deadly poisonous. Since she ate the dirt under the palm I wonder if she some how ingested seeds or old leaves. The Vet said poisoning does not cause a fever, but maybe I was wrong about the fever. However, she did feel really hot and she felt really hot because she kept moving to cold floor areas. You asked when she was last tested --- she had the short test last April. I don't have records. I wish I had taken her to the Vet the afternoon I found she was ill. However, the Vet feels this was actually a good way to go. She was old and terrified of Vet's offices --- she was neurotic because she came from a puppy mill (found out after mom bought her and couldn't get AKC papers because the breeder was under investigation). Anyway, thanks for listening and letting me talk this out. Joy was uncomfortable those last 24 hours --- but not in pain and not terrified. I'm having her cremated and returned so she can wait with my dad's ashes --- when mom's goes I'll bury the 3 of them together. Sorry --- that probably sounds terribly weird! One last thought --- If you have Sago Palms in your yard I really have learned that every part of the plant is extremely poisonous ---- 50% to 80% of dogs who ingest the plant can not be saved at the Vet's office.

[k9diabetes]

I'm very sorry to learn of Joy's passing and what a traumatic experience it was for you. You had obviously done a good job with her Cushing's disease and the fatty growths most likely were lipomas, which generally are harmless.

So much of what happens in life with our dogs is beyond our control and often is beyond the reach of veterinary diagnostics.

Sometimes even if you turn over every rock to find out what's happening with your dog, the answer still doesn't come. Our dog did not have Cushing's disease but he had diabetes and rather severe heart disease. We managed to control all of that but he was still obviously frail and failing and we did every noninvasive test we could and did not manage to identify the cause until, just two weeks before he passed away, we found cancer in his lungs while checking for congestive heart failure. Most likely the tumors in the lungs were secondary to cancer somewhere else and he had had it for a while. To this day, I don't know where it started.

But for one x-ray meant to check for something else, our dog would have abruptly started bleeding internally and been gone within 24 hours and we would have had no idea why despite a whole lot of looking.

You did all that you could for Joy - that's all anyone can ask, all anyone can do. You loved her and took care of her health and emotions and made her a beloved member of your family. Those are the things that really matter.

Godspeed to Joy,

Natalie

[labblab]

Dear Jessica,

I, too, am so sorry for your loss of Joy. But I just want to "second" the wisdom of what both Debbie and Natalie have written, and hope that you will be able to find comfort in their words. You all saved Joy's life the day you first brought her home from the puppy mill. Each and every day spent in a loving home was your gift to her. So as hard as it is, please do not second-guess yourself about those final hours. You had no reason to believe that anything so serious was going to happen so quickly.

I am very grateful that you've returned to tell us what has happened. Both so that we can offer you our support, and also so that we can join you in honoring Joy's life and spirit. We have a special memorial thread of honor here, and we would like to add Joy alongside our other beloved pups. Here is the thread:

http://www.k9cushings.com/forum/showthread.php?t=2865

If you would tell us the day of Joy's passing, we will create a special line for her. And if you would wish to share a photo of Joy, we can add her to our memorial album and add a photo link to her line. At any time that you choose, you can email a photo to us at k9cushings@gmail.com.

Once again, I am so sorry. And I send you many hugs in loving memory of little Joy.

Marianne

[Squirt's Mom]

Dear Jessica,

Bless your heart, so much on your plate. I am so sorry to hear about Joy. It is never easy to lose one - whether you know the cause or not. We lost our Ruby and have no idea what was wrong with her. She had been sick for some time but the vets couldn't find the reason. I know exactly what happened to my Crys. The grief is just as heavy for each of them.

Joy was blessed to have had such a wonderful life with you and your mom - something I know she had never dreamed was possible until she was taken from that mill. Because of you and your family, she crossed The Bridge on wings of love.

Thank you for coming back to let us know. We are here any time you wish to talk.

Our sympathies,
Leslie, Squirt, Trinket, Brick and our Angels, Ruby and Crystal

[Cyn719]

Jessica - So sorry for the passing of Joy - I know it is so hard but just remember Joy was loved very much and knew that - love and prayers are with you

[jrepac]

Jessica,
sorry to hear of Joy's passing; it's really hard to lose them unexpectedly like that, I can totally relate. As others have said, those external tumors were likely "fatty tumors" (lipomas) which are common in a cushpup, but ultimately harmless. Sometimes, with Cushings, other things can lurk in the background and take them from us unexpectedly. Cushpups often have weakened immune systems and can be struck down by something other dogs would likely recover from; and surely age plays a factor as well.

BTW, I did not find your idea of burying your Joy w/your parents strange in any way....I've been contemplating something similar.

Jeff, Angel Mandy & the Girls.

[mytil]

Jessica,

I am so very sorry for your loss. It is so very hard not to second guess things at this point. I agree with Debbie, unless an examination is done, there is no way to tell for certain. It did seem to come on very quickly.

((((((hugs))))))
Terry

[Casey's Mom]

I am so very sorry for your loss of Joy. RIP little angel, and peace to you Jessica.

Love and many hugs,