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vick
01-17-2011, 02:09 PM
Hi there. We have Riley, with Cushings and we really want to know what to expect and what we can do to help him. I've looked through some of the many excellent resources here but am a bit bewildered as to where to start!

Here are some details:

Riley is age about 12. He came to us at around 18 months have been horrifically abused by two seperate 'owners' prior to this. He has always had psychological problems as a result of this. But we've perservered and most of the time he's been pretty content. He's an airedale / lurcher cross - the height of a lurcher and the build of an airedale - super strong and fast when he was younger. He weighs 32 kilos and is neutered.

Nearly five years ago Riley became terribly ill and nearly died. His body just shut down. Incontinence, vomiting, raging temps, no appetite, couldn't stand up, repeated fitting, hair loss, open sores on his joints, really low platelets, ulcerated mouth and nose, huge nodes and he was in terrible pain. It was horrendous. Lots of tests and many days lots of vet time later he was diagnosed with chronic Immune-mediated arthritis (IMA). He was put onto Prednisolone - initially 25mgs per day. Gradually, over the next six months we were able to stabilise him at 10 mgs per day and then got him down to 5 mgs per day. Any attempts at going lower or stopping the Pred leads to a flare -up of symptoms within days. He's currently on 5mgs - 10 mgs depending on how he's doing. His system is so sensitive he can't even have a kennel cough vaccination as it triggers his system into chaos.

Two years ago we thought we were seeing changes of body shape, texture of hair etc but weren't really sure. At his next check-up we mentioned it to the vet and he said that as soon as we'd brought Riley in the room he'd suspected he'd developed Cushings.

Two years on we have a dog that is struggling with his IMA (joints that are very sore licked raw, terribly stiff and gets fevers at the drop of a hat) and one who has the following (we believe) Iatrogenic Cushings symptoms:

Hair loss, hair thinning, changes in hair texture, large lumpy hard cysts, excessive drinking, urinating frequently but without a decent 'flow', really greedy for food, eating poo while out on walks, some behaviourial changes (particularly aggression towards our cats around food), barking at nothing and just behaving strangely, disturbed sleep patterns, his skin bruises to almost black if we use his old brush (I felt awful for this), his head has lost all its fat - just skull really, legs are getting really thin and wasted and his torso is like a barrel. We also think something is going wrong with his eyesight. Having said all that he's still full of life when out for a walk!

The problem is that he can't come off the Pred, otherwise he will rapidly deteriorate and die - so this has to be continued.

Really what we would like to know is what to expect - we're scared for him and don't want to see him suffer. So we're wondering:

Whether we will see an ongoing deterioration of the symptoms we've mentioned above?
Are there other symptoms that might develop?
Also, and I know this is a difficult question, but what is it that will eventually take away a dog with this type of Cushings?

Sorry for the huge post and thanks.

Squirt's Mom
01-17-2011, 02:57 PM
Hi Vick and welcome to you and Riley! :)

Bless his heart. :( And yours, too!

Typically, with Iatrogenic Cushing's the offending med is gradually decreased until it can be eliminated but that isn't always possible, as you well know. Treatment with one of the cortisol lowering meds would seem to be defeating the IMA treatments so I don't know if they would be an option for Riley or not. Hopefully one of our gurus will be able to give you more input there and have some other suggestions to boot.

As for what happens in a cush baby that is not being treated for whatever reason, this link will tell you what can happen -

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

You mentioned his eyesight. There is a condition called SARDS that presents with Cushing's signs as the sight is being lost then once the pup is blind, those signs usually disappear. Here is a link on SARDS:

http://www.k9cushings.com/forum/showthread.php?t=213

With all the advances in modern medicine, it is hard to accept there is no other option for Riley except prednisone but I know that is fact for some human friends of mine and it is a hard pill to swallow - pun intended. :o Pred is a wonder drug and life-saver, no question, but it also has it's evil side when used long-term. :( Were they able to determine the cause of his IMA?

I want you and Riley to know that ya'll aren't alone. I can't promise we have the answers you seek but I can promise that we do have loving hearts and broad shoulders. Sometimes it just helps to know there is someone who will listen and who will understand the connection between us and our babies. We are here and we will help in any way we can.

Riley is a very lucky boy to have such a great support system and advocacy team on his side!

Hugs,
Leslie and the girls - always

Sabre's Mum
01-17-2011, 03:07 PM
Hi Vick

I have quickly read your post and Leslie's ... I am in the middle of doing a few things and will be back to give you a full reply. I have a vizsla with IMHA (immune mediated hemolytic anemia) and SRMA - diagnosed Dec 2009 and still on meds - and hence am conversant with treatments for dogs with immune mediated illnesses. I have lots of things racing around in my head of options but I will back in about an hour or two to give you a full reply.

Til then ..

Angela and Flynn (our IMHA SRMA vizsla) and our Angel - Sabre (cushings vizsla)

Sabre's Mum
01-17-2011, 04:43 PM
Hi Vick

Back now … First I will give you a little background to Flynn our 18 month old Hungarian Vizsla.

Our little Flynn has been on meds for over a year now … we started on VERY high doses of prednisone 60mg per day for his IMHA – he was about 18kg at the time. He was diagnosed with SRMA (steroid responsive meningitis arteris) in December 2009. Five weeks later he was also diagnosed with IMHA .. at this stage the pred was not able to hold his PCV and we added in azathioprine. It was touch and go for a while there as the azathioprine takes at least 10 – 21 days to kick in. We have since reduced him completely off his prednisone and he is now on 25mg azathioprine every other day. We are intending to try and take him off meds completely and hope that neither of his long term illnesses do not relapse.

Yes … with the symptoms you describe it is likely that Riley has iatrogenic cushings from long term use of prednisone.

The aggression is in my opinion definitively a prednisone thing. I have read that dogs on prednisone can get aggressive … we did experience this with our Flynn. Every noise seemed to be magnified and upset him. At night time he was barking all the time and up and down all the night, so I can fully empathize with you.

Here is a link to prednisone side effects http://www.buzzle.com/articles/prednisone-side-effects-in-dogs.html

You will see there that:

Prednisone use in dogs can cause eye related problems such as poor eyesight, glaucoma, and cataracts.

Would your vet/IMS look at changing Riley’s medication to another immunospressant? Two that come to mind that many immune mediated dogs are on are azathioprine or cyclosporine. I suggest that you discuss with your vet/IMS your concern for Riley’s condition and see if the would be willing to change his meds. By withdrawing the prednisone you should see his iaotregenic cushings symptoms reverse.

Have you had a full blood panel recently? Personally I would look at this to make sure other conditions are not rearing up – eg diabetes (I see on the link above that long term use can lead to diabetes) and hypothyroid (I know that with IMHA dogs Dr Jean Dodds DVM does believe that most dogs with immune mediated diseases have low thyroid issues). Dr Jean Dodds has been extremely helpful to me with Flynn’s treatment … when my vet had given up hope. She is such an angel … providing email advice.

The other suggestion I have is to join a yahoo group that deals with immune mediated diseases. Someone there may have suggestions for you. I will PM you the link to the group and to another forum which currently has a dog who developed iatrogenic cushings.

Take care
Angela and Flynn