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[Momof2beagles]

Hi, we have two 11 year old Beagles, Sadie and Pooh Bear.

Sadie has a pot belly and whines in the evenings for more food. She will sit at our feet and whine and whine. i hate to see her so unhappy. She pants a lot too. Our vet did a UA and senior blood panel and some of her chemistry was elevated. I'm not sure what. The vet said it could be Cushing's. They were waitining on her UA Results. they may want to test her for Cushing's. She has taken Rymadly (anti-inflammatory) daily for some time for arthritis and hip dysplasia. Any advise?

[littleone1]

Corky and I want to welcome you and Sadie.

You have found a wonderful group of very caring, supportive and knowledgeable people.

It would really help if you could get a copy of the tests results that Sadie's had so far, and post the results that are not in the normal range, along with the reference range. Also, does Sadie have any other symptoms?

There are different tests that are used to diagnose cushings, as cushings is not easy to diagnose. There are other diseases that can mimic cushings. One of the first tests Corky had was the UC:CR, that can rule out cushings if there is something else going on. It can also be used to confirm that cushings is a strong possibility, and other tests do need to be done.

We're all here for you and Sadie.

Terri

[Momof2beagles]

Thanks! The test they talked about doing would be we drop her off at the vet's office one morning. They give her a injection of Cortisol?, watch her for a certain number of hours, then take a blood test.

Symptoms:

pot belly
panting
drinking lots of water
Overly hungry
whining
inability to get settled down in the evenings.

I do know her CBC was normal and her thyroid was normal, at least on this broad senior blood test panel. I'll try to find out which levels were not normal.

[Squirt's Mom]

Hi and welcome to you and Sadie! :)

Poor Bear, too! ;)

The test Terri mentioned, the UC:CR, is an inexpensive, non-invasive test that can rule Cushing's out BUT the test cannot diagnose it. If the test comes back normal, Sadie does not have Cushing's. If it comes back abnormal, that simply means something is going on and further tests are needed. It is a good place to start with follow-up testing to the ultrasound, unless the U/S clearly shows otherwise.

The more information you can give us about Sadie the more meaningful feedback we can provide. We love details so don't worry about writing a book. :D

To start, a few questions for you - other than the arthritis, does Sadie have any health issues?

Is she on any other meds, supplements or herbs besides the Rimadyl?

How much Rimadyl is she getting a day and for how long has she been on it?

How much does Sadie weigh?

Have you noticed her peeing and drinking more than usual?

Does she pant for no reason?

Does she seek out cool places to lay?

Have you had enough questions for now? :p

When my Squirt was first diagnosed, I lost what little of my mind that was in my possession at the time. I was devastated, consumed with fear. The more I read the more confused and frustrated and scared I became. By the time I found this wonderful bunch of folks, I was a total basket case - hair standing on end, eyes bulging out, slobber flying. :eek::p These kind folk took my hand and gently led me along until I could breath again...then they began to teach me what I needed to know to help my Sweet Bebe. The more I learned, the less afraid I became. Knowledge truly is when dealing with Cushing's. We are our babies first and last defense, their only voice, their advocates, and the more we know, the stronger we are in these roles.

So read all you can here and elsewhere then ask lots of questions. We will do our best to help you understand. You will be amazed at the depth of knowledge and first-hand experience you will find here.

I want you to know that you and Sadie are not alone on this journey. We will be here with you all the way. We even have our own little looney bin. If you ever have the need, just holler and I will scoot over for you. :p

I am glad you found us and look forward to learning more about the both of you as time passes.

Hugs,
Leslie and the gang

PS. There is a lot of good information in our Helpful Resource section to get you started on your reading. ;) The Kate Connick site is written in an easy language to understand and she has a great list of the common signs of Cushing's.

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

PSS. I see we were typing at the same time and you have already answered some of my questions! :cool:

[Momof2beagles]

To start, a few questions for you - other than the arthritis, does Sadie have any health issues? Hip dysplasia, disk problem in back, newly detected heart murmer

Is she on any other meds, supplements or herbs besides the Rimadyl? Cosaquin and Tavist allergy

How much Rimadyl is she getting a day and for how long has she been on it? (1 Rimadly a day - 2 a day when she is extra stiff)

How much does Sadie weigh? 37 pounds, see is a little chunky

Have you noticed her peeing and drinking more than usual? She has been drinking more than usual

Does she pant for no reason? She seems to pant a lot in the evenings when she is whining for more food.

Does she seek out cool places to lay?
Actually, she loves to lay in the sun

Also, she has not jumped up on the couch or her ottoman for over a week. So we think her hip is bothering her. She hasn't been herself for over a week.

Normally she is very active, loves to run in circles, dig holes and act silly.

The vet said her liver and pancrease enzymes are high. CBC and thyroid fine.

[Momof2beagles]

Oh, what about diet. She has been on Hills Science Diet R/D (reducing diet). She eats Milk Bone dog bisquits and Pup corn. also she gets people food treats which we are trying to stop.

What about Hills Science Diet I/D for her????

[addy]

Hi and Welcome,

Cushings is a hard disease to diagnosis. My own experience has been to approach it in a slow methodical way. Sometimes it is hard to do that, hard on us because we are frightened and want answers right away and sometimes hard from the vets perspective because you can get false positives on tests and because other diseases can mimic it.

The UC:CR test is the fastest way to know if you need to proceed with further testing. It will not diagnosis the disease but will either rule it out or tell you to test further.

You have gotten good advice from the others and some really good links to start learning. Learn as much as you can. It will sometimes be confusing but knowledge is part of the battle we all fight.

I am glad you have found us.

Hugs,
Addy

[leigh]

Hi, and welcome!

My dog Lily recently started treatment. The folks here have been amazing. The eve before she was to begin treatment, I made my first post. I got some great information, they told me about a vet at the drug company who makes vetroyl (Dr. Allen). I left a message for the company and he called me and we (vet and me) reduced Lily's initial dosage because of it.

My vet feels like Lily might stay at 20 mg a day instead of going up to 30, I owe that to the nice folks here that Lily didn't start her meds too high.

Just my personal story about the wealth of information provided here. Good luck and sorry you are going through health issues with your dog - you've come to the right place.

Leigh & Lily

[lulusmom]

High and welcome to the forum.

I will try not to duplicate what others have already provided but repeating stuff is not always a bad thing here. Sometimes it helps things sink in. I'm a comprehension challenged person so it takes me more than few times to get it. :D

Let me start out by saying that if your vet has any suspicions whatsoever that Sadie has cushing's, s/he needs to take her off of Rimadyl asap. If she has cushing's, she is self medicating herself with the excess cortisol so she doesn't need Rimadyl at the moment anyway. Rimadyl can have some serious side effects in a healthy dog and it can spell real trouble for a dog with uncontrolled cushing's. Rimadyl is tough on the liver and can elevate liver enzymes as well as the pancreatic enzymes. Did your vet counsel you on the side effects of this drug and tell you what to look for in the way of side effects.

Rimadyl can mimic some cushing's symptoms such as excessive drinking and peeing, exercise intolerance and general lethargy. As I mentioned before, it can cause some of the same blood abnormalities such as high liver enzymes. Until you find out if Sadie has Cushing's, I would highly recommend that you ask your vet for an alternative treatment to Rimadyl, such as tramadol.

As far as diet, cushdogs should be on a good quality moderate to high protein, low fat diet. Hills ID is a prescription diet that is not meant to be the dog's normal diet. It is given until the ailment for which it was prescribed has resolved or improves. I personally think the ingredients of all Hills prescription foods are horrible but they serve a purpose. I've heard that R/D is a great food to get the weight off so once Sadie is at a healthy weight, try checking out www.dogfoodanalysis.com and read the reviews. They grade on a scale of 1 to 6 with 6 being the best. You may want to think about replacing Milkbone Dog Biscuits and Pup Corn with something healthier, less fattening and less allergenic like green beans. I buy fresh or frozen and my dogs love them, my brother's dogs love them and my mom's dog loves them.

I'm sorry for the circumstances that brought you here but I'm really glad you found us. We're here to help you in any way we can. I see that Leslie has provided a link to good information for members new to the disease. I think that's a great place to start your education.

Glynda

[Momof2beagles]

Thanks all! Sadie got a prednisone shot last Thursday for severe itching and she was chewing her tail. So the vet said we can't test for Cushing's right now. Will have to wait a while.

I will start weaning her off the Rymidyl. The vet did say it can raise the liver enzymes. Our vets have always assured us that it was a safe drug. But I can wean her off of it, or at least not give it every day like we have been doing. What about Dermax or Feldene (Piroxocam)? Would it do the same thing?

What about her whining in the evenings? She paces, whines, comes up to us and whines, and wants us to feed her more. She gets breakfast and dinner and only does that in the evenings.

[lulusmom]

Please see my comments in blue below:


Thanks all! Sadie got a prednisone shot last Thursday for severe itching and she was chewing her tail. So the vet said we can't test for Cushing's right now. Will have to wait a while.

Dogs with cushing's produce an adrenal steroid called cortisol. Prednisone is a synthetic form of this steroid so as I mentioned before, if Sadie has cushing's, she would be self medicating herself for arthritis and allergies. Pet owners often don't know their dog has either of these conditions until they are unmasked once cortisol levels have been brought down to acceptable levels with treatment.

I will start weaning her off the Rymidyl. The vet did say it can raise the liver enzymes. Our vets have always assured us that it was a safe drug. But I can wean her off of it, or at least not give it every day like we have been doing. What about Dermax or Feldene (Piroxocam)? Would it do the same thing?

Rimadyl, Deramaxx, Zubrin, Metacam and Piroxocam are all NSAID's (non-steroidal anti-inflammatory drugs) and even in an otherwise healthy dog, these drugs can cause serious side effects and the risk of side effects is increases exponentially for a dog with cushing's. There is a wealth of information available to vets and petowners regarding the risks associated with NSAID's and any vet who prescribes these drugs need to explain the possible side effects and what to watch for.
There are a lot of drugs a vet can prescribe without educating pet owners of possible side effects but NSAID's are not one of them and a vet most certainly should never assure a pet owner of their safety. Hopefully your vets assured you that "in most cases", the drug is safe.

Here are links to information regarding adverse reactions associated with NSAID's:

http://www.dogsadversereactions.com/nsaid/nsaidspage.html

http://www.vet.uga.edu/VPP/clerk/totten/index.php

Excerpt from vet.uga site regarding increased risk of side effects for animals receiving concurrent gluccocorticoid therapy. Please note that cortisol is a gluccocorticoid so dogs with cushing's are at greater risk.

Animals at an increased risk of having gastrointestinal side effects include geriatric animals, animals receiving multiple NSAIDs, as well as animals receiving concurrent glucocorticoid therapy. However, it should be noted that it is not recommended for animals to receive multiple NSAIDs or glucocorticoids in addition to NSAIDs.7
http://en.wikipedia.org/wiki/Carprofen
http://www.srdogs.com/Pages/rimadylfr.html

Excerpt from vet.ug site regarding a vet's responsibility to provide instructions to pet owners:


Supportive care is used to treat NSAID toxicity. Due to the serious complications of NSAIDs toxicity, it is prudent to attempt to prevent toxicity rather than treat it. Veterinarians should educate clients about early signs of toxicity and instruct them to discontinue the medication if these appear. This strategy will likely help to prevent the development of the more severe complications of NSAIDs toxicity. Consideration of other less toxic therapies of pain control - weight loss, opioids, chondroprotective agents, and physical therapy - may allow a reduction in the dose and/or frequency of NSAID administration, which will inherently reduce the likelihood of toxicity.4 However, idiosyncratic reactions to NSAIDs may still occur even at reduced doses. Careful patient selection followed by close monitoring and sound clinical judgment will aid the clinician in the prevention of these toxicities.


What about her whining in the evenings? She paces, whines, comes up to us and whines, and wants us to feed her more. She gets breakfast and dinner and only does that in the evenings.

Dogs with cushing's do tend to get more restless and even hungrier in the evenings. This is because, unlike normal dogs, dogs with pituitary based cushing's have higher levels of acth in their blood during the evening hours. Higher levels of acth means the adrenal glands are pumping out even more cortisol so if Sadie does have cushing's, this could explain the increased hunger and behavioral changes in the evenings.

Excerpt from study entitled "Diurnal ACTH and plasma cortisol variations in healthy dogs and in those with pituitary-dependent Cushing’s syndrome before and after treatment with retinoic acid"

Daytime variations in ACTH and plasma cortisol were studied in healthy dogs and in dogs with pituitary- dependent hypercortisolism (PDH), before and after treatment with retinoic acid. In control dogs ACTH showed a higher concentration at 8.00 AM and between 2.00 and 6.00 PM, with the lowest concentration registered at 10.00 AM (p < 0.05 vs. 8.00 AM and 2.00 PM and p < 0.01 vs. 4.00 PM). Cortisol did not show significant differences. In dogs with PDH, ACTH was lower at 8.00 AM (ACTH: p < 0.01 vs. 2.00 and 4.00 PM; and p < 0.05 vs. 6.00 PM). The lowest cortisol concentration was registered at 8.00 AM and 8.00 PM and the highest at 4.00 PM (p < 0.05 vs. 8.00 AM and p < 0.01 vs. 8.00 PM). After treatment, the lowest ACTH concentration was registered at 10.00 AM (p < 0.01 vs. 2.00 and 4.00 PM). To conclude, the adrenal is desensitized in PDH possibly showing negative in diagnostic tests.





P.S. Extreme hunger and behavioral changes are also symptoms of hypothyroidism. Can you please get a copy of the Sadie's last bloodwork and post the abnormalities for us, including normal reference ranges? If she has low thyroid, the T4 will be low; however, dogs with cushing's often have low T4 levels but this is usually a transient issue (sick euthyroid syndrome) which corrects itself once the dog is stabilized on treatment.

[Momof2beagles]

What is a good dog food for the Cushing's Doggies?

Moderator's Note: I have merged your new thread into Sadie's original thread. We normally like to keep all posts on a pup in a single thread as it makes it easier for other members to refer back to the pup's history, if needed.

[jrepac]

Thanks all! Sadie got a prednisone shot last Thursday for severe itching and she was chewing her tail. So the vet said we can't test for Cushing's right now. Will have to wait a while.

I will start weaning her off the Rymidyl. The vet did say it can raise the liver enzymes. Our vets have always assured us that it was a safe drug. But I can wean her off of it, or at least not give it every day like we have been doing. What about Dermax or Feldene (Piroxocam)? Would it do the same thing?

What about her whining in the evenings? She paces, whines, comes up to us and whines, and wants us to feed her more. She gets breakfast and dinner and only does that in the evenings.

Generally speaking, aside from extremely adverse effects among Labs, Rimadyl is safe and effective. However, if a dog has Cushings, Rimadyl will worsen liver conditions; the liver will already be stressed from the Cushings and Rimadyl will exacerbate the situation. I was in a similar situation a few years ago; luckily I stopped the Rimadyl before conditions worsened.

I'd concur w/Glynda, get your baby off the Rimadyl (and all NSAIDS, if you can). Only then can you properly test for the presence of Cushings.

Jeff & Angel Mandy

[Squirt's Mom]

Hi,

Generally speaking, cush pups need diets with lower fat than usual as they are prone to pancreas issues.

Do you know what her allergies are? I'm asking because, other than the canned variety, SD r/d is mostly corn and soybean - two ingredients many dogs are allergic to. Might be worth talking to you vet about something other than SD, or start using the canned, to help her lose weight. Getting her off the corn products for a bit might help with the itching if they are playing a role in her allergies (the canned still has soy products). I would stop the treats altogether for awhile unless they are things like green beans, carrots, apples, oranges - fresh food, not canned or seasoned.

How is Sadie doing since her pred shot?

Hugs,
Leslie and the gang