Bailey--10 year old Boston Terrier--Precushings

[Arianne02]

Hello,

This site was recommended over at Woofboard for Boston Terriers.

Last month my ten year old Boston Terrier female---Bailey was given a diagnosis of Pre-Cushings. The vet said all tests indicate that it is the pituitary version of the disease.

Mothers know when something is "off" with their kids, and Bailey is my shadow----so I "knew" something was wrong. I tend to be rather pro-active when it comes to Bailey----especially her.

We lost her half brother over three years ago to a heart tumor. He was running around like a nut in the afternoon---NO sign of being sick. Bobbie was a velcro dog, and I thought it strange that he did not take a nap with me. Went looking for him, and he was blue and gasping for breath in the living room. He had a tumor that had ruptured and filled the pericardium with fluid. The cardiologist did drain the fluid, but there was not much they could do for him. It was the hardest thing I've ever had to to do----losing my grandmother was easier, but seven months later we helped my baby move on.

Anyway----back to Bailey. They did some initial blood work and urine sample. This showed an elevated liver level/ emsine. They we did the low dose DEX test (believe that is what it was called). I was told that all of her levels were Pre-Cushings, and since she was only showing mild symptoms that not treating right now would be the best thing.

Bailey drinks just a little more, and asks to go out a bit more too----not that much--just a bit.

She has always been built like a little roast, but it seems that her belly has dropped a bit, and the end of her nose looks chapped. I did order some doggie nose cream for that.

As far as hair----she has always had a thin coat, and naked pink belly and rear end.

Bailey goes in for her shots on Saturday, and I just wanted to know if there was anything that I should be asking the vet.

There are a number of dogs that they are treating that have Cushings, and even one Boston. The other vet has a Boston---so they know the bread.

I just wonder about "not treating" her at this point. I was reading about all the damage Cushings does if not treated.

My heart breaks at the thought of loosing my child, and I want to do what it best for her.

Please anything at all will be very much appreciated.

[frijole]

Welcome. You sound like a wonderful advocate for your Bailey and so regardless Bailey will be fine. It would be helpful if you could get the readings from the blood tests and post them so that we can see what led your vet to say it was early stages of cushings.

All of the leading experts in the field stress NOT to treat if there are no symptoms. You have some signs that could be early warning signs but when we say dogs drink alot of water .... we are talking buckets not just a bit more than normal. ;):D

Also please know that the ldds test can have false positives - one of my dog had a couple of them. So at this point I would keep my eyes open in the event it is cushing's but it could be something else that caused the elevated cortisol and therefore the test results. This is why posting them might be helpful.

So please don't worry at all at this point. Cushing's is not a death sentence and it progresses very slowly. So Bailey will be just fine.
Kim

[jrepac]

Did Bailey get a UCCR test done? That's always a must.
But, I would say the same, don't rush to treat if there are no obvious symptoms. When I went thru this the last time, our first round of testing was negative, but then the symptoms cropped up more prominently. So, treatment really became beneficial and we confirmed the Cushings diagnosis shortly thereafter (a little backwards, I know, but my initial treatment was w/Anipryl, which was pretty mild and helped the symptoms greatly). Just keep an eye on Bailey and take things day to day.


Jeff & Angel Mandy

[Arianne02]

Thank you so very much for your responses:)

Bailey goes to the vet on Saturday for her shots---so I'll get the numbers for her tests then. She has had two blood tests, and a urine test-----I know the one blood test was the low dose DEX, but can't remember the name of the other one. Will get all that on Saturday.

Another thing----she had three lumps removed--they were benign--thank god! Anyway--the hair from the one never grew back---just a couple of little patches. The hair on the other two spots is very thin.

She has developed another lump on her side, and the vet did draw fluid from it. She said it was just a fatty cyst, and to leave it be unless it gets bigger. The three incision sites from before took some time to heal-----one even kept pulling open and had to be stapled. So the vet does not want to remove the other unless it is absolutely necessary.

Bailey only drinks a bit more water then she use to------nothing like what is described. She has turned into a K9 hoover though.

Will update after I get back from the vet this weekend.

Oh--the vet also said it could be sometime before she develops full blown Cushings.

[kapohotricia]

Welcome, Arianne and Bailey,

I, too, have a Boston Terrier, 20 lb Kirby, almost 11 years old, who is in his second month of Pituitary Cushings treatment. About one month into treatment the bottom area beneath his nose got raw and red. I have been gently applying Vit E oil and it has now completely healed up. His coat has thin patches too and one bare patch and I am applying Vit E oil to that but no changes yet. The tip of his little tail is bare.
Anyway, I do understand what you are going through. We only want to do the best we can for our babies but it's so hard to know what's the best!
Though I am new to this I agree with the advice above.We didn't start treating Kirby until his back legs were shaking and he didn't want to walk or play. We didn't mind cleaning up the occasional pee, though it was most days of the week before we started treatment, but we did care about his quality of life. When it was time to start Trilostane (after a full blood panel and LDDS test to confirm Pituitary Cushings) the vet wanted to start him on 60mg. I was warned by a Boston breeder who has treated 2 of hers that our Bostons are very sensitive to these meds so we started him on 10mg. After 3 days his drinking and urinating habits were normal but cortisol levels remained high for another month. After 6 weeks his cortisol levels were down. He had 3 days off and is now on only 5mg. I just wanted to let you know that "low and slow" is the safest way to go when you do start treatment. I'm thinking that a few days off occasionally is a good thing. These are serious meds.
Well, I just wanted to share our experience to help anyway I can and to let you know you are in our thoughts. Boston lickies to precious Bailey from Kirby and hugs from me,

Tricia

[Squirt's Mom]

I'm thinking that a few days off occasionally is a good thing. These are serious meds.

Just to make sure everyone understands there are differences in how Trilostane and Lysodren work. A few days off, when required, isn't a big deal with Trilo as it has a very short life in the body anyway plus there is no induction, or loading, phase to get the adrenals where they stop releasing cortisol. With Lyso, a few days off can mean starting all over again if the adrenals regenerate quickly - ie, you could end up having to do another load.

Trilo simply disrupts the signals along the pathway between the pituitary and adrenals. This can be stopped and started again quite easily. However, with Lyso the objective is to erode a very tiny layer of the outer cortex of the adrenal so they cannot pick up the signals that are still be sent along that pathway. Once that layer regenerates, which can happen rapidly in some pups when the Lyso is stopped, then the process has to be started all over in most cases.

So what may be easy to do with one drug, may be quite a different story with the other. I just wanted to be sure ya'll understood they cannot be compared apples to apples. ;)

Hugs,
Leslie and the gang

[kapohotricia]

Thank you, Leslie, for pointing out the difference between Lysodren and Trilostane. I was referring to my Kirby's treatment which is for Trilostane only and should have pointed that out so as not to confuse her.
By the way, my vet won't use Lysodren. The files on this drug indicate that the effects on the adrenals can be irreversible. She used it once with sad results before Trilostane became available in the USA. I know that every case is different and there are plenty of members successfully using Lysodren with their dogs. I, personally, agree with my vet that Trilostane is the safest treatment option for my Kirby and I know that both drugs carry risks. I watch Kirby like a hawk for adverse effects. I just wanted to share my limited experience so far in hopes it could be helpful for Bailey's owner to know how one other Boston Terrier with a similar diagnosis, further advanced, is responding so far to treatment.

[lulusmom]

Hi and welcome to the forum.

Please see my comments in blue below:


Hello,

This site was recommended over at Woofboard for Boston Terriers.

Last month my ten year old Boston Terrier female---Bailey was given a diagnosis of Pre-Cushings. The vet said all tests indicate that it is the pituitary version of the disease.

I am not sure what a diagnosis of pre-cushing's means but assume that's your vet's term for a dog whose test results are conclusive for cushing's but symptoms are overt enough to justify a confirmed diagnosis....right? It really will be helpful if you round up all the tests that were done and post the results for us.

Mothers know when something is "off" with their kids, and Bailey is my shadow----so I "knew" something was wrong. I tend to be rather pro-active when it comes to Bailey----especially her.

We lost her half brother over three years ago to a heart tumor. He was running around like a nut in the afternoon---NO sign of being sick. Bobbie was a velcro dog, and I thought it strange that he did not take a nap with me. Went looking for him, and he was blue and gasping for breath in the living room. He had a tumor that had ruptured and filled the pericardium with fluid. The cardiologist did drain the fluid, but there was not much they could do for him. It was the hardest thing I've ever had to to do----losing my grandmother was easier, but seven months later we helped my baby move on.

How heartbreaking for you. I am so very sorry for your loss.

Anyway----back to Bailey. They did some initial blood work and urine sample. This showed an elevated liver level/ emsine. They we did the low dose DEX test (believe that is what it was called). I was told that all of her levels were Pre-Cushings, and since she was only showing mild symptoms that not treating right now would be the best thing.

Again, I have no idea what pre-cushing's levels are but it might make more sense after you post the test results. There is no such thing as pre-cushing's results for the low dose dex test. It is either consistent with cushing's or it's not. Perhaps her liver enzymes were only mildly elevated so your vet feels it is early in the disease??

Bailey drinks just a little more, and asks to go out a bit more too----not that much--just a bit.

Most cushingoid dogs have dilute urine and urine specific gravity is low. Did your vet do a urinalysis to check the urine specific gravity and for bacteria? A good 40% of dogs with cushing's will have a urinary tract infection at the time of diagnosis. This is because cushing's is an immunosuppressive disease and the urine is usually diluted out. For this reason a culture should be done.

She has always been built like a little roast, but it seems that her belly has dropped a bit, and the end of her nose looks chapped. I did order some doggie nose cream for that.

It's very strange because I thought my dog was the only cushdog with a crusty and cracking nose. It was consoling to find out that his is not the only one. Once his cortisol was under control, however, his nose was back to normal.

As far as hair----she has always had a thin coat, and naked pink belly and rear end.

Bailey goes in for her shots on Saturday, and I just wanted to know if there was anything that I should be asking the vet.

I assume that by shots, you mean vaccines. If Bailey has cushing's, whether early or not, and if cortisol is elevated, in my opinion, it is a really bad idea to vaccinate her. Vials of vaccines specifically state that they are to be given to healthy dogs only and a dog with uncontrolled cushing's cannot be deemed to be healthy. Your vet probably knows this and should be willing to do a titer test in lieu of a vaccine. My dogs treat with an internal medicine specialist and he has said no more vaccines "period" and I agree. However, other members report that they and their vets feel comfortable with vaccinating as long as the cortisol is being controlled.

Everyone should be aware that there are some unscrupulous vets who continue to place dogs at undue risk by recommending and sometimes demanding that annual vaccines be given. I parted ways with my old gp vet for their rigin position on this. These vets are ignoring current vaccine guidelines which state that after initial one year booster, most vaccines, and most certainly rabies, are only required every three years. /COLOR]

There are a number of dogs that they are treating that have Cushings, and even one Boston. The other vet has a Boston---so they know the bread.

I just wonder about "not treating" her at this point. I was reading about all the damage Cushings does if not treated.

[COLOR="blue"]Cushing's is a very graded disease and it progresses at a snail's pace. The goal of treatment is not to cure the disease but rather to control the symptoms that become troublesome more so for the pet owner than the dog. If Bailey doesn't really have overt symptoms and no complicating factors, then you've got plenty of time to decide. More importantly, you have plenty of time to make sure the diagnosis is correct. Because cushing's is the single most difficult canine disease to diagnose, it is also the most misdiagnosed canine disease.

My heart breaks at the thought of loosing my child, and I want to do what it best for her.

I have two cushdog's, one of which was diagnosed at three years old. She is now nine years old and going strong. With effective treatment, there is no reason why a dog cannot live out their normal life expectancy, with a very good quality of life. We have many members who will attest to that fact. You may have seen sites that list the life expectancy of a cushdog to be two years. Two years is probably an average based on the fact that most dogs with cushing's are fairly senior when diagnosed. A good number of them are already nearing their life expectancy so with or without treatment, two years is a safe estimate.

Please anything at all will be very much appreciated.

We're here to help in any way we can and the more information and test results you can provide, the better able we will be to provide you with more meaningful feedback.

[kapohotricia]

I want to echo Lulusmom regarding vaccines. My vet stopped vaccinating Kirby when he got cancer and will no longer give him shots. They should only be given to healthy dogs with strong immune systems after they have have their full schedule of puppy shots. Some vet schools are apparently now changing their recommendations for all dogs too. There is no rabies in Hawaii so I don't know about that one.
So, lulusmom, your dog's nose was affected too? Perhaps it was the lower cortisol levels, rather than the Vit E that healed Kirby's then? And thanks for the encouragement to us new Cushings moms.

Aloha and hugs to everyone,

tricia

[Arianne02]

Okay--got the DEX test results:

Cortisol Pre: 3.3
Cortisol 2: 1.4
Cortisol 3: 1.6


"Again, I have no idea what pre-cushing's levels are but it might make more sense after you post the test results. There is no such thing as pre-cushing's results for the low dose dex test. It is either consistent with cushing's or it's not. Perhaps her liver enzymes were only mildly elevated so your vet feels it is early in the disease?? "

Bailey's liver enzymes are slightly elevated------and yes, my vet feels that she is very early in the disease.


"I am not sure what a diagnosis of pre-cushing's means but assume that's your vet's term for a dog whose test results are conclusive for cushing's but symptoms are overt enough to justify a confirmed diagnosis....right? It really will be helpful if you round up all the tests that were done and post the results for us."

Yes---you hit the nail on the head:)

I started using this product on Bug's nose, and it looks so much better: http://www.snoutsoother.com/

It was weird----her nose shed little almost scale like parts, but now it's all nice new skin.