perplexed. - Annjee - (10 y/o toy poodle)

[annjee & me]

Hi all. I wrote a really long post telling you about Annjee & me. When I pushed the submit button I was informed that I was not logged in. Can anyone help me?

[Roxee's Dad]

Hi and first let me welcome you and Anjee to K9cushings.

Look in the upper right area of the page and check the box that says Keep me logged in... then it won't time out and log you out.;)

[annjee & me]

Sorry I do not see anything that says "keep me logged in"

[Roxee's Dad]

Sorry... Check the box that says Remember me....

http://www.k9cushings.com/forum/showthread.php?t=1329

[Spiceysmum]

Hi,
This has happened to me many times as I always forget to tick the Remember Me box but if you just log in again the post usually appears! Welcome to the site.

Linda

[annjee & me]

Hi all,
I am very new to this forum. Annjee is my 10 year old toy poodle. She is beige and weighs 15pounds. Her symptoms are: pot belly, panting, bilateral bald patches on her rear., . She is not thirsty and eats normal. Her alkaline phos. came back elevated. The vet office I go to has 2 female vets. They have been covering for one another while on vacation - so I have been getting some contradictory info. For instance, Dr V said that the low dex test will tell me if Annjee has Cushings and also whether it is Pituitary or Adrenal in nature. I also read on the internet that to low dex test is capable of doing this. However, Dr L tells me that I need an ultrasound after the low dex test in order to determine the type of Cushings it is. I read t;hat an ultrasound is very difficult to read in a toy! Annjee just had her dental visit yesterday and is a bit wiped out today. I am going to let her rest and calm down from her ordeal fo a week or two. In the meantime, I need to decide whether or not to go on with treatment. She is very happy and doesn't appear sick. I really hesitate to start giving her any dex and lyso. since she is not sick l Oh and I have 2 of annjees pups from her only litter. They are 7 years old.
I read that the way to regulate lyso is to watch and see when she stops being so thirsty. How do I do that if she isn't thirsty to begin with. Oh and they all drink out of the same bowl ! I know that they normally drink 1 oz per pound each day, so I will have to keep her isolated in order to get a baseline intake.
Well, thanks for listening I hope I hear from you guys.
cathy

[I]Hi Cathy, I merged this post with your original thread. Even tho you didn't get to post your original post, we like to keep all info about each dog in their own thread. That makes it easier to refer back when questions arise.

[addy]

Hi and Welcome,

I am glad you found your way to our forum. We will help however we can.

Cushings is a difficult disease to diagnose and since the various tests used to make the diagnosis can have false positives and false negatives, more than one test is needed along with a history, blood work and physical exam. My pup had UC:Cr test which indicated we needed to further explore Cushings. She then had an ultra sound and full adrenal panel done with the University of Tenn. I did not do the low dose dex test as it felt it would be too stressful for her at the time.

Hair loss, panting, hind leg weakness, excessive appetite, increased drinking and urinating are some of the symptoms. A dog does not need to have all of the symptoms. My Zoe started with just hair/coat issues.

The most important thing you can do for your pup is learn everything you can about this disease so you are a good advocate for her.
Our Resource section is a good place to start.:):)

Hugs,
Addy

[lulusmom]

Hi and a belated welcome to you and Annjee.

I am sorry for the circumstances that brought you here but I'm glad you found us. We initiate our new members by asking them a ton of questions so get ready for your initiation. :D

Most, if not all, of us keep copies of our dog's medical tests, vaccine records, etc. in a folder. This folder comes in handy if you ever have to take Annjee to an after hours clinic. On call vets really appreciate having their patient's medical history at their finger tips. The folder will also come in handy for when we ask you to post test results. If you do not have copies, your vet should be happy to provide you with them. When you get them, please post the results here. We only need to see the high or low values on the bloodwork and please include the normal reference ranges.

The results of the low dose dex suppression (LDDS) test sometimes does tell you if the dog has pituitary dependent cushing's but a good number of times, it doesn't. Regardless, it's a good idea to have an abdominal ultrasound to check the status of the adrenals and the surrounding internal organs. I've never heard that ultrasounds are difficult to do on a toy breed. My Lulu had an abdominal ultrasound before we started treatment and she weighs a hair over 4 lbs and the radiologist was able to see everything just fine. My other cushdog, Jojo, weighs 6.5 and if not for his huge bladder getting in the way of everything, his ultrasound would have been okay too. The vet said he had never seen a bladder as big as Jojo's and I can understand. That was almost four years ago and he is still drinking and peeing buckets.

The goal of treatment is to eliminate the troublesome symptoms like a voracious appetite and the excessive drinking and peeing. If Annjee has no troubling symptoms you may want to rethink treatment as well as the diagnosis. Symptoms are a huge component of a diagnosis and an experienced vet would not prescribe treatment to a dog that does not have overt symptoms. The appetite and the water in take are the only two symptoms that you can use as a gauge to determine when Annjee is loaded on Lysodren so in my opinion, it's too risky to start treatment with Lysodren. I would wait until symptoms became a lot more apparent.

I'm not sure if checking Annjee's water intake is necessary if she does not have pu/pd (excess peeing/excess drinking) Did your vet do a urinalysis? Most dogs with cushing's have low specific gravity and dilute urine because the kidneys have lost their ability to concentrate. If she had a urinalysis done, please post the results here.

I love toy poodles and have shared my life with a few of them. My first dog ever was a little apricot toy who lived to the ripe old age of 18 1/2. The average weight for a toy is 4 to 8 lbs. My mom's toy poodle was 16 lbs and she was morbidly obese. She panted most of the time and her belly was big but so was everything else. :D Is it possible that Annjee's panting and pot belly could be from her being overweight?

As far as the symmetrical hair loss, poodles are a breed that are predisposed to alopecia x. I have a bald pomeranian which I believe is not due to her cushing's but her genetic predisposition to alopecia x. There have been a few studies that show that these dogs usually have elevated intermediate hormones but these hormones don't always cause problems, meaning that aside from hair loss, the dog is totally asymptomatic.

I know I'm covering a lot of ground so sorry if I am making your head hurt. :D It seems like you are still in the initial stages of testing and I want to stress that even if further tests are positive/consistent with cushing's, unless Annjee has more symptoms, you may want to hold off on treatment. Cushing's is a very graded disease, meaning it progresses at a snail's pace so there is no need to rush to treat until you need to.

Glynda

[annjee & me]

Hi Glynda,
thank you for your reply. Annjee's liver function test showed an elevated Alkaline Phos. I am watching her very carefully. She is a bit listless but otherwise she seems fine. Thank you for your suggestion to take my time to test and treat.
I initially was going to rush into things but I had a little voice telling me to slow down. Do you know whether or not the Lysodren arrests the growth of tumors or does it just reduce the production of cortisol by the adrenals?
thanks
cathy

[lulusmom]

Lysodren targets the adrenal cortex and erodes (kills) cells and when enough cells have been killed off, the cortisol is reduced to a more normal level for a cushdog. Because of this mechanism of action, it is thought the if a dog has an adrenal tumor, lysodren will effectively shrink the tumor as well. Only a small percentage of dogs 15% to 20% will have an adrenal so the law of averages says that Annjee has pituitary dependent disease. Most dogs with pituitary dependent cushing's have an itty bitty lesion on their pituitary which is responsible for everything going haywire. Another small number of dogs will have a much bigger tumor called a macroadenoma and it is known that treating with lysodren can facilitate the growth of a macroadenoma.

I know this is all scarey sounding stuff but to put things into prospective, my two tiny guys, like a lot of other dogs, have been on quite large doses of lysodren for years with no ill effects. If the point in time comes that you need to start treating, just make sure you have educated yourself on whatever treatment you and your vet choose.. The rule of thumb is that if a treatment is prescribed by an experienced vet and administered by an educated pet owner, the chances of side effects are greatly minimized and in a lot of cases, eliminated completely. The more you learn, the calmer and more confident you will become. The side benefit of that is that you will have become an excellent advocate for Annjee and that should be all of our goals....I mean for our own dogs, not Annjee. :D

[annjee & me]

I feel really blessed that Annjee is doing so well. I take her for a half mile walk every day and I think she really looks forward to it too! In addition, her back legs are getting stronger and she is able to climb the stairs better. She is really a sweet little girl and I pray that she remains symptom free. I am worried about her having a seizure. She has nerver had one but I have been reading the posts and they sound awful. Is it the pituitary tumor that can cause a seizure?
cathy

[lulusmom]

Hi Cathy,

An enlarging pituitary tumor (macroadenoma) can cause seizures but I doubt that this is what caused Annjee's seizure. My little Lulu has had five seizures in the last four or five years and her specialist doesn't know why. Most of the time, there is no one thing you can put your finger on so you can only hope that this was an isolated seizure that will never happen again. FYI, vets won't prescribe seizure meds unless the dog is seizing frequently.

Glynda

[annjee & me]

annjee has never had a seizure. She has been in really good spirits lately and her panting has even decreased and almost dissappeared. Her only symptom right now is thinning hair on her behind and an elevated alkaline phos. I pray over her alot. I am continuing to hold off on low dex test and treatment. Will keep you posted.
cathy

[jmac]

What was her Alk Phosphate level (and what is the normal range)? Maybe I missed it in an earlier post, but I didn't see it. Also, if you want to get more info. about if your dog has Cushing's, you may want to have the LDDS test done (or another one). My dog, Hannah, ended up getting the LDDS test after her ALKP level was really high on the day she was supposed to get her dental. Instead of doing the dental, he did the LDDS test, which did come out positive for Cushing's. I still didn't rush things because her symptoms were not terrible-just a slight increase in thirst and urinating and a large appetite, but no panting, pot belly, skin issues, hair loss, etc. I then had them do a UA on her and check the specific gravity of her urine (because dogs with Cushing's usually can't concentrate their urine) and it was just a tiny bit lower (less concentrated) than normal. I waited about a month because my vet said we did not need to rush treatment (as did the helpful people on here) and I did pursue the abdominal ultrasound, but that was mostly for my peace of mind. It didn't show anything abnormal, which correlated with my vet's hypothesis that she is probably in the early stages. My vet also said he did not want to treat with anything serious (Trilostane or Lysodren) if she did not have significant symptoms, and I didn't want to either. Instead, I decided to try Anipryl, which he offered as a place to start IF I wanted to, and it has actually worked pretty well for her. We started in March and she seems to have a slightly more normal appetite-she used to paw at us and bark at us every night around 8:00 (I think for more food) and that has stopped entirely. He rechecked her liver levels in April and her ALKP dropped from 1770 to 600 something. We will retest again in August. There are really no side effects with Anipryl, but it is only successful about 25% of dogs, but I'm glad it is working for Hannah.

Anyway, you do have time to decide what to do, and definitely don't rush into anything; but it certainly wouldn't hurt to pursue further testing if you can afford it.

Julie & Hannah

[lulusmom]

annjee has never had a seizure.

Errrrrr, aaaaaaah, duh! I'm thrilled that Annjee has never had a seizure and I hope it stays that way. I wish I could remember who it was I thought I was responding to. It sucks to have Halfheimers.