Cassidy has Cushings (Pembroke Welsh Corgi - 16 y/o - Cassidy has passed.

[liz]

My wonderful Pembroke Welsh Corgi Cassidy has Cushings. She was tested and diagnosed on 6-29-11. She was tested for thyroid at the same time and both the Cushings test and the thyroid test were indicating problems. Her vet decided to start treatment for the Cushings first and then to re-evaluate her in four weeks to see if the thyroid was still a problem. She has been prescribed the drug Trilostane 60 mg once daily. Cassidy also has been treated for a heart problem and takes Vetmedin, furosemide and enalapril. Leading up to the testing for Cushings, Cassidy had experienced two very serious dental infections and had undergone several dental extractions. At the time of her dental extractions the CBC test showed liver enzyme elevation in May of this year. At that time the vet thought it would be a good idea to give her a supplement to help her liver called Denosyl. About a month after starting Denosyl I noticed that Cassidy has developed a rash--oozy and scabby--I took her to see the vet thinking that it might be a problem with the Denosyl. We decided to take her off the Denosyl and wait two weeks to see if the skin improved and then to test for Cushings and thyroid problems. Right before the testing Cassidy was drinking quite a bit of water and needing to go pee--quite large amounts--very clear urine. Her appetite was ravenous and panting quite a bit; she also has had a cough. Now five days on Trilostane and the panting has been diminished, she has had another episode of the skin rash, she has only had one episode of the cough, she's sleeping a lot (but all of my dogs are sleeping a lot in this hot weather).
Cassidy will be 16 years old on July 25, she is a spayed female, weighs 22.8 lbs. and is a wonderful dog. I will appreciate your comments and help. Since the onset of her heart problem I have made home cooked food for her--lean skinless chicken, sweet potato or pumpkin, yogurt, brown rice, Missing Link and salmon oil. I would appreciate any suggestions you folks may have regarding diet.

[StarDeb55]

Welcome to you & Cassidy, Liz! You have given us a good start by describing the symptoms you have seen with Cassidy. What will help us even more is if you will gather up all of the test that have been done to diagnose the Cushing's & post the actual numbers. On the general labwork such as a senior wellness panel or super chemistry panel, please just post the abnormals, along with the reporting units, & normal ranges. This just helps us to give you more informed feedback.

I have never used trilo, but I can tell you this that a starting dose of 60 mg. sounds like a huge dose for a pup who is just over 20 lbs. Dechra, who make vetoryl, is recommending a starting dose of 1 mg. per lb. body weight. Their published information may not reflect that, but a number of our members have called their vet technical reps, & this is what they are verbally recommending. It is very important that an ACTH be scheduled for 10-14 days after starting Trilostane to monitor how Cassidy is doing. You also want to make sure that her electrolytes are checked at that time, too. With what appears to be a pretty big dose, please watch her very carefully for any signs that her cortisol may be dropping to low. This would include severe lethargy, nausea, vomiting, diarrhea. Members whose pup's cortisol have dropped very low have reported that their pups are so ill, it's almost like their "dying". I know you will watch her carefully. Other members who have more experience with Trilo will be along to offer their input.

We are to help in any way we can.

Debbie

[coopersmom]

Liz,

You'll get a lot of good information here. My Randy has been on Trilostane for nearly four weeks. He takes 100mg, which he has been tolerating o.k. but still worries me that it might be too much. His first stim test was in range, goes again Monday. Since we're still rookies in this game I can't give you much advice. Just watch her closely and try to relax as much as you can. You'll imagine all the bad things that could happen, this forum will reassure you if you need it or alert you if you need it.

[liz]

Thank you so much. I will go to the office to get those numbers. This group is such a help at such a tense time. Here is another question: how often do you bathe your dog when they have the crusty rash? I don't want to dry out her coat too much. Any other dietary recommendations would be much appreciated.--Liz and Cassidy

[addy]

Hi and Welcome,

60mgs does sound like a huge starting dose for a 20 pound dog. Make sure to watch closely. My Zoe is 19 pounds, has colitis and is drug sensitive. Our IMS started Zoe at 10mgs.

We have so many wonderful links and information in our resource section. If you have not yet looked through it, please do. The more you know the better advocate you can be for your pup.

Hugs,
Addy

[Harley PoMMom]

Hi and welcome to you and Cassidy,

I am so glad you found us but very sorry for the circumstances that prevail that you need to be here. We will help you in any way we can.

I, too, agree that the starting dose of 60mg is high but what else really concerns me is that two of the medications Cassidy is on are contraindicated in dogs being treated with Vetoryl/Trilostane.

The furosemide and enalapril are the medications that I am very concerned with. According to the U.S. Product Insert published by Dechra (manufacturers of brand-name Vetoryl), Angiotensin-converting enzyme (ACE) inhibitors should be used with caution with VETORYL and Potassium sparing diuretics (e.g. spironolactone) should not be used with VETORYL Capsules, as both
drugs have the potential to inhibit aldosterone, increasing the likelihood of hyperkalemia. You can read this information here: Dechra's U.S. Product Insert. (http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf)

Has your vet mentioned any of this to you?

Most times a regular GP does not have the experience required to treat a dog with many health issues going on, this is where an IMS's knowledge and skill can be very useful as an IMS has handled many pets with concurrent illnesses.

Please know you are not alone on this journey and we will help you help Cassidy.

Love and hugs,
Lori

[lulusmom]

Hi and welcome to the forum.

Debbie has already provided you with great information so I won't echo her and will comment on the skin issues. I have a little Chi who we've been treating with a battery of antibiotics for three months trying to get a bacterial skin condition under control. The crusty sores started around her neck and moved down under her arms and ended up just about everywhere. If your vet did not do a skin scrape or biopsy, you should consider having that done so you know what you are dealing with. If it is bacterial, bathing alone will not resolve the problem. In addition to two antibiotics, I bathe my little one two to three times a week with Melasab shampoo.

It is not uncommon for cushdogs to develop demodex mange, as their immune system is compromised by the disease. If mites are present, a skin scrape on a slide under a microscope will confirm. Like a bacterial infection, bathing alone will not resolve the problem.

I'm sorry for the reasons that brought you here but I'm really glad that you found us. We're here to help so ask any questions you may have and we'll do our best.

Glynda

[Cyn719]

Hi I really agree with the information you are getting from the other posts of these wonderful people - my dog is on vetroyl and she is 84 lbs now and the vet had her on 160 mg of this drug - way to much medication which I did not know at the time -- this put my dog into Addision Crisis which is caused by to much medication - I came on this forum last week needing help and these amazing people came to my call of help and steered me in the right direction on how to handle my situation - if it wasnt for them I dont know how penny would be at this moment - please whatever you do make sure you stay on top of her ACTH test making sure the levels dont drop to low - also make sure your vet is knowledgeable of Cushings Disease - it makes a huge difference if they are just treating the disease or know how to treat it and are specialized in the disease - it does make a huge difference as I found out the hard way - my vet did not know how to handel this situation and thank God I had this forum to guide me through - Good Luck to you Cassidy - you are never alone - you have a whole family on this forum - xo Cindy and Penny

[LacubriousDogs]

My dog started Trilostane in April this year. She weighs 40#+- and takes 35mg twice daily. I agree that your dog's dose sounds high. If you can, try to see a vet that specializes in internal medicine. They are typically better able to help manage all the issues that go on with our Cush pups. Plus they are up on the latest studies.

[mytil]

Welcome from me too,

The others have given some good advise with direct experience with Trilostane. The heart meds stuck out for me too, as Lori mentioned. Please check on this again with your vet and you can even contact the Dechra people.

I am certainly not a vet, but another thing that stuck out was that your vet wanting to treat cushing's prior to addressing anything going on with the thyroid. Thyroid conditions can have the same symptoms as cushing's.

So to get a better idea, please post those test results numbers for cushing's and including blood panel.

Terry

[Squirt's Mom]

Hi Liz and welcome to you and Cassidy! :)

Everyone else has covered things very nicely so I will address the diet. From what you have listed that she is eating, it sounds very good. Of course, I don't know the portions nor therefore the balance of nutrients but the ingredients are very good. Are you working with a canine nutritionist or nutritional consultant on her diet?

There are several sites where you can plug in ingredients for a recipe and get the nutrients provided. The one I use most is NutritionData - http://nutritiondata.self.com/. As for the nutrients Cassidy needs, you would want to work with a professional who can take her history and determine the requirements for her. I can take her weight, age, and activity level and tell you based on that what she would need if she were healthy. The data base I use does not have parameters for health issues as that needs to be tackled on an individual basis.

There is a good group that could help you by Monica Segal, who is a nutritional consultant. Here is a link to her site -

Monica Segal
http://www.monicasegal.com/

And to her forum -

Monica’s discussion group
http://pets.groups.yahoo.com/group/K9Kitchen/

The consultant I have used for over three years has stopped consulting but Monica is very good.

I am glad you found us!

Hugs,
Leslie and the gang

[liz]

I just wanted to check in with how Cassidy is doing. First off I have a call in for her vet. Last night Cassidy was restless and experienced some wheezy breathing, walking around, but finally rested quietly. She drank several times during the night. This morning I have not given her the Trilostane yet since I am waiting to hear from the vet. Her appetite was poor, but she finally ate some thin sliced deli turkey. I had offered her a scrambled egg with a teaspoon of plain yogurt which she showed no interest in. If I don't hear from the vet soon I am going to call Kansas State University's veterinary hospital.--Liz

[liz]

I went to the vet today to get the smaller dose of Trilostane which has been cut in half to 30 mg. We will start back on this lower dose when Cassidy's appetite improves. Thank you for your continuing support and concern. I told the vet about this site and that it might be helpful to other people. Again thank you.--Liz and Cassidy

[liz]

I went to the vet's office to get Cassidy's lab reports. I read about the importance of having copies of this info in case of emergency treatment--what a good reminder from this group.
Here are Cassidy's values:
Date of test 6/29/11 10:13 a.m.
cort 8.7
at 12:48 p.m.
cort 30.0'
Thyroid test--date 6/29/11 10:21 a.m.
TT4 0.7

I asked the vet to take a look at Cassidy today since she has continued to be lethargic and very uninterested in food. Her cough has continued so she had a chest x-ray which indicated some fluid in her lungs. Here is what the vet did in the office: electrolytes checked --okay, furosemide injection, Thyro Tabs to start tomorrow .2mg once daily, and the doctor wants her to have furosemide tablet a.m. and p.m. (one half 12.5 mg). Cassidy will see the vet on Friday to see how she is doing. The vet mentioned giving her some Prednisone; but I said no. I also suggested using a smaller dose of Trilostane perhaps 10 mg instead of the 30--which is half of what was originally prescribed. Hope this makes sense.

[liz]

Thought we had better send a note to tell you how Cassidy my Pembroke Welsh Corgi is doing. When I first wrote to you Cassidy had been put on Vetoryl (60 mg) which was a very large dose for a 22 lb. dog. She had a bad reaction to Vetoryl after four days on it so she was taken off it. The vet decided to take charge of her thyroid issues. Her test indicated low thyroid TT4 was .7. She is taking Thyro Tabs size .2 mg daily. Cushings is still an issue for her and since she takes meds for a heart problem it was decided to try Anapryl for her 5 Mg daily. She has been on the Anapryl for about five days now with seemingly no adverse reaction.
What kind of diet do you folks feed your Cush pups? I had been making homemade food for Cassidy--lean chicken, brown rice, pumpkin, some vegetables (usually sweet potato) and a teaspoon of plain yogurt, but Cassidy turned up her nose at it; so I bought her some canned food Wellness Sr. Formula which she seems to like. She is starting to have a skin rash again so it will be bath day tomorrow. Which shampoo have you found to help this itchy dry, flaky skin? Is there a conditioner that can help? What about her food? Any suggestions? Are my questions something that I could send to University of Tennessee? She will have her thyroid checked again in about two weeks. Any information will be appreciated. Oh yes I want to include the information that Cassidy celebrated her 16th birthday on July 25. I sure appreciate this great site.--Liz and Cassidy

[labblab]

Oh, Happy Birthday to sweet Cassidy!!!!!!!! :) :) :) :)

I'll leave it to other folks to offer out their food and skincare suggestions, but I can surely help to celebrate her birthday!!

All best wishes to your precious girl,
Marianne

[addy]

Happy Birthday Cassidy!!!!

Usually for a Cush dog a quality protein in a moderate amount is something to look for; lower in fat. I think you really need to take all your pup's health concerns into consideration. I use the Dogaware website to research dog food. You will find a wealth of knowledge there. What may work for one pup could not possibly work for another, so I hesitate to suggest a specific brand. Some of us are using raw diets, again a matter of individual choice, other health concerns, etc.


Dogaware.com is, IMO, the best place to start.

Hugs,
Addy

[liz]

Happy Birthday Cassidy!!!!

Usually for a Cush dog a quality protein in a moderate amount is something to look for; lower in fat. I think you really need to take all your pup's health concerns into consideration. I use the Dogaware website to research dog food. You will find a wealth of knowledge there. What may work for one pup could not possibly work for another, so I hesitate to suggest a specific brand. Some of us are using raw diets, again a matter of individual choice, other health concerns, etc.


Dogaware.com is, IMO, the best place to start.

Hugs,
Addy

Cassidy started experiencing breathing difficulties--she is at Kansas State University on oxygen--took all her lab work papers, medications and belief in the power of prayer for Cassidy. I am a wreck.--Liz

[addy]

Oh Liz,

I am so sorry to hear this. I am sending prayers and positive vibes for your beloved Cassidy.

Please keep us updated if you can. We are here for you.

Love,
Addy

[Nika'sMom]

I do believe in the power of prayer and I am sending them your way...many hugs as well Lynda....

[Squirt's Mom]

Hi Liz,

Sending prayers, healing white light, and positive thoughts for you and Cassidy. Please let us know how she is when you can. We are here if you need to talk, honey. I know how scared I am when one of my babies gets sick and this is where I always run....and they are always here.

Hugs,
Leslie and the gang

[liz]

Cassidy passed away this afternoon at Kansas State University's Veterinary Hospital. A friend drove me there this afternoon. I was able to hold her in my arms all the way back to Topeka. She is at peace. With a heavy heart that is filled with wonderful memories.--Liz

[Nika'sMom]

Liz...you are an amazingly strong person...I am so glad that you got to hold your Cassidy in your arms once again..how beautiful...Yes..Cassidy is now at peace and I feel your heavy heart in mine. You were such a good Mom and I hope that you hold on to those wonderful memories, because, that is what is going to get you through this difficult time...many hugs being sent to you, Lynda

[littleone1]

Hi Liz,

I am so sorry for your loss. My thoughts and prayers are with you. You did everything you could possibly due to help Cassidy. RIP Cassidy.

[addy]

Liz I am so very, very sorry to hear this.

My heart goes out to you and please know we are all here for you for support.

My deepest sympathies.

Love,
Addy

[Squirt's Mom]

Dear Liz,

I am so sorry to hear about Cassidy. The image of her in your arms on the way home is so very touching and I hope it brings you comfort in the coming days. I know Cassidy was watching you the whole way home with such love and gratitude for all you did for her.

We are here any time you wish to talk. We do understand the pain you carry today and will help in any way we can.

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

[liz]

Dear Liz,

I am so sorry to hear about Cassidy. The image of her in your arms on the way home is so very touching and I hope it brings you comfort in the coming days. I know Cassidy was watching you the whole way home with such love and gratitude for all you did for her.

We are here any time you wish to talk. We do understand the pain you carry today and will help in any way we can.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick and our Angels, Ruby and Crystal
Thank you for your kind thoughts. If I may I would like to post some biographical information about Cassidy. Cassidy came to me because she was a "gift" dog to some folks who didn't have room for her. I had just lost a very beloved Blue Heeler a few months before and was depressed. A friend of mine knew that I liked corgis and she asked if I would be interested in Cassidy. I grabbed the opportunity. Cassidy was from Pennsylvania and was flown out here to Kansas. She arrived at my home during the week that I was getting my folks Golden Anniversary party together. Always a lady this precious pup captured everyone's hearts immediately. Always happy to see you and her cuteness and that little button tail could brighten any day. Just looking at her made you know the world was a good place. My old vet who had taken care of our pets for years took one look at her and said, "Too bad you couldn't have got a cute dog" in jest of course. Cassidy entered into obedience school at five months of age and was always the top of her class. Canine Good Citizen at the tender age of six months, Kansas Therapy Dog #86 two months later. She and I visited Rolling Hills Retirement Center and Nursing Home for two years every Friday evening. She accompanied me to Wyoming for dressage camp and became the darling of the group. The instructor telling me in leaving "to be sure and take good care of Cassidy". Cassidy was petite in stature and many folks who first saw her thought she was a puppy. She never destroyed anything in the house, always had a good appetite, was especially fond of buttered toast, gentle with children and kind to everyone. Oh yes, she won the Smile contest at the dental office and had her picture in our dentist's newsletter. She gave me wonderful memories, making each and every day special. She and Bandit (my male corgi who passed away four years ago) were featured in the pictures of the International Corgi Calendar that was published for several years. All of our pets are special and it helps to share this information with you.--Liz

[Squirt's Mom]

You just keep sharing any time you wish. Those precious memories will sustain you in the coming times and it is an honor for us to be able to share in celebrating her life through your memories. It sure sounds like Cassidy had a beautiful life with you. I think it was meant to me that her first home didn't work out...she needed you and you gave her everything.

Hugs,
Leslie and the gang

[Maya]

Oh God bless her little soul....I'm terribly sorry for your loss :(

[bgdavis]

Liz,

I'm so sorry for your loss of Cassidy. Fluid building up in the lungs is usually a sign of heart failure. You had 16 wonderful years together and you did everything possible for Cassidy.

Hugs,
Bonnie and Angel Criss

[Jenny & Judi in MN]

Cassidy sounds like one very special dog. I'm so very sorry for your loss
Thanks for telling us about her.

hugs, Judi

[Roxee's Dad]

Dear Liz,
I am so sorry for your loss. I am sure Cassidy knows she is loved. Rest in peace sweet girl. You are our Newest and Brightest star in the sky.

[jrepac]

Sorry to hear of this; Cassidy was clearly a wonderful dog that had a wonderful owner. Rest easy baby.

Jeff, Angel Mandy, Pebbles & Pepper

[k9diabetes]

I am very sorry to learn of Cassidy's passing.

She had so much going on with her... it is hard dealing with heart problems along with other issues. Harder still to accept that the body has worn out and just can't go on.

The important thing is that she was a beloved member of her family - which she obviously was.

Natalie

[MBK]

Dear Liz -

I am so very sorry for your loss. Cassisdy sounds like she was a really wonderful dog. I read your story and it sounds like she was meant to be with you. I am so glad you got to celebrate her 16th birthday (she shares my birthday). I hope your memories bring you comfort.

Know that many people hold you in our thoughts.

[liz]

I am so comforted by your very kind comments. I picked up Cassidy's ashes yesterday. They were placed in a blue velveteen bag with "Until we meet again at the Rainbow Bridge" embroidered on it. Two lovely floral tributes were brought to the house; one from one of the horse boarders and one from the veterinary office. I am touched by the tributes to honor Cassidy. I wish that you all could have known her.--Liz

[Cyn719]

So sorry to hear about Cassidy - I know she was very special to you - just remember God sent her to you because he knew you would be a teffific mom to her and you were!!! You were able to spend 16 years together and that is so special!! Love and prayers

xoxo Cindy & Penny

[rbeasl]

Liz,

I am so very sorry for your lost. What a special little girl she was. I know she is looking down smiling at you and thinking Thank You for a Great Life.

RIP
Rhondalyn and Honey

[mytil]

Liz,

My heart is with you and I am so very sorry to read about Cassidy passing.

Always in Loving Memory of your girl
Terry

[liz]

Thank you for these kind messages. You folks seem to understand and care. What would I do without your help?--Liz