Flo just diagnosed (10 y/o cockapoo)

[momofflo]

Flo is an almost 10 year old cockapoo. We have been through a lot lately. 2 weeks ago we took her to the vet because she was lathargic and just not feeling well. They did blood test and we were told she had elevated liver count and a fever. They indicated that she might have Valley Fever. Sent her home with antibiotic and eye drops. She also had a goopy left eye. They called and said the Valley Fever was negative but put her on meds because you can get a false negative. She was not doing any better and had started drooling and having a hard time eating so we took her back because we thought she could have a bad tooth. They could not find anything. She was getting worse and refusing to eat so I took her to the emergency hospital because out vet was closed on Thrusdays. Right off the bat the vet tech found a bad tooth. They also noted that her right eye was very red. Long story short, I fired out vet, found a new one and now we are diganosed with Cushings. We are soon going to start Mitotane as soon as her other problems go away. I am very nervous!!!

I look forward to your comments and what I should expect.

[Jenny & Judi in MN]

Welcome. I know it is overwhelming. I am one of the least knowledgeable folks here as my Jenny is still getting regulated too. Can you let us know what tests they did to diagnose Cushings and what her actual results were?

Many people here have had false positive tests.

Does Flo have a bloated belly, drink a lot of water, have skin or hair issues? I'm sorry about her tooth, I hope she is getting some relief now that they caught that.

I met someone a week ago who's 17 year old dog has been happily living with Cushings since he was 11. So hang in there, people are very helpful and knowledgeable around here.

Judi

[addy]

Hi and Welcome,

Sorry to hear about the troubles with Flo. Cushings is a very hard disease to diagnosis and most vets experienced with the disease will not treat a pup without very strong symptoms. Not wanting to eat is not one of the symptoms of Cushings.

If you could tell us the tests that were done and the results that led you to a Cushings diagnosis that would be great. What other symptoms of Cushings does your pup have?

Pot belly, excessive panting, drinking, urinating, hind leg weakness, strong appetite, skin problems, coat problems, rat tail, frequent infections are all some of the signs of Cushings.

What dose has the vet given you of Mitotane and how much does your pup weigh?

Now that I have given you the third degree, please do not run away.;)
We see pups on the wrong dose, incorrectly diagnosed, etc so we have a list of questions we always ask.:):)

Hope we can help you. My Zoe was diagnosed June 2010 and first started treatment June 2011. Cushings is a slowly progressing disease so we usually have time. It is seldom an emergency.

Hugs,
Addy

[Roxee's Dad]

Hi and welcome from me too.
I see you have already been asked the usual questions :D The more we know about Flo and her diagnosis, the more we can help you understand what Flo is going through.

At the top of my list of questions is.. What test were performed that led to the diagnosis of cushings? UC/CR, ACTH, LDDS and was a high resolution ultra sound performed? Did they diagnose Pituitary or Adrenal based cushings?

Does Flo have excessive thirst, drinking a lot of water? Is she always hungry even after being fed? Any muscle loss or hair loss?

With a proper diagnosis and treatment, Most if not all of her symptoms will be relieved :D but really I like to emphasize the proper diagnosis because we have seen quite a few that were being treated for cushings, but had an underlying problem that caused their pup to have high cortisol levels. I also wanted to note that it is wise to hold off treatment until Flo is feeling well. Part of the treatment is watching how she is feeling so you know when you may need to with hold treatment. A rule of thumb around here is to with hold treatment if your fur baby is not feeling well.

Looking forward to hearing more about Flo in the coming days :D

[momofflo]

Flo has all of the typical symptoms. Excessive drinking, always hungry, constant panting, poor coat, ect. She will be on 200mg of Mitotane as soon as we get the ok on the treatment. She had the ACTH and the 2 hour test. My new vet is very positive that she has it with the tests and her symptoms.

She feels so good now compared to 2 weeks ago. I am almost hesitant to start the medication. With her panting and drinking I know she needs it. I just want her to feel good.

Thanks for the input.

[frijole]

Flo has all of the typical symptoms. Excessive drinking, always hungry, constant panting, poor coat, ect. She will be on 200mg of Mitotane as soon as we get the ok on the treatment. She had the ACTH and the 2 hour test. My new vet is very positive that she has it with the tests and her symptoms.

She feels so good now compared to 2 weeks ago. I am almost hesitant to start the medication. With her panting and drinking I know she needs it. I just want her to feel good.

Thanks for the input.
I'm scratching my head because you went from having an eye problem (which is not a cushings thing) to a cushings diagnosis. By chance was Flo on some form of prednisone drops? This can mimic cushings and would/could have affected the results.

It is real important to be sure of the dx - and the reason we are asking all these questions is the reason this site even exists - alot of people come here in a panic because their dog was misdiagnosed. Cushings is not easy to dx because alot of other illnesses can cause false positives and the symptoms.

So... just so I can sleep tonight - let's define 'eats alot'. Does your dog chew its food or inhale it? Cush dogs inhale :D They head butt trash cans, constantly search out crumbs in carpet etc. They think they are starved all the time - not just eating alot.

Water intake - alot means buckets - constantly refilling container and either going outside OR peeing in the house at night.

You said your dog had the acth test and the 2 hr test. The acth test is a two hour test, the other most common test is an 8 hr test. Can you look at the bill or test results and tell what the other one was? Was it a blood panel? Also please give us the numbers on the tests.

Did you have an ultrasound done? Lastly, I hope your vet briefed you on the use of lysodren. I'm posting a link which we have used for years in guiding those new to the drug. You need to understand it is a wonderful drug - saved my dog's life - but you need to respect it and understand how it works because if a dog gets too much they can get into serious trouble. I assume you have prednisone on hand in case of emergency. (required) Just to check the dosage amount, how much does your dog weigh?

Sorry for the questions but better safe than sorry and we just want to be 100% sure ! Glad you found us and don't be afraid to ask us questions. Kim

http://www.k9cushings.com/forum/showthread.php?t=181

[momofflo]

Let's start from the beginning. Flo has been drinking and urinating a bunch for a couple of months. At about the same time I noticed that her coat was not shiny. Then 2 weeks ago we took her to the vet because she was larthagic, panting and I knew she had a fever. They put her on Clavamox and eye drops. After a couple of days of being on the antibiotic she lost her appetite. Then I took her to the emergency vet and they took her off the Clavamox and changed to Antirobe and added a new eye drop. Her appetite was starting to come back but it was hard for her to eat because of her tooth. Then we took her to the new vet and they added another antibiotic and prednisone. That is when her constant hunger started.

When she went to the emergency vet they did a lot of x-rays. They called the next day to say she had an enlarged liver. So her symptoms are the enlarged liver, elevated enzymes, poor coat and excessive drinking. I would leave the food out because of the steroids. They did the ACTH test and a blood panel. No ultrasound. I don't have the numbers but if we go in today I can get them.


The vet did explain the lysodern and the possible side affects. We do have prednisone on hand if needed. The vet's office is about 1/4 mile so in an emergency we can get there fast.

I appreciate all of the questions so we make sure we have the correct diagnosis.

[frijole]

If Flo was taking the prednisone drops when she had the acth test it could have effected the results. Yes please post them if you can as well as any of the items from the panel that are above or below normal ranges. We have a lab tech that is an admin and she helps a great deal. When you post the numbers post whatever was high or low as well as what the range is for normal from the lab (since it varies)

Thanks! Kim

PS pls post Flo's weight. Thanks!

[momofflo]

Flo's weight is 21 pounds. I'll post the numbers as soon as I get them.

Thanks for the help!!!!

[frijole]

If you read up on how lysodren works you will see that the objective is to eat away at the part of the adrenals that is making the nasty cortisol that causes cushings. The key is to get the dosage just right. The protocol calls for a dosage of 25 to 50 mgs per kg of weight.

Flo weighs 21 lbs so that no divided by 2.2 = 9.5 kgs

9.5 x 25 mgs = 237.5 mgs of lysodren
9.5 x 50 mgs = 475 mgs of lysodren

Having a dose that is too high can quickly lead to problems. If you start on a dose that is too low it usually means that the 'loading process' is drug out and you end up having to increase the dosage slowly over time, each time paying for another acth test AND the stress is great - I know this cuz I have BEEN there. :D

Post the numbers please when you get them and we'll worry about the dosage later. Meanwhile, is it possible to measure the daily water intake? Log it for a few days and lets see how much Flo is drinking. Normal is 1 oz per pound so in your case 21 oz (2.6 cups) a day.

Just so you know the scariest part of cushings is getting the diagnosis right and then the dosage. After that it is a TOTAL cake walk! Seriously. My gal Haley was on lysodren for 4 1/2 yrs. She led a normal life and passed of old age at 16 12. My other dog Annie was misdiagnosed as having cushings and her journey has been much more difficult. Anyway.. key is getting the dx and dosage right AND getting you up to speed so you can be your dog's voice. You are doing great so hang in there and we are here to help. Kim

[StarDeb55]

Welcome to you & Flo! I'm the lab tech that Kim mentioned & I see that we are kind of neighbors.


Then we took her to the new vet and they added another antibiotic and prednisone. That is when her constant hunger started.

This statement concerns me in a huge way. If Flo was taking oral prednisone when any of the Cushing's tests were done, the results are inaccurate. Pred mimics cortisol on any of these tests & can cause a falsely elevated result. Long term use of any type of steroid can induce a 3rd type of Cushing's called iatrogenic where the only cure is to slowly wean the pup off the steroid.

Debbie

[momofflo]

Hi Debbie,

Yes, we are neighbors!! The vet is supposed to call me today. I will bring this up. I think I am taking Flo back in on Tuesday to check on her eye. I won't know until I speak to the vet.

Can I ask what Vet you use or is that not pc?

Thanks
Mary

[StarDeb55]

Dr. Mark Loeschen at VCA Elliott Park Animal Hospital. the corner of McClintock & Elliott. He is a GP vet, but has tons of experience treating Cushing's. In fact, I had to fire an IMS with my last boy, Harley, & go back to Dr. L. Dr. L had made Harley's diagnosis, but I went to the IMS for confirmation. Harley did great with Dr. L. Since Harley was getting up in years, 13 1/2 when he was diagnosed, Dr. L was very careful with him, & monitored him quite closely.

Debbie

[momofflo]

I just got the numbers. They are:

Base 4.3
Stim 29.7

What do you think?

Thanks
Mary

[StarDeb55]

Was that ACTH done while Flo had the dental infection, on prednisone, or ill in any way? Was this the only test done to make the diagnosis?

Debboe

[momofflo]

Yes, she was on prednidsone and antibiotics for the tooth.

No other tests were done.

Do you have suggestions?

[StarDeb55]

I'm afraid that this result is then highly suspect. Is she still on prednisone? If so, you need to talk to the vet about weaning her off of it. Once she is off of the pred, see if her symptoms start to subside. If they don't, then you will need to start the Cushing's diagnostic testing from the beginning. The first test I would suggest is a urine cortisol/creatinine ratio. This is a simple, non-invasive test where you could even collect the urine sample at home. If you get a negative result, you are absolutely not dealing with Cushing's, a positive simply means that Cushing's is a possibility, further testing required. Non-adrenal illness such as an active infection can cause a false positive result in any Cushing's testing, so Flo will need to be over everything, feeling pretty good, & off the prednisone before proceeding.

Debbie

[mytil]

Hi and a belated welcome from me too.

I have to agree with Debbie on this - IMO, the test results are skewed because of the pred, and the infection. And, yes these have a tremendous affect on the results. (Heck, I had a viral infection not too long ago and my blood pressure went to 150/130 - the ER drs freaked - until I mentioned could this be because of the infection? Answer yes - I had no history of high blood pressure).

I would wait until all this is cleared up and then test again.

Terry

[labblab]

From your description of Flo's pre-existing symptoms prior to the flare with her tooth, it is possible that she does, indeed, suffer from Cushing's. However, I must agree with the others that the results of her diagnostic ACTH test are an unreliable indicator because they would/could have been affected both by the prednisone and also the underlying oral infection.

Before starting treatment with medications as serious as mitotane or trilostane, a Cushing's diagnosis must be confirmed as reliably as is possible. So I would be very fearful about moving forward with treatment until Flo has completely recovered, has been taken off the prednisone, and can be retested.

Marianne

[frijole]

I agree with the other and want to point out that should Flo have cushings there is no rush to treat. Most people accidentally find out their dog has cushings (like me) and after they learn what cushings is they realize the dog has had it for years. You certainly wouldn't want to ignore the disease but you have time to wean off the prednisone and retest. Kim

[momofflo]

Flo will be off the prednisone in about a week. I am taking her to the vet on Tuesday to check on her eye so we can discuss whether to start the treatment or wait.

Thanks for all of the inputs.

Mary

[frijole]

Great. Like I said you have plenty of time to treat should it be cushings'. If you read up on lysodren you will quickly learn that it is NEVER to be given to a dog that does not have cushing's. It could quickly cause problems. I know this too because it happened to me. Please be confident when you are meeting with your vet that holding off to be sure of the dx will do no harm whereas starting the drug could cause harm.

Like Deb or Marianne said, doing the UCCR urine test could quickly and cheaply rule out cushings. If positive it simply means it could be cushings and then you'd have to do a couple of tests - acth, ldds, and/or an ultrasound.

Please also know that while frustrating, this happens a great deal where the dx is wrong or potentially wrong. It isn't an exact science and the drugs are just too powerful and potentially dangerous (if misused) to take a chance.

Good luck. Kim

[Squirt's Mom]

Hi Mary,

Since the ACTH was taken while Flo had prednisone in her system, that test is invalid - those results cannot be looked at to determine whether she has Cushing's or not. So you can just chunk that test and that money in the trash. Your vet should have known better than to give an ACTH with pred on board. If it were me, I would be getting the next ACTH for free. ;) Prednisone and cortisol will test exactly the same on the tests for Cushing's - all of them, so your vet took your money and put Flo through a test that had no chance of being accurate. Because of this snafu, discussing when to start treatment is moot. You do not want to start treatment for a condition you do not know she has - especially with drugs as strong as Lysodren or Trilostane.

It may sound like we are harping on your vet but that is not the case. Few vets know a lot about Cushing's or the treatments for it. We here have seen baby after baby who was rushed into treatment on iffy tests pay the price - baby and parents both. We don't want that for you and Flo.

The few signs you have given that could be related to Cushing's can be squarely laid at the feet of the prednisone she has been taking. Increased appetite, drinking and urination are all side effects of pred so I personally question whether you are seeing the effects of the pred VS actual Cushing's.

I repeat what others have said - Cushing's is a very slowly progressing condition taking years to begin to do damage. Please, please take the time to let Flo get better, get the pred out of her system, then look into testing - only then will you have any idea if Cushing's could be in play or not.

We are all here to help you and Flo any way we can.

Hugs,
Leslie and the gang

[momofflo]

Hi Leslie,

Thanks for all of the concerns. Do you have any documents that can back up the acth test and prednisone? I have found several articles that says it's ok to be on prednisone while doing the acth test. It just gets so confusing on what to believe. Like I said I am going to the vet tomorrow and would like to have some backup if I am going to question her treatments. She is a new vet and I don't want to challange her if it's not necessary.

Again, thanks for all of you inputs!!

[StarDeb55]

If glucocorticoids are to be used in the initial treatment of such patients, dexamethasone sodium phosphate will not interfere with plasma cortisol determinations. Other glucocorticoids, such as prednisone and prednisolone, may cross react with the cortisol assay

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

The quote is from the "diagnostic confirmation" section of the link I have posted.


Prednisolone, prednisone and hydrocortisone will cross-react in the cortisol assay and give falsely elevated results. Such therapies should be avoided in the 24 to 36 hours prior to the test. Dexamethasone does not have this effect so it can safely be used prior to confirmation of diagnosis without causing assay interference.

The second quote is from the following:

http://thehormonelab.com/handbook/adrenocortical-function/canine-hypoadrenocorticism-addisons-disease

If you want further documentation, I can find a ton more if you need them.

Debbie

[momofflo]

Thanks, Debbie - this should be enough. It's still a sticky situation because there are other articles that say the prednisone does not affect the test. We'll see how it goes tomorrow.

[frijole]

Thanks, Debbie - this should be enough. It's still a sticky situation because there are other articles that say the prednisone does not affect the test. We'll see how it goes tomorrow.

Could you link these articles? I'd like to read them. Thanks! Kim

[labblab]

Can you give us links or tell us the names of the articles that you are finding that say that prednisone given within 1-2 days of testing does not have the potential to affect the ACTH results? Maybe there are special circumstances involved in these articles that we can help sort out. Or if not, this would be important information for us to learn about since it runs counter to the research with which most of us here are familiar.

Thanks!
Marianne

P.S. I see Kim and I are on the same wavelenth here! ;)

[momofflo]

I'll have to do it tomorrow, I'm on my iPod right now.

[Squirt's Mom]

Hi Mary,

Just checking in to let you know that waiting room is gonna be crowded today because you will have many of us there with you. Let us know what you learn, ok?

How is Flo today? I hope she is feeling better and better!

Hugs,
Leslie and the gang

[momofflo]

Thanks for the support!! Flo is ok today, I don't think her eye is improving.

Do you have any suggestions on how to do obtain the urine for the urine test? I'm not quite sure how to get it. I really want to do this test. It seems the best way to rule out Cushings.

Mary

[Keiko's Mom]

Hi. If I have to get urine sample from my female dog....I take her out first thing in the morning on short lease....when she squats, I slip a small bowl under her.....hope this helps.

[momofflo]

Here is one of the articles but I think it is for humans. If I am reading it correctly it says that prednisone can lower the cortisol. I could be wrong.

http://www.labtestsonline.org.au/understanding/analytes/acth/test.html

[Squirt's Mom]

From the link you posted -


Is there anything else I should know?
Some drugs and conditions can cause ACTH levels to rise, including amphetamines, insulin, levodopa, and metoclopramide.

Drugs that cause ACTH to fall include dexamethasone and other drugs that act like cortisol (including prednisone, hydrocortisone, prednisolone and methylprednisolone), and megestrol acetate.

The ACTH test is looking at these values and we don't want them to be affected in any way by other drugs - especially those that mimic cortisol - like prednisone. You want these tests to show what is going on with Flo in her natural state, not in an altered state produced by the use of pred - or any of these other drugs. ;)

Hugs,
Leslie and the gang

[StarDeb55]

The link you posted is for human ACTH testing.

Debbie

[StarDeb55]

The following link is from Idexx, one of the biggest vet labs in the country:

http://www.idexx.com/view/xhtml/en_us/smallanimal/reference-laboratories/testmenu.jsf?selectedTab=Find-A-Test

When you type in ACTH in the test menu "search" field, the following quote is from Idexx testing protocols, under the "overview" section concerning interfering substances:


Icterus (repeat test if present), anticoagulants, corticosteroid therapy, spironolactone therapy

If one of the biggest vet labs in the country is stating that corticosteroid therapy causes problems getting an accurate ACTH, I would believe it as they are doing this test on a daily basis.

Debbie

[labblab]

Here is one of the articles but I think it is for humans. If I am reading it correctly it says that prednisone can lower the cortisol. I could be wrong.

http://www.labtestsonline.org.au/understanding/analytes/acth/test.html
I believe the article you are citing is talking about measurement of the level of ACTH ("adrenocortocotropic hormone") that is naturally present in a patient's bloodstream. This is a totally different test than the ACTH Stimulation test, which is instead a measurement of cortisol levels in response to injections of an ACTH product. It is the ACTH Stimulation test that would have been performed on Flo.

When performed in dogs, a test of naturally occuring ACTH is called an "Endogenous ACTH" test. It cannot be used to diagnose Cushing's in the first place, but it is sometimes used to try to distinguish between the type of Cushing's (pituitary vs. adrenal) after a general diagnosis has been made.

So the natural level of ACTH can be used as a diagnostic indicator, too, but that is not the test that was initially done to diagnose Flo's Cushing's. And prednisone affects both types of test results, just not in the same way. Here's a link that discusses the Endogenous ACTH test in more detail:

http://www.fetchdog.com/learn-connect/dog-resource-library/health/diagnostic-tests/Endogenous-ACTH-Adrenocorticotropic-Hormone-in-Dogs/D/300600/P/1:5:55:601:6103/I/AR000010035

Marianne

[momofflo]

Debbie and Marianne,

Thanks for all of the explantions. I am learning more each day!!

Mary

[momofflo]

Flo had her visit to the vet yesterday and it went very well. We are still trying to figure out what is really going on with her. The vet thinks she has an inner ear infection which is also related to the problem with her eyes. We are going to continue with the antibiotics and finish off the prednisone as scheduled. For now we are keeping the Cushings on the back burner. If we don't see any improvement with the ear infection she may want us to see a specialist. Hopefully the antibiotics keep working.

Mary

[Squirt's Mom]

Hi Mary,

So glad to hear the visit went well and hope the continuing treatment will solve her problem. My mom used to have inner ear problems and she would be so sick at times it was scary. I hope you start to see improvements in Flo very soon! :)

You can't imagine what a relief it was to read that Cushing's has been pushed to the back for now. ~~whew~~ I really believe this is the right path for Flo at the moment. However, that does not mean you can just disappear. You and Flo are family now and we want to hear from you. :)

Thanks for letting us know! Keep up the good work, Mom! Flo is lucky to have you on her side.

Hugs,
Leslie and the gang

[momofflo]

I wanted to update you on Flo. She goes back to the vet on Tuesday to check on her eyes and inner ear problems. I should then know where we go from here.

How did this website get started? It's a great help for those of us who are learning about Cushings.

Thanks again for all of the input.

Mary

[frijole]

This website was an offshoot of another one that was shut down but is the work of many wonderful people whose dogs all had cushing's at one point. Its a real life version of paying it forward. I'm here because these people saved my dog's life and my sanity. :) Been here about 6 years now. Glad you are having the same experience. Keep us updated on Flo! Kim

[Squirt's Mom]

This site is the result of a lot of hard work and a great deal of love for babies affected by Cushing's. This is "paying it forward" in action, to second what Kim said.

If not for the kind, loving, knowledgeable folks here, Squirt and I would have been so lost and I question whether she would still be with me today. And, an added bonus are the many friends, good friends, we have made here - friends I will cherish all my days.

I am glad you and Flo are part of our family, now.

Hugs,
Leslie and the gang

[momofflo]

We went to the vet and everything checked out fairly well. She is going to continue on the antibiotics because her inner ears are better but not how they should be. The vet and I noticed that Flo was looking much better and happier. Before we do any more blood test the vet wants to wait until she has been off the prednisone for a month. We still thinks she has cushings, but since she is so much better I am thinking of holding off starting the lysodern. Do I wait until her symptons get worse? I am hoping for some expert advise from all of you.

Thanks again for all of your help and support.

Mary

[addy]

Hi Mary,

Glad to hear Flo is feeling better.

The purpose of treatment is to alleviate symptoms, treatment cannot cure our pups. If there are no symptoms, we do not know if the medicine is working.

For my own dog, I waited for her symptoms to be stronger before I started treatment. Even now, as we decide on the correct dose for my Zoe, I have to rely on her symptoms. Her cortisol is not considered "controlled" yet most of her symptoms are and she is even growing hair:rolleyes::rolleyes:

It can be confusing, I know, but IMO, I would want to wait for the prednisone to be out of her system and a return of strong symptoms before going down the Lysodren road. Are there other health concerns being exasperated by her Cushings?

Hugs,
Addy

[Squirt's Mom]

Hi Mary,

I agree with Addy - just put the Cushing's in the drawer for now and don't worry about starting treatment until this infection is cleared up and the pred is completely out of her system. There is no rush to start treatment - this infection is much more important than the Cushing's for now. ;)

You're doing a great job, Mom!
Hugs,
Leslie and the gang

[momofflo]

Thanks Addy and Leslie,

Most of her symptoms have gone away. She was drinking a bunch for her, having a hard time jumping on the couch and mostly being lathargic. When she got groomed the last time they clipped her too close and that hair has not grown back. She never had a pot belly. So, thanks to your advice I am going to hold off on treatment. She will be off the pred on 10/12 so after that we will do more testing. This will give both of us a break from going to the vet all of the time.

Thanks again,
Mary

[momofflo]

This is an update on Flo. She is a completely different dog. She is happy, acts like a puppy and looks really good. We have her on several supplements. She is on milk thistle, vitamin E and DHA. I know that she still has cushings but you would never be able to tell by looking at her.

Wishing all a very happy new year and the best for all of the dogs.

[Squirt's Mom]

So glad to hear that Flo is doing well! I know you are so very happy to see her this way.

Hugs,
Leslie and the gang

[addy]

What great news!!!!! Keep up the good work.

Hugs,
addy

[Squirt's Mom]

How is Flo? I haven't heard from you in a while and was wondering how she is doing....would love to hear from you when you get a chance.

Hugs,
Leslie and the gang

[momofflo]

Thanks for asking. Flo is great....no signs of cushings. She is totally back to normal. I read here everyday and I am amazed at all the care that is given to these dogs. You are all great!!!!!

[Squirt's Mom]

It's been a while so I thought I'd check on you and Flo. Hope things are still rocking along like last report!

Hugs,
Leslie and the gang

[momofflo]

Flo is doing just fine. No symptoms of Cushings. She is now 11 and shows no signs of slowing down. Flo and her sister Mavis keep us busy and make us laugh every day.

Thanks for checking in on us. I read all of the posts here everyday and am amazed at the care and love of all the dogs.

[Squirt's Mom]

Eleven?! Weeelllll.........



Happy 11th Birthday, Flo!
and many more!



We hope you got lots of goodies and belly rubs!

Hugs,
Leslie and the gang

[Harley PoMMom]

Happy Birthday, Flo!!!

[addy]

Flo


happy , happy birthday!!!!

[molly muffin]

Oh gosh I missed saying Happy birthday Flo!!

Sharlene and Molly Muffin

[Squirt's Mom]

How is Flo doing these days? It's been a while since we heard about that sweet girl! Hope she is doing well!

[momofflo]

Flo is not doing very well. She is still hungry but does not want to go for walks anymore. We took her to the vet a couple of weeks ago and she could feel that she has a very enlarged liver and possibly cancer and she thinks her hormones are messed up and possibly atypical cushings. Her white blood cells were also slightly elevated and her liver values have gone up. We currently have her on 2 antibiotics, melatonin, lignans, metacam, omega 3 supplements, and liver treat supplements. We go back for another blood test in a couple of weeks. Her belly area is getting larger so I think we may go for an x-ray to see if that can tell us anything. I think she is suffering more than my husband does so we are always discussing when to put her out of her misery. I am hoping the x-ray will give us some answers. She is also having poop problems, she has to go quite often and has not made it in time a few times so our carpet is taking a beating. It's ok because it needs to be replaced soon. Flo turns 12 next Sunday.

We also have Mavis who is now 13 but she is doing great. She still thinks she is a puppy!!!!

Thanks for checking in on us. Do you have any ideas to help?

[Squirt's Mom]

I think it's time to have her tested for Cushing's. I would certainly do that before thinking of letting her go - unless they have proof positive something like cancer or liver disease is in play. The enlarged liver and elevated liver enzymes are part of the Cushing's picture as is the loss of hind end muscle and ability to endure much exercise or jumping. ;)

The melatonin and lignans are the initial treatment approach for Atypical so if she does have this form, you are already doing something to address it. However, if the cortisol has gone up she could be true cushionoid now and will need the Lsyodren in addition to the melatonin and lignans (they are needed for the Estradiol, if it is elevated, which can be produced in many areas of the body outside the adrenal glands).

Has anything in her diet changed that might be causing the stool issues? Just because the brand of food hasn't changed doesn't mean the manufacturer didn't change the formula - they aren't required to let the public know when they do that so the only way is to call and hope they will be honest with you about any changes in their feed. What is she eating?

[momofflo]

She does not have the symptoms for cushings. She does not drink a lot of water and is not starving all of the time.

We have not changed any food or anything else to cause the loose stools. The vet thinks she is not digesting her food and it is going right through her. She weights the same but is much thinner. Because of everything going on the vet thinks it is all related to her liver.

The next step is the x-ray to see if we can tell what is going on.

Thanks for your input, it is always appreciated.

[doxiesrock912]

Flo's mom,
Each dog presents differently. An ultrasound will show much more than xrays, especially in relation to possible Cushings. I urge you to rule it out please.

The last symptom that our dog had was extreme thirst. We brought her to the vet for skin issues. She'd had diarhhea for quite a long time which was diagnosed as IBD. In hindsight, I suspect that she's had Cushings for at least a year but the symptoms mirrored old age and IBD.

Daisy has been on Trilostane for 6 months now with some dosage tweaking, but she's doing great!.

[Squirt's Mom]

Just FYI - Trilostane (Vetoryl) is not recommended by UTK for pups with elevated intermediate hormones (Atypical). Lysodren is the drug they recommend for these pups because Trilo has been shown to cause elevations in those same hormones. ;)

[momofflo]

Daisy's mom, thanks. We want to go with the x-ray due to costs. Hopefully it will show us something definitive.

I will post the results.

[Squirt's Mom]

Been much too long! How is Flo doing?