Atypical Cushing's and diet

[Molliepaws]

Hi everyone,

I am new here - after dealing with some sudden aggression towards humans this summer, our border collie Murphy was diagnosed with end stage hypothyroidism and recently with atypical Cushing's as well. I wrote about some of it here http://nebcrfosters.blogspot.com/2011/09/on-aggression-and-thyroid.html.

Here are the labwork results
http://i254.photobucket.com/albums/hh84/phejnova/MurphyCushings.jpg

We are still getting the thyroid stuff under control, having a difficult time finding the optimum dose of Soloxine. Meanwhile, we will start giving melatonin and lignan for the Cushing's levels (I ordered both from Swanson.com).

I am slowly making my way through the resources in this forum, and I am wondering if there has been any discussion pertaining to Cushings and diet? Our dogs do better on raw diet than on kibble and so I am hoping to stick with that, but wondering if there are things I should be adding or avoiding...

Thanks :), Petra (and Murphy)

[addy]

Hi and Welcome,

Glad you found your way here. Others will be along soon to go through your test results. As for diet, my Zoe has Cushings, not atypical. She has remained on her raw diet to which I add Honest Kitchen Embark and Zeal. She gets a probiotic every day. She also has IBD so diet depends on what is all going on with the pup. What works for one may not work for another. IMO, quality protein is the most important.

Have you gone on the Dogaware.com website? Tons of info there on food.

Hang in there, glad you found us.

addy

[Harley PoMMom]

Hi and welcome to you and Murphy!

I see from your blog that you sent the thyroid panel to Dr. Dodds, great job as Dr. Dodds is an expert in thyroid issues.

Here's a handy link to our Atypical files from our Helpful Resource Section: Congenital adrenal hyperplasia-like syndrome/ Hyperestrinism/ "atypical Cushing's" (http://www.k9cushings.com/forum/showthread.php?t=198)

Another link from our Resource Section with information about thyroid problems, there are articles from Dr. Dodds: Thyroid Disease, Diagnostic and Treatment Misunderstandings (Dodds) (http://www.k9cushings.com/forum/showthread.php?t=1627)

Please know we will help in any way we can, so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[lulusmom]

Hi Petra and welcome to you and Murphy,

In your blog you mention that aside from the change in behavior, Murphy had no symptoms of hypothyroidism. Can you tell us what symptoms and/or blood abnormalities aside from the low thyroid that prompted your vet to test for atypical cushing's? Does Murphy drink and pee in excess, pant, any skin and coat issues, does he have a voracious appetite despite the thyroid supplementation?

I don't believe I've ever seen a case of atypical cushing's where the 17 oh-progesterone is normal both pre and post acth stimulation so I did a bit of research and per Dr. Rhett Nichols, DVM DCVIM, there is an exaggerated response to 17 oh-progesterone in dogs with both typical and atypical cushing's. I'm still confused but that's how I spend most of my time. :D I noticed the biggest elevation in the estradiol. This particular hormone can be found in tissues outside of the adrenal gland in fatty tissues and the gonads. Has Murphy been neutered?

None of us are nutritionists but the textbooks say dogs with cushing's should be fed a higher protein, low fat diet. A good number of us feed a moderate to high, good quality protein, grain free diet. Some members home cook, some feed commercial and a few may feed raw. Choosing our dog's food can be confusing and I think few of us would reach agreement on many brands of commercial food and not everybody would agree with raw feeding and some prefer to cook their doggie diets. My dogs did well on raw and if your dogs do really well on raw, then why fix what ain't broken? I fed a commercially prepared rawfood so I have no idea which supplements are required with raw feeding, but as long as you've got that covered, then I don't think you would have to worry about adding anything.

[Molliepaws]

Thanks for the nice and thoughtful responses, everyone! I will check out all the links...

Here are some answers to your questions.

Murphy was neutered in 2008. He was a stray and was neutered at the SPCA before I pulled him - unfortunately I have no other info about his neuter or prior history. :(

He doesn't really show any typical signs of Cushing's other than perhaps an obssession with food which started after we put him on the thyroid meds. The reason we tested for Cushing's... he had a relapse of aggression after we slightly lowered his thyroid meds in November. Both my vet and Dr.Dodds were skeptical that such a slight change in meds (lowering Soloxine from 0.3mg to 0.25mg twice a day) could cause such a significant difference in his behavior. They felt something else was going on, so I when I brought him in for another thyroid test, my vet suggested we test his hormone levels as well (plus lyme which has been coming back negative). It turned out that some of his thyroid levels were super low again and likely the culprint of the behavior change, but meanwhile the adrenal levels came back slightly elevated. My vet does not seem super worried about it at this point (she did mention that the estrogen levels are not a good indicator), and suggested we go ahead and just use the lignan and melatonin to see if we can get the levels back to normal.

Definitely interesting about the 17 oh-progesterone. Sounds like good news to me. After our other dog was diagnosed with symmetrical lupoid onychodystrophy last year, I certainly feel like our household has reached the standard quota for exotic canine diseases. :rolleyes: If not Cushing's, what else could cause the marginal elevation of the other hormone levels, I wonder? I'll bring it up with our vet next time I see her.

[frijole]

Wow you have been thru the ringer huh? Well there are other reasons that the adrenal hormones could be slightly elevated. Cushings isn't the only possibility so I am glad your vet is taking a wait and see approach. Melatonin won't hurt to give to a non cush dog - not sure about the lignans but someone will post I am sure. Hang in there! Kim

[gpgscott]

Welcome Petra and Murphy,

I cannot find a reference to end stage hypothyroidism.

I do find reference to end stage renal failure in association with hypothyroidism.

Hypothyroidism is treatable. End stage renal failure is not.

Your posted scan of the UTK adreanal panel is too small to read.

Dosing a hypothryoid dog is not difficult it is a matter of bloodwork and weight.

Best. Scott

[Molliepaws]

Hi Scott,

Murphy is hypothyroid (nothing to do with kidneys). The term 'end stage hypothyroidism' was actually on the report from dr.Dodds and I believe it simply meant that the dog couldn't have gotten much worse without going into coma and dying - we caught it just in time.

While normally it is not difficult to find the right dose of Soloxine for hypothyroidism, it has been difficult for Murphy. With 0.3mg, his levels get too high (not good for his liver). If we lower it just a teeny bit to 0.25mg, his levels fall dramatically and he starts showing behavioral changes (aggression).

As for the labwork results I posted, you can view them bigger by clicking on the 'View' tag at the top of your screen and then hitting 'Zoom'.

Hope this helps.

[gpgscott]

As for the labwork results I posted, you can view them bigger by clicking on the 'View' tag at the top of your screen and then hitting 'Zoom'.

Hope this helps.

Anyone know anything about this?

Petra,

If the thyroid can't be controlled easily I think that points to another complicating issue.

I have experiece with -thyroid in both humans and pups, 'no biggie' in both cases in terms of dosing and big returns in health.

Border collies are very demanding. I wonder if your pup senses there is another issue going on and trying to tell you so.

Diagnosis is a critical and complicated phase of treatment.

Best. Scott

[MiniSchnauzerMom]

Originally Posted by Molliepaws View Post
As for the labwork results I posted, you can view them bigger by clicking on the 'View' tag at the top of your screen and then hitting 'Zoom'.

Hope this helps.


Anyone know anything about this?

Scott,

In the Firefox browser up at the very top of the toolbar under "view" you can zoom in or zoom out to make the page/print larger. In IE there is also something similar to choose the largest size text. The report is pretty fuzzy looking though.

Louise

[Molliepaws]

Sorry about the fuzziness of the report - it was faxed to me by my vet and so you guys see what I see.

Scott, yes, something else might be going on. That's why we tested for Cushing's, tick borne diseases and ran general bloodwork. Haven't found much. However, the aggression does go away when his thyroid levels are up - there is definitely a correlation. Right now, we are back to 0.3mg of Soloxine and will be testing in a couple of months. I guess the next step would be an MRI, but I am not crazy about the idea of the $3,000 bill unless the vet think there is a good reason to go for it.

Thanks for sharing your thoughts!

[gpgscott]

Petra,

I also would not favor the MRI, at this time.

For a pup you have to imobolize and that means drugs.

There are two reasons for MRI , localization and identification. Both of these are pre-surgical tools

MRI will inform a medical treatment in a manner of confirmation.

I think you need to be seeing a good Verterinarian IMS and seeking that diagnosis first.

Scott