Lack of Appetite (Update: Lymphoma)

[caper]

Hi All,

Our Golden Retriever who's turning 7 this week is being tested for Cushings. I know the vet has the results currently and am waiting with my heart in my hand for the results. Our dog took sick what seemed very very quickly on NY Eve...just got up seemed like he's hurt his back and stopped eating. Then the drinking/urination came one that night, and since then he hasn't eaten a bite on his own. My wife and I are "force feeding" him through a syringe. He's lost alot of weight this week.

He's had the ACTH and LDDS test this week as well as a full panel blood test.

Everything I read about cushings says this is backwards, I know I'm just hoping for the best, but the soreness, lack of appetite, etc has me terribly confused. I've tried searching but no luck finding any similar issues. Fortunately before this he was very healthy, we have litter mates and his sister is a walking infirmary, but he has been very healthy.

Does anyone have a similar experience, and did the meds help? I read Lysodren has the side effect of losing appetite...he can't eat less than he is now which is nothing.

Thanks all for your support/help.

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[Squirt's Mom]

Hi and welcome to you and your baby,

This does not sound like Cushing's. Cushing's does not come on that rapidly. It is a very slowly progressing condition and we often think our baby is simply aging until they have labs that indicate a problem.

Has he been checked for diabetes? Is there any chance he got into some poison, antifreeze, anything like that around NY?

I am waiting anxiously with you for those results. When you get them, would you mind posting them here on this thread so we can see them? We are not vets but we have lived with Cushing's and various other conditions and are familiar with labs.

I am glad you found us and want you to know that you and your baby are not alone. If this is not Cushing's, we will help you in any we can regardless. If it is Cushing's, then you are in the very best place possible to learn how to help your boy.

Let us hear from you as soon as you can!
Hugs,
Leslie and the gang

[caper]

Hi Squirt's Mom...great name BTW. Thanks for your followup and support.

When going through all the symptoms I was certain it was Addisons. That was the initial testing he was put through, but the results from the ACTH test led them to believe Cushing as the results were the direct opposite of what Addison would show.

The symptoms I see are:

Drinking/Urination
NO...and I mean NO appetite, we've tried foods any dog would take your fingers off for.
Lethargic, sleeps alot
Losing weight quickly, but this is associate with not eating.
Shaking, but I think we solved this with the Baytril comment below

We too did think of anti-freeze but retraced our steps and there's just no possible way.

A terrible side effect was he was prescribed Baytril, I believe they over prescribed and within 30min of taking the pill he vomited. It took us a few days to catch onto this, and I'm afraid it's helped with the upset stomach. Since we stopped he has not vomited at all.

With antifreeze poisoning I would hope the full panel would help as well.

I am still waiting impatiently for this call. Everytime the phone rings I jump. They have 1more hr and I'm dialing back. I will return with the results either way based off the call from the vet.

[Harley PoMMom]

Hi and welcome from me as well,

Any non-adrenal illness will elevate the cortisol levels in a dog. So testing a dog for Cushing's while the dog is ill is not advised.

A loss of appetite with increased drinking/urinating are symptoms of Addisons or kidney problems. If bloodwork was done could you post the results for us.

Love and hugs,
Lori

[lulusmom]

Hi and welcome to the forum.

I concur with Leslie. The sudden onset of illness as described is not associated with cushing's. Cushing's is a very graded disease so symptoms are slow to develop. Unless a dog is dealing with a GI problem that may be associated with Cushing's, such as pancreatitis, untreated cushdogs have ravenous appetites and aches and pains associated with arthritis or disc issues are usually masked by the high levels cortisol. Cortisol is the body's natural anti-inflammatory to a cushdog is self medicating until treatment brings those levels down to a therapuetic level.

The acth and the LDDS tests are the two top diagnostic tests used to diagnose cushing's; however, both are likely to yield false positive results in the face of nonadrenal illness or severe stress. Overt symptoms are a huge component of confirming a diagnosis and your dog doesn't have the usual symptoms. Was an abdominal ultrasound done? There is an adrenal tumor called a pheochromocytoma which is not the type of tumor seen with cushing's but it can cause the some of the symptoms we see with cushing's such as excessiving drinking and peeing. It can cause inappettance too. Was your dog diagnosed with the adrenal or pituitary form of the disease?

A dog that has to be force fed is a very sick dog and I honestly don't believe cushing's is the cause. I have two cushdogs, both of which went for quite some without being diagnosed and their appetites were off the chart. Their hindquarters were pretty weak from the muscle wasting caused by the catabolic effects of excessive cortisol but they were not in physical pain. There are only two effective treatments for typical cushing's, Trilostane and Lysodren. Neither should be given to a dog that is not eating so if it were me, even if my vet confirmed a cushing's diagnosis, there is no way I would give either of those drugs to my dogs.

Are you seeing a gp vet or a specialist? If not a specialist, then I would heartily recommend that you get a referral to an internal medicine specialist asap. If you are seeing an internal medicine specialist, I would definitely get a second opinion asap. If you don't know any internal medicine specialists in your area, perhaps if you let us know what city you are near, members may be able to give you a name. You can also do a search using the link I have provided below:

http://www.acvim.org/websites/acvim/index.php?p=3

Glynda

[caper]

So I called the vet for the 2nd time today, and they were not going to have anyone look at the results until tomorrow...so naturally my patience worn thin I've looked elsewhere. The advice on an internal specialist is appreciated.

I requested the results be printed off, and I have just picked them up. I also took your advice and have an appt at 10:15am tomorrow with an internal specialist @ Altavista Animal hospital in Ottawa, ON. Maybe I'm over reacting I don't know I'm not willing to chance it...but I know they have no sense of urgency and I certainly do.

The results of the LDDS test are:

Gave 0.01 MG/KG (0.07ml)
Took Blood @ 0hr/4HR/8HR

Cortisol 141 (15-120 NMOL/L)
Cortisol (4hr DEX) 54 (0-10 NMOL/L)
Cortisol (8hr DEX) 36 (0-10 NMOL/L)

I'm not a vet nor do I understand what these results say, but to me it looks like the Cortisol level was high when injected and dropped throughout they day as would be expected.

I'm hoping someone with more experience can shed some light.

My first day on this forums and you folks have helped more than my normal vet.

[lulusmom]

Hi again,

I am very glad you have decided to book an appointment with an internal medicine specialist. In your shoes, I would feel the same sense of urgency. Having to force feed your dog is horrible and in my layperson's opinion, his condition should be considered an emergency. I'm at a loss to understand why your vet doesn't think so. :confused:

We're not vets either but most of us have learned how these tests work and how to interpret the results. The results you posted are consistent with cushing's; however, for me, those results are suspect simply because your dog is definitely sick and doesn't present as the cushdog. The body responds to stress by dumping cortisol and if your dog is sick enough to have to be force fed, his body is definitely experiencing some major stress. I would, therefore, have been very surprised if the ldds results were negative.

I'll be staying tuned in for your update after your IMS appointment tomorrow. In the meantime, it would be great if you could post the results of any blood chemistry or urinalyses that were done. With respect to the bloodwork, just post the abnormal values, including the normal reference ranges. There are certain abnormalities that we commonly see with cushing's so I'm curious to know if there are any abnormalities that don't fit with cushing's.

Glynda

[caper]

Thanks for looking Lulusmom. Is there a way to paste a scan or attach a doc as it's a long list that would take me an hr+ to type out.

I'm not quite sure how to tell what's normal and what's not...

If I was to take a guess:

AMY = 1284 (200-1200)
BUN = 15.6 (2-9)
CA++ = 3.68 (2.15-2.9)
CREA = 225 (27-124)

[lulusmom]

You can scan the docs and send them to my email address, which I just sent to you via PM...you've got mail. :)

[caper]

You can scan the docs and send them to my email address, which I just sent to you via PM...you've got mail. :)

Thanks just sent them your way.

[caper]

Well we had our appointment with the Internal Medicine specialist. I'll start by saying thankyou to all those who responded and sent well wishes despite me being brand new to the forum.

Right now I'd take Cushing with a smile...they're quite confident it's something called Type A Lymphoma which is a terrible prognosis. It basically mean if the tests prove as expected it's a death sentence. We'll do 6mths of Chemo and hope for the best. The remission rate isn't great for this, and even thats hopeful is the impression we were given.

My wife and I are completely heart broken and confused/sad/angry and numb, all those feelings you can't control. Poor boy only turned 7 on Saturday, and he's never had an ache or pain or any health issue before hand.

[StarDeb55]

I'm so sorry to hear this. I would like to hold out a small ray of hope. My first cushpup, Barkley, was also diagnosed with lymphoma at the age of 13. We went through chemo using 5 round of doxyrubicin, once every 3 weeks. With the chemo, B's oncologist told me 6-8 months expected survival for the type of chemo we used. B beat those odds by a mile. He survived 20 months with an excellent quality of life. When an oncologist give you an expected survival with a certain chemo protocol, all they can do is quote you the statistics for what they have seen in their practice. Your pup may do much, much better than expected, I really hope so. I will also tell you that before we finally got a diagnosis pinned down, B was an extremely sick pup. I was literally watching my boy die by degrees over a 2 week period before we finally got a diagnosis. About 10 days after his first round of chemo, it was like B's fairy godmother waved her magic wand over him, saying, "You will feel better!" I got home from work that afternoon, & I could tell immediately I had my boy back, & neither of looked back for nearly 2 years.

Best Wishes & please keep us posted.

Debbie

[Snoopy&Rummer_Mom]

Oh, I'm so sorry to hear about your pup. I will keep you all in my prayers. I am sure this is a hard diagnosis to deal with but I see a silver lining in that you went to a specialist who was able to determine what you baby has and he can get the proper treatment. Praying for you guys.

Maria, Snoopy and Rummer

[Squirt's Mom]

I am so sorry you and your wife, and your baby, must face such a terrible crisis...but let Debbie and Barkley's story give you hope. Theirs is not the only such story I have heard either. Docs, whether human or animal, always give the worst case scenario. My dad, who was a dentist and often the first to see cancerous developments as a result, explained that this was done to prepare the patient and their family, so they could do what they needed to do to be ready for the inevitable. But he went on to say that doctors are not gods, they have no crystal ball, in truth, they never know a true time...and that more often than not, the patients blew those limits out of the water.

I have no doubt that Caper has received the best of care in your hands, that alone gives him a leg up. He is strong and healthy otherwise going into treatment. That combined with the strongest medicine known to exist - love - gives him the best possible hope. He is so very lucky to have ya'll as his mom and dad.

Please don't think that you have to leave us since he doesn't have Cushing's. That is not acceptable. ;) Ya'll are family now. I told you earlier that you would not be alone regardless - and I meant it with all my heart. We will be here for you the whole way. If you need to talk, we will listen; if you need to scream, we will let you; if you need to cry, we will cry with you. We are with you.

Sending prayers and healing white light flying your way!
Hugs,
Leslie and the gang

[bkdice]

Hi there! I am so sorry to read about the Lymphoma dx. :( I see Debbie has already replied, but I'd like to reply too. My cush pup, Niko, was dxed with Lymphoma 2 months before his 16th birthday. With encouragement from Debbie, we did 4 rounds of a single agent chemo drug - Doxorubicin. We got 8 months of remission, while the average expected was 5 months, with 5 rounds of doxo.

Debbie also steered me towards a wonderful supportive yahoo group called LymphomaHeartDogs (http://pets.groups.yahoo.com/group/LymphomaHeartDogs/). There are dogs that have gained remission, and stayed in remission for years! Please do not look at the statistics. While you may not get the miracle, you MAY! There is another cush pup member on there now (Kim and her boy Randy).

Again - I am so sorry for the dx. I remember very well what a horrible blow it was, and how helpless you feel. :( Hang in there... there is hope.

[caper]

Wow you folks are great...Deb just reading your story gives me some hope. After our call last night I had it in my mind if he makes the summer we'll be lucky. I watched my dad die of Lung cancer and my mom survive Breast cancer (12 yrs in remission). It's an ugly disease that has way too much meaning in my family.

SquirtsMom you are right the doctor give you worst case scenario, it's just a tough pill to swallow...and no I don't plan on straying form this forum now. Sometimes people virtual or not just know what your feeling, and it seems this is a good home for me. I'll have nothing to add about Cushings, but it is nice to see people who care so much for their animals when the world has so many who don't.

@bkdice that's for the site I'm heading over there now to see what I can find out.

[StarDeb55]

Lymphoma heart dogs was extremely helpful to me, & I'm so glad that Bettina mentioned the group to you. If you want a little more detail of my Barkley's story, you can read it here:

http://www.k9cushings.com/forum/showthread.php?t=345

Please feel free to PM anytime through the forum, if you have any questions.

Debbie