Newly diagnosed 10 year old beagle -Lucy

[cspurcell]

Hi! My dog Lucy was recently diagnosed with Cushings. Her annual health blood screen showed elevated liver enzymes and she had gained some weight. She mentioned possibility of Cushings but didn't recommend testing yet because she didn't have many symptoms.
I went ahead and had her tested and the Low Dex test confirmed pituitary kind. She has shown some muscle weakness, leg trembling and her head does seem to have a more skeletal appearance and her coat is thinner. Vet recommends not beginning Trilostane until more symptomatic. When do you start treatment? I did take her to a holisitic vet and she really didn't offer me anything other than changing her diet to a higher quality of food. She was concerened that the grain free foods have too much protein, hard on the kidneys, and too much fat, weight control. I have switched her over to grain free that is lower in protein and fat than most grain frees. Does anone have experience with a raw diet? Also she is on a glucosamine supplement. I've read that maybe I should not keep her on that medicine. Any comments or thoughts would be appreciated. Overwelmed and worried, want to make good decisions regarding her care. Thanks! Carolyn

[jmac]

Hi Carolyn, and welcome to you and Lucy!

Although unfortunate circumstances have brought you here, you have come to the right place. There are many caring, helpful, and knowledgeable people who are here to help you and Lucy.

Others will be stopping by shortly to help you out, but in the meantime, can you please post Lucy's abnormal test results (with the normal range)? It sounds like Lucy is showing some Cushing's symptoms. Has her drinking and urinating increased? Is she eating more or begging for food? These are usually the things owners notice first.

As far as deciding when to treat, it generally depends how strong the symptoms are. My dog was diagnosed last March after her pre-dental blood work came back abnormal. Her ALKP was very high and my vet asked about her drinking/urinating and we decided to test for Cushing's. She also has the pituitary form. She has very minimal symptoms at this point, so I am not treating her. We did try Anipryl for a few months because it has no side effects and does help some dogs with their symptoms. Hannah's ALKP level dropped significantly, but I didn't notice a major change in her already mild symptoms, so we stopped and she is now taking Denamarin, a liver supplement, to see if that will help her ALKP level.

When you use a stronger drug, you need to monitor your dog's drinking, urinating, and eating in order to know how the medication is working, so symptoms need to be strong enough for you to notice. It is nothing you have to rush into, so you have time to think things over and get educated. This site will be incredibly helpful for you and the people here will walk you through everything. While you wait for others to come along and offer advice, you can read the helpful articles on this site to learn more about Cushing's.

I'd like to welcome you again and tell you that we are here to guide you and Lucy however we can.

Julie & Hannah

[Squirt's Mom]

Hi Carolyn and welcome to you and Lucy! :)

As wrong as it may seem, your vet is correct to wait to start treatment until Lucy is showing more classic signs. What we usually see in our cush babies is an increase in water intake, increase in urination - sometimes having accidents or losing house-training -, and a huge appetite. These signs are not only important in diagnosing the condition they are critical in monitoring how well the treatment is working at a particular dose. So your vet seems to be steering you right at the moment.

If you wouldn't mind, it would help us a great deal to see the actual test results that Lucy has had done recently. Any abnormal blood work as well as the LDDS and any urinalysis done.

As for diet, cush pups are prone to pancreatitis so keeping the fat content is good but most folks recommend a little bit higher protein than usual. Grains are entirely individual - if your dog handles them well, no reason not to feed them - just don't go overboard or you'll have a chubby gal-pal. :D While carbs are not a requirement for dogs, they do have benefits for them.

Glucosamine is a good supplement for joint support. I have given it to most of my babies alone and in combination with Condroitin and/or MSM. As is always the case, it depends on the individual pup as to whether it is good for that pup or not. Why are you giving it? Have you seen any differences, positive or negative, since starting it?

Being overwhelmed, scared, nervous, pulling your hair out, gnawing your fingernails to the bone - these are all normal when we first hear the word "Cushing's". I wish I had stopped there - I went on to become a total basket case. :p But the more I learned the less afraid I was and I am sure the same will be true for you as well. Use us. Ask any questions you have and we will do our best to help you understand.

You and Lucy are not along on this most adventurous of journeys. We will walk with you every step of the way.

I'm glad you found us and look forward to learning more as time passes.

Hugs,
Leslie and the gang

[Harley PoMMom]

Hi Carolyn,

Welcome to you and Lucy! So glad you found us and we will help in any way we can.

Cushing's disease is one of the most difficult diseases to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing Cushing's and other non-adrenal illnesses share some of the same symptoms as Cushing's.

Strong symptoms are a huge part of making the diagnosis, and a Cushing's savvy vet will not initiate any treatment without strong symptoms and a proper diagnosis.

Could you post all abnormalities that were found on the test/s that were done on Lucy. How much does she weigh? Any other health issues?

You are not alone on this journey, we are all here to support you and your sweet Lucy. Please feel free to ask any and all questions.

Love and hugs,
Lori

[marie adams]

Hi Carolyn,

Welcome to you and Lucy!!:)

It looks like the experts have already started giving you advice. You are in good hands here so please ask as many questions as you have.
If the experts don't know they will research until they find it.

Take care!!!:)

[Cyn719]

Carolyn and Lucy

Welcome and ditto to what Marie said:)

Hang in there. You will get the answers you need.

Hugs xo

[cspurcell]

Thank you everyone for the warm welcome. Spoke with Lucy's vet yesterday and confirmed our decision to hold off on treatment. My main concern as of now is her diet and also the mild rear leg tremors. She has them maybe once a week, but it doesn't keep her from wanting to go on her walk or jumping up on the bed and going up and down the stairs. Someone on the thread asked about her blood work. December of 2010 her Alk Phos was 571, however that vet didn't mention cushings. I guess because I didn't realize mild symptoms at that time or she just wasn't presenting enough for me to notice. At that time her thyroid was low and we began solaxdine? and that brought her thyroid number back up to normal. She is still on that med. Her yearly check up in December of 2011 Alk Phos was 1557 so we did the cushings test b/c that vet mentioned it me. Rest of her blood work was in normal ranges. As far as the cosequin supplement, we put her on it a year and half ago b/c we noticed some stiffness (mild) in getting up stairs, etc. I'm considering a raw diet. Any thoughts? Also, Lucy's weight Dec. 2010 -30 lbs, August 2011- 26lbs, December 2011- 30 lbs (had changed her diet and I think I was over feeding her) Today's weight is 28 lbs.
Carolyn and Lucy.:)

[jmac]

Hi Carolyn,

Lucy sounds a bit like my Hannah, with the exception of the thyroid issue. Hannah's yearly blood work showed her Alk Phos to be about 1770 and that is when my vet asked about Cushing's symptoms. Everything was normal on Hannah the year before. She had mild symptoms, which is why we tried Anipryl first. She only weighs 12 lbs. so it wasn't too expensive to try out. It did bring her ALKP down to 300 over a period of about 4 months. Since we didn't see any other big changes, we took her off to see how she did. She is about the same symptom wise, but her ALKP is back up to about 800 so we are trying Denamarin, a liver supplement to see if that helps. That is something you might want to consider. I don't have any information on a raw diet, as Hannah is on a Rx diet for crystals in her urine.

Keep us posted on how Lucy is doing!

Julie & Hannah

[addy]

Hi Carolyn,

My Zoe is on a raw diet, started out with one because of her colitis/IBD. I add tablespoons of Honest Kitchen Embark and Zeal to her turkey patties. Whether or not that is the best way to go I can't say. Zoe's diet is high in fat which is a concern to me. You may want to consider the fat content in the raw diet you consider. I just can't switch foods easily with Zoe. If I had my druthers for my dog, I would be decreasing her raw and increasing her Honest Kitchen. Seems like every time we get to that point something crops up to stop it.:rolleyes:

For my dog, I prefer a minimally processed food.

This probably doesn't help you much, just thought I would mention fat and raw diets. Cush pups are proned to pancreatitis. Some people swear by raw, some hate it, I'm neutral:D;)

hugs,
addy

[marie adams]

Hi Carolyn,

My Maddie had the leg shakes along with the panting that first concerned me, but the vet said she was just getting old--no mention of Cushings--I look back now and it was because she didn't really know anything about it. This went on for about 6 months then Maddie started losing her underfur and then regular fur, but it all was in certain areas. She still continued to function, but really slowed down in her energy--she was use to running miles every day with my husband on his bike.

I finally found a link to Cushings and I knew that is what she had because her appetite and many other symptoms made sense. Once I put her on Lysodren she improved, but never got back her muscle in her hind legs or her energy--she was 11 yrs old at this time.

I started her on a no grain raw diet from Northwest Naturals--I used the chicken flavor. Down the line I started giving her some dry food also from California Naturals--No Grain Venison. She did fine on this, but she never had issues with food. She was always very healthy. I added fish oil, vit c, the joint meds, and flaxseed oil.

I wish I could have started her sooner on the meds and I would have if I knew she had Cushings. It might have helped with her hind leg muscle atrophy, but who knows....every dog is different.

I came to this site when I first started with her meds. They all helped me get through with their knowledge. It also helps if you have a vet who knows quite a bit about Cushings.

Take care!!!

[cspurcell]

I live north of Atlanta and was wondering if maybe I should try to find a specialist that deals with Cushings, if there is such a thing. My vet seems knowledgeable about Cushings, but maybe we could find someone with a little more experience. Our current vet says she has had experience with Cushings. Has anyone taken theirs to a specialist? I wonder how you would go about finding one. I think in a big city like Atlanta they would probably have one. I also want to post Lucy's Low dose dex test results. This is the only test my vet has given. Her cortisol sample resting was 11.9, 4 hours 3.8, and 8 hours 1.8. Vet feels like it's definetly pituitary kind of cushings. I have noticed the past few days her back legs seemed more bowed out when she sits especially when she's on a hard wood floor. Not sure if that means anything. I think I am going to make an appointment just for our vet to look at her and to think if she notices anything. It's been a month since the vet has seen her. Any thoughts are comments would be greatly appreciated. Thanks so much! Lucy and Carolyn

[labblab]

Hi Carolyn,

Yes, there are internal medicine specialists in the Atlanta metro area who ought to be familiar with Cushing's. Here is a listing of specialists throughout the state of Georgia:

http://www.acvim.org/websites/acvim/index.php?p=228

My own Cushpup was diagnosed and treated by Dr. Dorfman at Georgia Veterinary Specialists. Their offices are located in the Sandy Springs area just north of the I-285 perimeter highway. I see there are also a couple of specialists located farther north in Marietta and Alpharetta. Often, speciality clinics require that dogs be referred to them by general practice vets -- owners can't just call up directly for an initial appointment. But if you are interested in having Lucy seen by a specialist, I would hope that your own vet would help you set up an appointment.

Do you know what the "normal" reference range was for Lucy's LDDS test? Usually it is something around 1.4 ug/dl -- meaning that if the 8-hour result is higher than that, it is consistent with Cushing's. If that was the normal cut-off for Lucy's test, then her results are indeed consistent with pituitary Cushing's (since both the 4-hour and 8-hours results were less than 50% of the baseline value). But her baseline value was very high, which suggests that she may have been very stressed at the time of the test.

If you have questions or worries about Lucy's situation, it can be very helpful to seek a consultation with a specialist. Although their charges may be somewhat higher to begin with, overall you may end up saving money down the road by making sure that any further testing or treatment decisions are really necessary and/or appropriate.

Marianne

[lvasilio]

Dear Carolyn and Lucy,
I am a "newby" to this as well, having just had my Jake diagnosed in early January. I spent days reading posts and learning so much from our esteemed members. You couldn't have found a better place to learn and share.
Jake is not fully controlled yet but because of all the info provided here he is getting excellent care. I challenge the vet all the time. Jake had all the symptoms for months but I was chalking a lot up to other reasons until he had routine blood work. Diet is very important. I changed Jake's diet because of all I learned from out members and it has made a huge difference with stomach issues he had been having for months. He is now on a combo of Blue Buffalo fish and sweet potato, moist and dry, and it has helped tremendously. I also subscribe to Whole Dog Journal and they are the tops for analyzing moist, dry and raw diets. Please consider subscribing to that. You can get an on line version. They have just completed a new study on dog food. It has everything you need to know.