My girl Ruby

[celticlass69]

Hi; just joined.
My girl Ruby is a treasure, she was a helper dog for a mentally challanged girl who unfortunately didn't treat her well as a result we adopted her. She loves to do anything we do, including going out on our boat fishing. She is a mixed breed of Aussie cattle dog, Lab and Corgi. She has had hypothryoidism for at least 4 years now, she is 12. She was a bit overweight when we got her but we got her weight down with medication, regular exercise and rx food.
Last August, she hurt her left back leg getting into our truck. It turned out that she had a cruciate ligament injury but that her muscles in that leg were at least 50% of her waisted. It was then that we found out about cushings. Unfortunately, it didn't end there.
Now we are faced with palliative care due to her liver failure. She has started to have skin, hair loss which we are managing. She is quite happy still, enjoys all that she can. For now, we are treating her pain with medication, twice a week unless more is needed. When her quality is no longer we will help her on her way. I'm glad I found this forum as I know this will get hard.

[labblab]

Welcome to you and your Ruby!

She sounds like a dear girl who has more than earned some joy in her retirement years :o. Bless you for adopting her!

Can you tell us some more about the testing that led to the Cushing's diagnosis? Also, has your vet spoken with you about medication treatment options for Cushing's?

You mention that Ruby is experiencing liver failure, and I am wondering whether this may be influencing your decision whether or not to treat the Cushing's? One thing I can tell you is that it is not at all uncommon for Cushpups to have very elevated liver enzyme readings, but this does not mean that their livers are actually failing. Once effective treatment is started, the liver values can improve or even resolve for many dogs. Or at a minimum, not advance any further or get any worse.

It will help us a great deal if you can tell us more about Ruby's test results (exact numbers would be wonderful!). We have many senior dogs who are being treated quite successfully for their Cushing's, so it may be the case that there are more options available for Ruby than you are currently aware of.

Once again, welcome, and I look forward to learning more about your special girl.
Marianne

[Squirt's Mom]

Hi and welcome to you and Ruby! :)

I saw your baby's name and had to come read about her...I had a Ruby, too. ;)

Thank you for taking Ruby into your home and hearts, giving her the love and care she deserves. I have no doubt that she knows how much she is loved.

Fair warning - we will bombard you with questions at first but that's just so we can get a better idea of what is going on and be able to give you more meaningful feedback.

How was the liver failure diagnosed? Would you mind posting those test results? Does your vet feel it is related to the Cushing's or a separate issue? The liver is often impacted by the excess cortisol but once the cortisol is under better control, the liver will heal itself to a degree. Have you discussed treating the Cushing's?

Would you mind posting the test results that she had to diagnose the Cushing's? Include the units of measurement (ug/dl, mnol/L, etc) and the normal range for each value. On her lab work, all we need to see are the abnormal values - too high or too low - but all the info they gave you on the cush tests, we would like to see...including any ultrasound reports.

What meds, supplements, and/or herbs is Ruby taking now?

How much does she weigh?

What signs are you seeing other than the skin? Changes in water intake, urination, appetite, energy level, sleep patterns, moods?

Had enough questions yet? :p Ok, enough from me....for now. ;)

I want you to know that you and Ruby will not walk your path alone. Regardless of why you are here, you both are now part of our family and this family stands by each other through thick and thin. We will be here to answer what questions we can, help you learn as much as we can - and perhaps learn from you, to listen, to hold your hand. We will walk every step of the way by your side. All you ever have to do is holler - and someone will be here.

Hugs,
Leslie and the gang

[marie adams]

Welcome to you and Ruby,:)

As Leslie said you are now part of the family. There is so much experience and knowledge here to help you. You are definitely in good hands. :)

Take care!!! :)

[Cyn719]

Welcome the the forum:):):)

So sorry for Rubys problems but I know you will be comfy with all the members here........they are fantastic!! Yup they will drill you:D but believe me all that drilling gets the job done! Because of this forum my Penny is still with me today!! That's why we call ourselves Cush Angels!:)

Hugs xoxoxo

[celticlass69]

Hi; new to the forum, tried to start thread yesterday but unsuccessful.
We are the proud family of our girl Ruby. Ruby was a helper dog for a mentally challanged girl. Unfortunately, she was unable to take proper care of Ruby. So we were fortunate to be able to adopt her. She is a mixed breed of Aussie Cattle Dog (red heeler), Labrador, Corgi. She is a very energetic 14 years old. She had a preexisting Hypothyroid that with proper testing, medication and diet we've been able to get within a good level and have reduced her weight.
Last August, she hurt her back left leg getting into our pickup truck. She loves doing everything with us, including going out on our boat fishing. Well, when we took her to the vet we found out that approximately 50% of her muscle mass was gone and that she had very seriously injured her cruciate ligaments. After testing to make sure she could handle the pain medication we found out that her liver is failing.
Our vet informed us of Cushing's disease (syndrome) and the implications and prognosis for her. Due to her advanced age we are opting to give her palliative care, making the most of the time she has left. Unless we told you you wouldn't know she was ill. She loves to play and appears quite happy.
In the last 3 weeks she has started having skin problems, hair loss on her back just above the hips. This area is getting bigger. We've done test to make sure that this is not due to other conditions, ie. fungal, parasitic, etc. So we're again treating the symptoms.
I am a palliative care worker and know what may lay in store for us. We've decided that when the more severe symptoms appear we will euthanize her. I hope that we may get her out on the boat one last time before that. A better friend, dog, you could never ask for.
I'm so glad I found this forum. I will keep updating Ruby's condition.

[Altira]

Our Kira had Cushing's too. She had to have both knees reconstructed. Well she didn't have to. I was just lucky enough to be able to do this for her. We learned later that Cushings likely messed up her knees.

I'm so sorry you are dealing with this most distressing time in your dogs life.

[mytil]

Hi and welcome to you and Ruby. I am sorry she is having these problems.

I have a few questions just to get a better picture. Is she still having pain or mobility problems from her injury and on any pain medication still? Your vet mentioned the possibility of Cushing's, but were any tests performed to verify this? And is she on any medication to support her liver? Here is a link that provides more information http://www.k9cushings.com/forum/showthread.php?t=192

There are other conditions that mimic Cushing's symptoms and am wondering if additional testing was done to eliminate these - i.e. thyroid issues, diabetes?

Keep us posted
Terry

[labblab]

Hello again!

As you'll see, you actually WERE successful in starting a new thread yesterday and you received several replies. I'm guessing, however, that your membership had not yet been officially approved at the time you first typed out your post, and therefore your post was not immediately visible on the forum. But both that first post and also your membership have been approved, so from now on, everything you write will be immediately visible to you and everybody else. :)

Please do look back through the replies you received yesterday.

Once again, welcome to you and to Ruby!
Marianne

[celticlass69]

Thank you all so very much for your replies. I am so glad I found this forum. I am looking forward to reading and responding with mine and other participants threads.
News on Ruby, it has been confirmed with blood tests, xrays and intense examination that she does indeed have cushings. Combined with her hypothyrodism, and age we have decided to treat her palliatively.
So far, we are keeping her pain under control .. both back legs have extensive muscle waisting. The area of skin on her back has increased in size to 3" by 4" egg shaped. We are cleaning this daily and applying polysporin .. there appears to be some fine hairs growing back in the origional hairless area. She is continously hungry and thirsty. We are limiting her food as we don't want to get too heavy due to the back legs issues.
She is very happy otherwise. And has been an excellent companion/friend/family member. When she starts showing the end signs of the inevitable liver failure then we will help her leave this world and wait for us on the other side of the rainbow bridge.

The Rainbow Bridge
Just this side of heaven is a place called Rainbow Bridge.
When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable.
All the animals who had been ill and old are restored to health and vigor. Those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by. The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.
They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent. His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.
You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.
Then you cross Rainbow Bridge together....
Author unknown...

[Squirt's Mom]

Hi,

Good to hear from you again.

I'm not sure what your vet told you about prognoses with Cushing's, but if you were told it was 2 years with or without treatment, that is simply wrong - yet what many vets are still taught in school.

At Ruby's age, with the correct treatment, she can live out her full life span and beyond. If memory serves, the pup we have had here live the longest after diagnosis was 12 years. Many, many pups here, and elsewhere, have burst that 2-year myth. ;)

If you are choosing simply not to treat, that is, of course, your decision. But I want to make it clear to you that Ruby does have other options that could vastly improve the quality, as well as quantity, of her life. Her age is not really a factor as that is about when most cush pups develop Cushing's, ie, she is not too old for treatment. The skin issues and leg weakness you are seeing are probably directly tied to the excess cortisol in her system and with treatment, these can improve for her. Treatment can give you back your baby, and can give Ruby back her active life.

Rarely is treatment as harsh as the damage the cortisol does to them without treatment.

All too often we have seen a vet tell a parent the "2-year myth", crushing their hope, not out of malice or apathy, but out of ignorance because that is what their texts tell them and they don't have the personal experience to refute it. I just don't want Ruby robbed of her chance based on misinformation.

We will do our best to help Ruby, and you, regardless of what you decide to do, or not do. But I couldn't sit here, quiet, and not let you know that treatment truly can help Ruby.

Hugs,
Leslie and the gang


**Just FYI, some links from our Helpful Resource Section** -

"About that "2-year" prognosis" -
http://www.k9cushings.com/forum/showthread.php?t=186

"Medical complications associated with untreated Cushings Disease" -
http://www.k9cushings.com/forum/showthread.php?t=195

[lulusmom]

Hi and a belated welcome to the forum.

I have two dogs with cushing's, one diagnosed 7 years ago and the other 4 years ago and both are doing well on treatment and have a very good quality of life. One was also diagnosed with hypothyroidism and the other diabetes insipidus. Your description of Ruby's appearance, being a happy dog, who you would never know was sick, is the norm for dogs with cushing's but left untreated that will change at some point down the road. Even dogs with very advanced cushing's, like my Jojo can, see an amazing turn around with treatment.

You mention liver failure, which is not normal with cushing's, so was wondering if you can please share details as to how your vet diagnosed it. Dogs with cushing's have a very distinct liver enzyme pattern with moderate to severe ALKP and mild elevation in ALT. If a dog is in liver failure, the ALT, being a liver specific enzyme, is much higher. Dogs in liver failure have usually lost a good deal of liver function at the time of diagnosis and are usually pretty sick. Dogs with cushing's don't really have a loss of liver function per se, but rather an over accumulation of glucogen, which doesn't kill off liver cells and can be reversed with treatment. Is Ruby currently taking liver support and did your vet give you any diet restrictions?

It would be very helpful if you could please post the results of the blood chemistry, complete blood count and the results of the actual diagnostic tests such as the acth stimulation test, low dose dexamethasone and ultrasound findings?

As Leslie said, we're here to help you and Ruby in any way we can and the more information you can provide us, the better.

Glynda

[labblab]

I hope you won't feel as though we are "double-teaming" you, but I also had wanted to add just one more reply, as did Leslie :o. She just beat me to the punch! :)

Since you are a palliative care worker, you have first-hand experience with the issues, questions, and emotions involved with end-of-life care and treatment decisions. I would never presume that any one of us here knows better than you when it comes to the most humane path for Ruby. But like Leslie, I just want to make sure that you are basing your decision on the most accurate info possible.

So I just have a couple of things to add. First, it may be the case that Ruby's hypothyroidism is a "primary" condition it it's own right. But for many Cushing's dogs, hypothyroidism is actually secondary to the endocrinological imbalances caused by the disease. Once the Cushing's is treated effectively, the dog's thyroid values also return to normal. My own dog was diagnosed with hypothyroidism at least a year prior to his Cushing's diagnosis, even though in retrospect we believe he was probably also Cushinoid at that same time.

And secondly, I want to stress again that actual liver failure is not an inevitable result of Cushing's. Elevated liver enzymes do not necessarily signal irreversable damage. So it may end up being some other consequence of Cushing's that forces your end-of-life-decision on her behalf. Just so you'll be forewarned, it may just be her overall increasing degree of discomfort from such things as loss of mobility and constant panting/thirst/urination/hunger. My own boy was so obviously miserable prior to starting treatment that we would not have allowed him to continue much longer in that way.

Again, I know you love Ruby dearly and I am not trying to twist your arm into treatment if you don't think it is in her best interest. But for the benefit of our other readers, I just wanted to add these additional thoughts for their consideration in making treatment decisions for their own dogs.

Marianne

[celticlass69]

The most recent test results indicate her liver is getting worse. All in all Ruby is holding her own. Her skin condition had been improving but now is again worsening. I'm having to look for something to cover her lower back as she has 3 new lesions. Does anyone have any ideas? She is very good while I take care of these areas ... of course a sweet potato chew helps :) . Her back legs are bothering her more. However, we have to try and limit her anti inflammatory pain killer as it is hard on her liver. She still enjoys eating, playing and generally being a loving, happy companion. I truly hope that she can one more time enjoy going to the trailer and fishing. She just loves car and boat rides.

[Squirt's Mom]

Hi,

Just popping in to see how our sweet Ruby girl is doing. Would love an update when you get a chance.

Hugs,
Leslie and the gang

[celticlass69]

Morning everyone,
Ruby just finished her dried sweet potatoe treat. This is her reward for my daily treatment of her skin. I've been having very good luck with the following regime; I examine her skin visually and by touch, I cut the hair short in the affected areas, I then clean the areas with peroxide, I finish off with polysporin complete (it has a topical pain killer). A few weeks ago the areas were from 2" to 3". Now they are about the size of a dime. I just ordered some shirts for her to protect her exposed skin from the sun.
She is doing pretty good. The odd days were her legs are more painful and her appetite is off but all in all quite good. We go to the vets on April 20th to see if she can handle the heartworm medication this year. I'll have to inquire about her Rabies and Parvo shots as well. Also, she has some sore areas around her nose .. I'm not sure if this is liver related or not.
Will update when find out. Till then take care.