New case here (Ginger) 7-8 y/o Beagle

[Terria0]

Hi all,
I suspect I may be visiting often for advice and information. My name is Terri and I have two beagles, Fred Astaire and Ginger. I adopted both in 2007, when they were about 2-3 years old. I'm not unfamiliar with these forums, as I did extensive research via a similar site when Fred Astaire had seizures. They are controlled (knock on wood) with phono and Potassium bromide combo. Now, Ginger has been newly diagnosed with Cushings. She is the sweetest little thing and it's killing me. She acts just fine, looks just fine, except where they shaved her for the ultra sound. When I returned from a vacation, she was urinating in the house and drinking a lot of water. At first, I thought it was a behavioral issue, but after a week, I decided I would rule out a bladder infection. I had never heard of Cushings before, and they did several tests before they were really sure that is what we're dealing with. We are going to start treatments with Trilostane about 20 mg. They think she does have a "low grade" or just the beginning stages of it. The vet does not see this very often and has consulted with many others, including the radiologists. Only one adrenal gland was slightly swollen, didn't notice any tumors. She weights just under 24 lbs. Right now I have plastic protectors on my carpets for her accidents, since she wiggles right out of diapers, my little escape artist. Right now we are waiting on the meds, the vet I see doesn't keep those on the shelf since it's so rare for them. Just wanted to introduce myself and my family here. I will look forward to advice, information, experience and well...support from you all. THANKS for being here!

[Harley PoMMom]

Hi and welcome to you and your sweet furbabies!

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

Other possibilites for increased drinking and urinating can be diabetes and other medications. Phenobarbital will cause excessive drinking/urinating in a dog. Also it will elevate the liver enzymes.

Could you get copies of all tests that were done and post any abnormalities here, the more we know about Ginger the better our feedback will be. Is Ginger taking any other herbs/supplements/medicines? How much does she weigh?

Here is a handy link with info about Trilostane/Vetoryl: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

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

Love and hugs,
Lori

[Roxee's Dad]

Hi and welcome to you and your fur babies :)

I would recommend that you become familiar with the Trilostane treatment protocols and I am sure you will see Ginger urination and drinking problems back to normal.:)

Does she have any other symptoms, like a ravenous appetite? or any hair thinning?

[Cyn719]

Hi and welcome to the forum. Sorry or the reason you are here but you will receive so much information on this forum. These members are great and will be here for you. Hang in there. It's a lot to absorb but we will get you through it:)

Hugs

[addy]

Hi and Welcome from me and my Zoe,

You will find knowledge and support here, it is a great place to come to.

I just have to tell you I love your pup's names:):):):)

Zoe started Trilostane last June and did very well until November when she started with what we think is airborne allergies.

Read as much as you can about Trilostane . It really helps.

hugs,
addy

[Terria0]

Hi all,

Thank you much for the welcomes! To answer more questions, Lori...I will post her irregular levels as soon as the vet calls back with them.

I can't take full credit...they were named when I got them, I just didn't change 'em! I like them, too. They were a breeder surrender pair. And according to the records I got from the first shelter they were placed, she was "spayed with pups." :(

She weighs about 23.6 pounds. She is approximately 7 or 8 years old. And...she IS a beagle, so she is always telling me she's hungry, but yes, she eats MUCH faster than Fred and does seem ravenous. Fortunately, she has no hair thinning. She definitely doesn't have diabetes, same question I asked, and she is not on any meds, herbs or supplements except heart worm preventative. We just changed them to Trifexis from Interceptor, but the symptoms started just before I did that, thus the two are not connected.

FRED is the one on phenobarb, so that is not what is causing HER issues. She drinks FAR more than he does, however.

[Harley PoMMom]

Oh Bless your heart for giving Fred Astaire and Ginger a forever home!





FRED is the one on phenobarb, so that is not what is causing HER issues. She drinks FAR more than he does, however.

I didn't know if you were aware that some medications such as pheno and the synthetic corticosteroids such as prednisone or dexamethasone will cause Cushing like symptoms.

Looking forward to seeing those test results!

Love and hugs,
Lori

[lvasilio]

Welcome to you and Ginger
I am relatively new to this site as Jake was just diagnosed in January. This is a wonderful resource for anyone just learning about Cushings.
It is well worth getting physical copies of all the test results to have on hand should you need to consult them on a weekend or an emergency situation. You may never need them but you also don't want to have to retest because you don't have them. It was one of the many pieces of advice I got from our members that makes so much sense. The chances are you will be consulting them on a regular basis.
Also diet is very important. I changed Jake's diet from what I learned here and it has made a huge difference.
Good luck on this journey. The best thing is you are never alone when you know you can turn to the loving, caring Cush found parents here.
Lesley and Jake

[Terria0]

Thanks, Lesley and Jake. Diet...I'll look at that. I had changed them to holistic food before, but not too long after that when I did is when Fred had his first seizure, so I switched them back to the other stuff, as recommended by the vet. So I will see what others are saying here.

Lori, they are mailing me copies of all the test results, stay tuned!

Terri

[jmac]

Hello-
I just wanted to give you and Ginger (and Fred) a belated welcome to the site! You have found a wonderful place and we will help support you and Ginger on your Cushing's journey. It sounds like you already got some good advice (I definitely recommend getting copies of EVERY test for yourself!) to get you started. Please keep us updated and don't hesitate to ask questions. We are here to help!

Julie & Hannah

[marie adams]

Hi Terri,

Welcome to you along with Ginger & Fred Astaire. Love those names also!! :)

The experts have already started helping. Please ask all the questions you can think of and there will be answers or researched to get the answers.

My Maddie had been on Lysodren and it worked well for her.

Take care!!! :)

[Terria0]

Update: Her meds are at the vet, so I go in tomorrow at 5 to talk to him and pick them up. I haven't gotten the copies of the test results in the mail yet, so I'll have them copy them when I'm there.

I so appreciate all the welcomes!! If there's a way to sort this via dogs ages, I'd be interested in seeing how the younger ones are doing on the meds and the reactions I should be watching. I will be glad to get the plastic off the carpets, too...but it's helped me. And to sleep through the night without getting up every hour or two to let my girl out...ohhhhh will that be a beauty. But until then...we do what we must, right!?!

Thanks, again, all!! I'm telling the vet's office about the site, also. (I have, but will tell him directly. I think he'd be interested.)

[Cyn719]

Hope the meds work well. Hope you get some sleep soon. I know we do what we have or our babies!!!

Hugs xoxo

[lulusmom]

Hi Terri,

I have two cushdogs and the first one diagnosed was only three years old and we suspect she went undiagnosed for at least a year because our gp vet couldn't spell cushing's, much less have a clue about it's symptoms. That was almost seven years ago. My second was a shelter rescue so I'm not really sure how old he was but he was diagnosed back in 2007. He's always been a grumpy old guy so if I were to guess his age, I'd say about 110 years old. :D:p:D The transformation with treatment was amazing for both my dogs so I predict that you have some much needed uninterrupted sleep in your immediate future.

Glynda

[Terria0]

Here are the test results for my ~7 year old Ginger. She's starting the Trilostane Oral 20 Mg tomorrow morning (she is 24 lbs) with breakfast and we'll do a follow up ATCH in 2 weeks:
First test was 1/10 and was a Urine Microalbuminuria. It was >30 High, reference range <2.5.
Specific Gravity: 1.007 (Low) Range 1.015-1.050
pH 8.0 (High) Range 5.5-7.0
Protein 3+ (High) Negative
Occult Blood 1+ (High) Negative

On 1/11, she received a CBC. Off-balance were:
WBC 17 (High) Range 4.0-15.5
Neutrophils (High) 15130 89% Range 2060-10600
Lymphocytes (Low) 680 4% Range 690-4500
Monocytes (High) 1190 7% Range 0-840
ALT (SGPT) is 158 (High) Range 12-118
Alk Phosphatase 178 (High) Range 5-131

On 1/14, she had a Cortisol Serial 2 (Dex)
Sample 1: 4.4 Ref Range: 1.0-5.0
Sample 2: 7.8 (High) Ref Range: 0.0-1.4
Sample 3: 4.5 (High) " " " "

On 1/31, she had an ultra sound:
Enlargement of right adrenal gland (measured .77 cm in width) Normal is <.7 cm. Left glad also approached upper limit of normal and measured 0.68 cm in width. Corticomedullary delineation is preserved within each kidney. Increased echogenicity of right renal crest was evident. The relative echogenicity of the renal cortices was within normal limits. A medullary rum sign was evident within each kidney. A small amount of floating echogenic particles were evident within the urinary bladder. The internal architecture and relative echogenicity of the liver was within normal limits. There is a clear visualization of small hepatic and portal venous vascular structures. The contour of the liver is smooth. A small amount of gravity dependent echogenic bile was evident within the gallbladder. No lesions involving pancreas, gastrointestinal tract, spleen or intra-adominal lymph nodes.
IMPRESSION: Primary differential for the presenting clinical complaint in light of the ultrasonographic appearance of the adrenal glands would be pituitary dependent hyperadrenocorticism.
COMMENTS: There is asymmetric cortical hypertrophy of the adrenal glands, however with the lab testing in this patient, emerging pituitary dependent hyperadrenocoricism would be my primary differential concern.

They recommended doing another urine test under stress-free situation, nothing stressful for a week, no car rides and collection of urine at home. Results on 2/6/2012:
Urinary Cortisol/Creatinine Ratio: 196

Hopefully in 2 weeks, the vet seemed pretty confident levels will be much better. (Fingers crossed!!)

Again: She has no blaring symptoms other than urination all the time...and every 1.5 hours in the night...sleep will feel great again! She does act starving...but she's a BEAGLE! ;) Fortunately, no thin skin or hair, except where they shaved her for the ultra sound sorta looks like a mow hawk. But it's growing back. She's freckled under her fur, too! Haha.

Reminder: We're doing oral version until we get the right dosage, then can order pills accordingly. They felt it would be easier to adjust dosage and for her since they don't make 20 mg pills anymore.

Hoping for the best...bracing for enemies...

[Harley PoMMom]

Was the urine sample performed via free catch or cystocentesis? The reason I am asking is because blood was found in the sample, which concerns me as this can mean an UTI is brewing unless the cystocentesis was performed, then a small amount of blood is usually present.

[Terria0]

Hi Harley PoMMom,

I know the one I did was free catch, and believe the first one (they did) was also, but not for sure. According to the write up that is in comments on the results page, it stated it was likely due to systematic disease due to the 3 or more positive results. I know if the 2nd urine test had shown normal or even "more normal" creatine levels, they would have tested for infection vs. cushings. But he talked to many specialists, and due to the results, they all agreed that was not likely. I can have them run another urine analysis when I take her in for the ATCH in 2 weeks if you think that would be prudent...?? I know I took her in to begin with for urinary tract infection. That's how we wound up here...

[Harley PoMMom]

With an elevated WBC and blood in the urine, if it were me, I would want an UTI ruled out. And although an UTI may increase creatinine levels, that always does not happen. Usually the symptoms of an UTI are blood in the urine, straining to urinate, and or drinking/urinating more.

An Urine culture and sensitivity test is the best way to diagnose exactly what bacteria is causing an UTI.

[Terria0]

Update: The vet said the blood in the urine is another indicative of cushings, along with the other levels. Or rather, due to the cushings...

[Terria0]

We are on day 3 of meds...still up several times a night. I figure it may take a couple weeks to kick in??

[Cyn719]

Terri
Hang in there. It takes time to kick in.

With Penny it did take a week or so.

Hugs xoxo

[lvasilio]

Hi Terri.
Jake took about a week to stop getting me up in the night. It took me a couple of nights before I realized we hadn't gotten up. Since I also adjusted his food we did get up a couple of other times but it's smooth sailing now. Good luck. A full night's sleep is just ahead!
Lesley and jake

[Barton]

Hello
Just a quick hello and welcome. As had been said before Cushing's is very difficult to pin down because of all the symptoms which could also be something else. It sounds from your post that your dog has adrenal gland Cushing's. My dog was also diagnosed with early stages of Cushing's. The ultra sound showed an enlarged adrenal gland with tumors and the subsequent LDST confirmed Cushing's. In my dog's case surgery was an option. Was there any information related to you regarding the possibility of surgery to take care of the Cushing's?

My very limited understanding of this disease is that an adrenalectomy is about the only true cure for Cushing's and unfortunately not many pets are able to have the surgery. However others on this site will know way more than I so please defer to there knowledge over my limited experience.

[Terria0]

Thanks for the encouragement, all! I had today off, so slept in...well, it's down to more like every 2 hours at night. No accidents of late (knock wood). Sounds like by Thursday, we're 1/2 way there!! Fingers crossed.

The vet and myself were hoping it would be as "easy" as adrenal gland cushings and surgery. The ultra sound just showed slight enlargement of one, but no tumors, etc. I believe they are going under the assumption of pituitary actually since nothing stood out there. I was also hoping that we could do the surgery and be done with it. Was not meant to be in our case. :(

I appreciate the timelines for improvement from your experiences!! THANK YOU ALL!