Nike, 8 y/o Lab - Confirmed diagnosis?

[nikethelab]

My 8 years old lab was diagnosed with cushings disease. She just had ACTH Stim Test done by the vet shich was done in the office and not sent out. I also had an ultra sound out to rule out the adrenal one than can be operated on.The medication has such severe side effects I am scared to oput my dog on them until Im definitely sure she has cushings disease?

[labblab]

Hello and welcome! I had noticed your reply posted on another member's thread and have taken the liberty of moving it so as to begin a new thread for you and Nike. This way, it will be easier for our members to reply to you directly.

I am sorry for the reasons that are prompting you to research Cushing's, but I am very glad you have joined us here!

Marianne

[frijole]

Hi there and welcome! First off you are wise to do a series of tests in order to be sure it is in fact cushings because it can be hard to diagnose and there are false positives on the acth test. Please get and post the results of the tests that were done so we can better help you.

You made a comment about the drugs having serious side effects and I wanted to hopefully calm your fears. Certainly you don't want to give drugs to a non-cush dog (that happened to me) but keep in mind that there are instructions and tests done along the way to prevent anything bad from happening. The key is to get up to speed on the disease and the drugs and so you can be your dog's advocate thru the treatment.

Also it is important that the vet treating the disease is following protocol for use of the drug and that the diagnosis is solid. You are off to a great start by finding us.

Ask questions - you aren't alone. My dog Haley was successfully treated for cushings for over 4 years and she passed at the age of 16 1/2 non-related to her cushings. So your dog can live a normal happy life ok? Kim

[nikethelab]

Thank you one thing that is unusual is my dog does not have an elevated liver level. That is one reason I was concerned if it was definitely cushings disease. What kind of test is done to find out if its the atypical type. I was told there is an eight hour test. Also I read somewhere that University of Tennesse has a test they run that no one else does. Has anyone heard of this?

[addy]

I am scared to put my dog on them until Im definitely sure she has cushings disease

Hi and welcome from me as well. I understand that feeling totally. I was in denial for a year. Cushings is a hard disease to diagnosis and symptoms and history play such a big part of the diagnosis. Strong symptoms are a reason to start treatment once you are confident of the diagnosis. The drugs used are scary but in the hands of an experienced vet they help our dogs so much.

Could you tell us the results of the ACTH test? Was the ultra sound done at a specialty clinic? What symptoms does your pup have? For how long? Does your pup have any other health issues? Who diagnosed your pup? What drug was recommended and how much? What does your dog weigh?

Now that I bombarded you with 20 questions, don't run away.;) Others will be along soon to say hi.

hugs,
addy

[lulusmom]

Hi and welcome to you and Nike.

I too am sorry for the reasons that brought you here but I'm glad you found us.

It would be very helpful if you could get copies of the acth stimulation test results and the ultrasound findings and post them here? Your vet probably also did a blood chemistry, cbc and urinalysis. We would be very interested in seeing the results of those too. Just the abnormal values, with normal reference ranges is fine.

What lead you and your vet to suspect and pursue a cushing's diagnosis? Does Nike have the common symptoms associated with cushing's such as excessiving drinking and peeing, voracious appetite, panting, loss of or thinning coat, skin issues and/or muscle wasting? Is she on any current medications?

A good number of our members come here scared to death of the drugs used to treat cushing's. I assure you that it is perfectly normal to be afraid at this stage of the game. We've all been there and most of us have learned through experience and education that our fears were unfounded. In our experience, the primary cause of adverse reactions to the drugs is an inexperienced and uneducated vet who does not follow dosing or monitoring protocol. This becomes an even bigger problem if an uneducated pet owner places blind faith in an inexperienced vet. The fact that your vet did an acth stim test in office would indicate that s/he has experience and probably treats a lot of dogs with cushing's. These snap test machines are quite expensive and very few vets have them.

Looking forward to hearing more about your precious Nike.

Glynda

P.S. I see that Kim and Addy posted while I was typing. Slow here. I'm sorry for any duplication.

[nikethelab]

Nikki used to weigh 90 pounds . About Christmas time Nike started to put on weight . She now weighs 113 pounds. The vet tested her thyroid and thought it was thyroid. He put her on Soloxine. Half of a 1.0 mg tablet a day. Then we took her back and she lost two pounds but he increased her thyroid to 1.0 mg a day. Then she did not lose weight.She still did not lose weight so he tested her for Cushings. Her symptoms are she is drinking a lot of water, urinating a lot, she has always had a big appetite, kind of a ponch on her belly. She started not being able to jump on the bed several months ago but we thought it was her weight gain.She was panting some but it has stopped.She is not losing any fur but her fur isnt as shiny. She doesn't seem quite as active.Her bowel is a bit runny too sometimes.

[lulusmom]

The excess cortisol in dogs with cushing's can lower thyroid hormones but this is a temporary problem which resolves once a dog has stabilized on an effective cushing's treatment. This transient effect on the T3 and T4 hormones is called sick euthyroid syndrome. Usually there are other blood abnormalities as well, such as liver enzymes ALKP and ALT and cholesterol. It will be helpful to see the results of all of the testing that has been done so far. Did your vet do a full thryoid panel?

[marie adams]

Welcome to you and Nike! :)

I know the feeling of not wanting to put your dog on the drugs--I was looking for any way that I could but that way. I remember telling the vet she had Cushing's and they tried to tell me she didn't. I pointed out her thinning coat (no under fur and bald spots). She had all the symptoms Nike has. When I finally found the link to Cushing's I knew that is why she had been acting the way she had--panting, ravenous appeptite (she never got food off the table, but started doing that), I didn't notice the excessive drinking, but realized she was--so many other symptoms. The vet did the urine test and the ACTH and she told me I was right Maddie had Cushing's.

I was told Lysodren was the drug they recommend and I was :eek: not comfortable with that, but relented and glad I did. She finally got back some of her quality of life back. The forum helped me through her loading and peace of mind I was doing the right thing for Maddie.

Everyone here is so caring, helpful, and knowledgeable so you are in good hands. You are family now....:)

Take care!!:)

[nikethelab]

Hi there and welcome! First off you are wise to do a series of tests in order to be sure it is in fact cushings because it can be hard to diagnose and there are false positives on the acth test. Please get and post the results of the tests that were done so we can better help you.

You made a comment about the drugs having serious side effects and I wanted to hopefully calm your fears. Certainly you don't want to give drugs to a non-cush dog (that happened to me) but keep in mind that there are instructions and tests done along the way to prevent anything bad from happening. The key is to get up to speed on the disease and the drugs and so you can be your dog's advocate thru the treatment.

Also it is important that the vet treating the disease is following protocol for use of the drug and that the diagnosis is solid. You are off to a great start by finding us.

Ask questions - you aren't alone. My dog Haley was successfully treated for cushings for over 4 years and she passed at the age of 16 1/2 non-related to her cushings. So your dog can live a normal happy life ok? Kim

I need to find out how to start a thread. I dont see how to do it now. Also how do you post a picture?

[labblab]

In order to post pictures, take a look at the headings on our "Frequently Asked Questions (FAQ)" section:

http://www.k9cushings.com/forum/faq.php?faq=vb3_board_faq#faq_vb3_user_profile

You'll be able to get help with setting up your personal photo album, and also posting a small picture ("avatar") of your dog to go along with your username in your replies.

In order to start a new thread, go to whichever forum you are interested in. Then, when you find yourself on the first index page for that forum, look for the little blue "button" that says "New Thread." It's on the left, right above the heading that reads "Threads in Forum." Click on that blue button, and you will be able to a write a post that will start off a new thread.

Having said that, though, if you are wanting to add more info about Nike, or ask another question that relates to Nike, it is better to just keep adding new replies to this existing thread. That way, all the history and info will be consolidated in one place, and that makes it easier for folks to knowledgably offer feedback and suggestions.

Marianne

[Squirt's Mom]

Hi,

Unless you are starting a thread for a new baby with Cushing's, other than Nike, or it is not related to Cushing's, then you just keep posting here. This thread is where you will post everything related to Nike. If you have something you wish to talk about that is not related to Cushing's, then we have a section called Everything Else and that is exactly what it is for. We share jokes, recalls, ask questions about issues with our other babies even cats - it is open for just about anything.

Hope that answered your question!
Hugs,
Leslie and the gang

[nikethelab]

What I want to post a thread about is people's experience good and bad with Mototane and Vetoryl. My regular vet wants to put Nike on Mitotane 500 mg 2.5 tablets twice a day for one week. Then reduce dose to 2500mg every 72 hours. Then I got a second opinion from the vet who did the ultrasound. She said they have better luck with Vetoryl and wanted to put her on 2 60 mg tablets of vetoryl once a day for 7 to 10 days then test her then 2.5 tablets twice a week. I am just so confused which med to put Nike on, I will try to post her test but Im not sure what Im doing. Ultrsound Ultrasound- Liver mildly subjective enlarged. Moderately diffuesely hypercholic and mildly heterogenous.There are multiple small hypercholic nodules seen. spleen,gastrointestinal,left right kidney, bladder , pancreas normal. Left adrenal moderately enlarged 1.16, right adrenal moderately enlarged 1.05cm.

[nikethelab]

ACTL stim snap dx 10 :06 7.9 ug/dl 11:35 22ug/dl 12:06 22 ug/dl

[nikethelab]

Thyroid snapshot DX TT4 1,2 ug/dl euchthroid sick dx

[nikethelab]

bloodtest in January abnormal results were neu high*(12.73 PLT low to medium high(783 k/UL ) alkp high (248 u/L) ( Lipa 2225 u/l high) rest were in normal range

[nikethelab]

Nike weighs 113 to refresh you. I am really concerned about side effects. I dont want her to be sick or for it to compromise her organs.

[lulusmom]

I have two cushdogs and they have been treated with both Mitotane (Lysodren) and Trilsotane (Vetoryl). Both are very effective and what you need to take into consideration before making a decision is how familiar are these vets with the drug they are recommending. Based on the treatment protocol you related to us, neither one sounds intimately familiar with the drugs. :( First let me address vet number 1 who is recommending Lysodren. Recommended loading dose is anywhere from 25 mg to 50mg per kg of weight per day divided into am and pm dose. Experienced vets aren't intimidated by the drug and normally prescribe the full 50mg. Vet number 1 is right on the money with prescribing the max of 50mg per kg. Prescribing a low dose (25mg/kg) is a pretty good way to make sure it takes forever to load the dog and trying to come up with an appropriate maintenance dose is more difficult as well.

The one thing that concerns me is that you mentioned that after loading the vet would put Nike on a maintenance dose of 2500 mg every three days. I am hoping that you misunderstood him because that is three time the loading dose. Depending on how long the dog loads and where their cortisol levels are after loading, a weekly maintenance dose is usually equal to the daily loading dose. In other words, if Nike is like most dogs and loads in 5 to 8 days and her post stimulated cortisol after loading is 2 - 4.5 ug/dl, an appropriate "weekly" maintenance dose would be 2500mg, which I would split over no less than three or four days.

I have real concerns with vet number 2 as well. There is no loading with Vetoryl so there is no maintenance dose. It is to be given daily or split into two daily doses am & pm. Because of its short half life, it is ineffective to give every other day or thrice weekly doses. I do know that when I got the diagnosis for my first cushdog and was preparing to start loading, I'm not sure I heard half of what my vet said and I don't think I could have done as good of job as you have of recalling my conversations with my vet. Is it possible that perhaps you got the two treatment protocols confused? In any event, no matter which treatment you chose, we've got you covered and will help you every step of the way.

Cushing's is a very graded disease which progresses at a snail's pace so there is plenty of time to do your homework. Take a look in our Helpful Resources subforum and read up on both drugs so you have a better understanding of the treatment you and your vet choose. Not all vets are well versed or experienced with treating a cushdog which is why it is so important that us petowners educate ourselves so that we don't have to place blind faith in our vets. I learned that from the good people here who helped me understand that my gp vet was an idiot (my words but the shoe fits). :D Just remember that the key to successful treatment without adverse reactions is an educated pet owner and an experienced vet. The more you learn, the better advocate you can be for Nike.

Trilostane/Vetoryl Information
http://www.k9cushings.com/forum/showthread.php?t=185

Lysodren Loading Instructions and Related Tips
http://www.k9cushings.com/forum/showthread.php?t=181

[nikethelab]

On vet number one I was reading right off the prescription he prescribed. I will scan it and down load it. Number two vet I was reading it off of her typed notes that she wrote .I will scan both so you can read them.

[nikethelab]

Can I put an attachment on here.

[lulusmom]

Yes you can attach the following file types:
bmp
doc
gof
jpe
jpeg
jpg
pdf
png
psd
txt
zip

If you have any trouble, let me know and you can send them to my personal email address and I will post them for you.