View Full Version : Max, cushings questions/Holistic approaches?
I'm doing this for a dear friend who is beside herself with fear for her dog who has been diagnosed with cushings.
The dog is twelve years old and only had this diagnosed recently.
The treatment seems to be only drugs.
Now can anyone please tell us what to expect.
Are there concerns over the treatment that crop up?
side effects that need to addressed.
what can go wrong , and are there some treatments better than others?
and does anyone have any thing to tell that the Vet did not warn them about.
i am going to see this friend tomorrow and give her access to this account.
she is not exactly savvy on forums....
if this goes against any rules...i won't do it....
and will have her register...
just trying my best to make everything less stressful for her...
thanks everyone
Dave.
frijole
05-23-2012, 12:12 AM
Dave, I think it is fantastic that you are helping out a friend. Please reply to the email you should have received so membership is official and you can then see all your posts right away.
I remember the feelings you and your friend have with the diagnosis of cushings and I can only say one thing - do not worry! Yes, you have to use drugs to treat it... but they work and your furry friend can lead a normal and a happy life!
My dog Haley was diagnosed at 12 and lived to 16 1/2 - she passed of old age not cushings. She used lysodren.
The key is to have a vet that knows about cushings, has treated a lot of cush dogs and that can communicate. The owner must be willing to get up to speed on the disease and the tests and the drugs. We can help with all of that. Go to our important resource section and start with this link:
http://www.k9cushings.com/forum/showthread.php?t=180
One thing that is very important - this disease is very often misdiagnosed. So the first thing we are going to want to know is the dog's whole story from beginning of symptoms to end including what tests were done, what drugs have been given, the results of all tests. It really helps us help you better.
That's enough for now - just know this is NOT a death sentence. Welcome. Kim
Leena
05-23-2012, 01:34 AM
I too remember the fear and TONS of questions when my dog was diagnosed , the un-diagnosed, then diagnosed, then dianosed with atypical cushings!!! It is a process! Read up, get answers from the wonderful folks here, and hang in there! They will help you here and you will be so informed! Tell your friend she is in the right place for answers and to not worry too much! (yes, i worried!!!, but, I felt informed for being here ) Knowledge, is power :)
mytil
05-23-2012, 07:02 AM
Hi Dave,
Welcome to you and your friend - I think it is great that you are doing this for your friend, very nice.
I echo what the others have mentioned above; very important to educated oneself and please give us the details on test results, symptoms etc.
Also ask your friend what other conditions has her dog been tested for - diabetes, thyroid conditions?
What breed is your friend's dog (even if it is a mixed).
Is her dog on any medication? If yes, please let us know which medication.
Keep us posted
Terry
Squirt's Mom
05-23-2012, 10:06 AM
Hi Dave,
What a wonderful friend you are to do this! Please let her know she is not only welcome to use the thread here you have set up for her and her baby - we are all waiting for her with open arms.
Oh, man! Do I remember being afraid! :eek: "Basket case" is how I typically describe myself when my Squirt was first diagnosed, and that is being kind. :p A friend here later told me she saw me as a woman with her finger stuck in a light socket, hair standing on end...she kindly left out the parts about my bugged out eyes and flying drool! :D
But these kind folks took my hand and gently led me along until I could start to breath once again...then they began to teach me. Knowledge truly is power when it comes to Cushing's and the best education to be found is right here...as is the best support system in the world! ;)
For now, tell your friend a few things for me -
1) RARELY is Cushing's a death sentence for a treated pup.
2) Cushing's is a very slowly progressing condition so we typically have plenty of time to learn and make the right decisions for our cush pups.
3) This forum is very user friendly - your friend can click around all she wants with no problem. If she isn't allowed to enter a certain area, a box will pop up and let her know that - but no harm done! I was a clicking fool for quite some time. :o
4) Last, and most important - your friend and her baby are not alone. We will be here right by their side every step of this journey, willing to help in any way we can. They now have a new family...and it's an awesome family.
Dave, I am so glad you found us and look forward to meeting your friend and her baby soon. Again, thank you for helping her!
Hugs,
Leslie and the gang
Hi Dave,
I just wanted to welcome you and your friend to the forum. I agree, it is sure nice of you to help your friend out!
I only have a minute, but I want to tell you I can totally relate to how your friend is feeling. My dog was just under 12 when diagnosed (she is now 13) and I was absolutely terrified and devastated. I spent every moment I had reading everything I could find online (which is how I found this site) and spent a lot of time crying and worrying.
I quickly found out that I could relax a little, take time to do a little more research, and to decide if, and how, to treat my dog. This is important information to pass on to your friend. Please tell her not to panic.
As someone else already mentioned, the first thing we need to know is everything we can know about your friend's dog: breed, weight, medications, diet, symptoms that led to a test for Cushing's, and the test(s) done. There are many dogs who are incorrectly diagnosed, and the wonderful people here are excellent at guiding you in the right direction. Once we have all the necessary info. we can offer suggestions and advice.
You have found a wonderful place with knowledgeable, caring, helpful, dedicated people who will be there every step of the way as your friend navigates through Cushing's. I can't say stress enough the fact that it is NOT a death sentence, and many, many dogs will still live out their full life-span. As for my dog, her symptoms are mild, and I am still not treating her.
Again, welcome to you and your friend. I am so glad you found us!
Julie & Hannah
Well thank all of you for your kindness and warmth.
This thread proved very helpful. I read it over the phone for my friend, and it helped her.
The most important aspect, i think, is it gives her breathing room and time maybe to get another vet's advice.
THOUGH DIAGNOSED, HER DOG,MAX, IS NOT SHOWING ONE SYMPTOM!!!
I am seeing her this afternoon, and will show her how to get up and running here. She tried, but , needs a little help .This will be her first forum experience .
Your all very kind and understanding, and one really does get the feeling of knowledge is power.
All my Best to all of you,
Dave
Hi, I'm Laura ,Dave's friend and Max's mum.
Max is a 12 .5year old Shipoo who is getting suppresion test tomorrow to verify if he has cushings.
The test was recomended because his liver enzymes have increased from 400 may 11th 2010,to 1200 may 2012 .(Canadian measurement standards).
However Max has no traditional sypmtoms of cushings. no excessive drinking or urinating, eating disorders, skin disorders..basically none at this time except for vet's testing of liver enymes.
If diagnosed I am very concerned with traditional meds because of side effects..
I am leaning towards a more holistic approach at this time...
Because he is not exhibiting symptoms!
It is my understanding that the drug only relieves symptoms...ie.no cure
But if there is no symptoms why give a harsh drug to the little guy.
I'm wondering what would happen if I do nothing at this point in time.
Should i wait till actual symptoms are visible or obvious.
I was thinking of trying to modify diet or vitamins, suppliments, anything of this nature instead of harsh drugs at this juncture.
Sooooo.
any body useing a holistic approach to this disease?
Please any suggestions would be appreciated before I decide which treatment I should go with.
I'm also afraid of the false positives that I read about here .
any help , any body with any expierence in anything like this would be more than appreciated.
I love my Max and only want the best for him.
gratefully yours
Laura
MODERATOR NOTE: I have merged this post with the thread Dave started for you and Max. We like to keep all the info about each pup in one thread. That way it is easy to look back through the history if desired.
I also changed Dave's original title to reflect Max's name and the request you made for Holistic info. If you would like a different title that would make it easier for you to find, just let one of the mods or administrators know and we will be happy to take care of that for you. Glad you are here!
Steph n' Ella
05-23-2012, 06:41 PM
From my reading, the only way to really tell the correct dosage for meds is relief of symptoms...so I don't know how your vet thinks you're going to medicate w/o symptoms. Also, I don't really think you have a diagnosis.
There is tons of knowledge on this forum and I am sure everyone will give you links on diet, etc.
I would be more concerned about the elevated liver enzymes...what is causing the elevation if it is not cushings?
From my reading, the only way to really tell the correct dosage for meds is relief of symptoms...so I don't know how your vet thinks you're going to medicate w/o symptoms. Also, I don't really think you have a diagnosis.
There is tons of knowledge on this forum and I am sure everyone will give you links on diet, etc.
I would be more concerned about the elevated liver enzymes...what is causing the elevation if it is not cushings?
That is great advice and I will ask the vet exactly what you just said.
"If max has no cushings symptoms , then why the liver enzyme issues. and what is causing the liver enzyme elevations?"
Last year upon doing an ultrasound his adrenal glands were slightly enlarged.
sorry if i did not mention that.
thanks for responding.
Laura
Hi Laura,
Welcome to you and Max. I can totally relate to how you are feeling and want you to know you have PLENTY of time to figure things out and do not need to be thinking about treatment at this point. First, can you tell the normal range for the liver enzyme you mentioned? Also, is the level that was elevated the Alk Phostphate? Was it routine blood work, or why was it checked? Also, why did Max have an ultrasound done? Can you tell us if Max is on any medications, and if he has any other health issues?
It is very common for dogs with Cushing's to have an elevated ALKP level, and that is actually the only reason my dog, Hannah, a now 13 year-old Shih Tzu, was diagnosed. She was in for her yearly dental procedure and her ALKP level was 1770 so my vet did not perform the dental and asked me about Cushing's symptoms and did the LDDS test that day instead. Hannah was drinking a little more than normal, but she was not a big drinker to begin with. She was begging for food a little more, but her appetite was not voracious. She also had become hesitant about jumping onto furniture. (I found out later she also had some disc issues in her back).
According to the LDDS test, she did have Cushing's (the pituitary form). She had (and still has) very minimal symptoms. My vet told me I did not have to do anything for treatment at that point, especially since you basically monitor their eating and drinking to know if treatment is working. If the eating and drinking is not excessive, you have nothing to monitor and therefore, could harm your pet with the medication.
I initially tried Anipryl with Hannah because there are basically no risks. It is also used for canine dimentia. It is only considered effective in a small number of dogs, but I wanted to give it a try. Her ALKP level did drop but I didn't notice a huge difference in eating and drinking....but, like I said, it wasn't terrible in the first place. Eventually, I took her off of it. We then tried Denamarin, a liver supplement, for about 4 months. Her ALKP level was back down to about 200 (which is normal) as of 6 weeks ago. Her ALKP has not been normal in over a year, so that was a huge success. I would definitely recommend a liver supplement at this point.
As I mentioned on your friend's thread earlier, I was a nervous wreck and was totally devastated with Hannah's Cushing's diagnosis. As you said, there are false positives as well. Also, if a dog is not exhibiting symptoms, most people would not recommend treatment. Hannah was diagnosed about 15 months ago, and I have never tried either drug. I am too worried it would do more harm than good at this point. Know that you have time and that treating Cushing's right now may not even make sense for Max.
I look forward to hearing more about him and to getting tomorrow's test results. I am so glad you found us! We will now be here to support and guide you. I know I would not have made it without this wonderful group!
Julie & Hannah
Hi Laura,
Welcome to you and Max. I can totally relate to how you are feeling and want you to know you have PLENTY of time to figure things out and do not need to be thinking about treatment at this point. First, can you tell the normal range for the liver enzyme you mentioned? Also, is the level that was elevated the Alk Phostphate? Was it routine blood work, or why was it checked? Also, why did Max have an ultrasound done? Can you tell us if Max is on any medications, and if he has any other health issues?
It is very common for dogs with Cushing's to have an elevated ALKP level, and that is actually the only reason my dog, Hannah, a now 13 year-old Shih Tzu, was diagnosed. She was in for her yearly dental procedure and her ALKP level was 1770 so my vet did not perform the dental and asked me about Cushing's symptoms and did the LDDS test that day instead. Hannah was drinking a little more than normal, but she was not a big drinker to begin with. She was begging for food a little more, but her appetite was not voracious. She also had become hesitant about jumping onto furniture. (I found out later she also had some disc issues in her back).
According to the LDDS test, she did have Cushing's (the pituitary form). She had (and still has) very minimal symptoms. My vet told me I did not have to do anything for treatment at that point, especially since you basically monitor their eating and drinking to know if treatment is working. If the eating and drinking is not excessive, you have nothing to monitor and therefore, could harm your pet with the medication.
I initially tried Anipryl with Hannah because there are basically no risks. It is also used for canine dimentia. It is only considered effective in a small number of dogs, but I wanted to give it a try. Her ALKP level did drop but I didn't notice a huge difference in eating and drinking....but, like I said, it wasn't terrible in the first place. Eventually, I took her off of it. We then tried Denamarin, a liver supplement, for about 4 months. Her ALKP level was back down to about 200 (which is normal) as of 6 weeks ago. Her ALKP has not been normal in over a year, so that was a huge success. I would definitely recommend a liver supplement at this point.
As I mentioned on your friend's thread earlier, I was a nervous wreck and was totally devastated with Hannah's Cushing's diagnosis. As you said, there are false positives as well. Also, if a dog is not exhibiting symptoms, most people would not recommend treatment. Hannah was diagnosed about 15 months ago, and I have never tried either drug. I am too worried it would do more harm than good at this point. Know that you have time and that treating Cushing's right now may not even make sense for Max.
I look forward to hearing more about him and to getting tomorrow's test results. I am so glad you found us! We will now be here to support and guide you. I know I would not have made it without this wonderful group!
Julie & Hannah
Thank you so much for your reply' I feel so much better,
I am anticipating a cushing postive result tomorrow because my
vet has stated that based on the normal enzyme standards in Canada
of I think aound 400 - Max is beyond the norm as it is 1200.
If I did not go in for the annual check up and blood work profiling
I would not be aware that Max has a problem because as noted he does not appear to have any observable symptoms.
Last year in May 2011 Max had an ultrasound done because the liver enyzmes were somewhat high which indicated that the adrenal glands were mildly enlarged. No cushing test was done last as the vet that it would not come back with a definitive result.
This year strictly based on the significantly higher liver enzyme reading he is highly suspicious of cushings disease - hence the test tomorrow. If the result is cushings he suggests Testolane.
I feel apprehensive about not going with what the vet suggests but
on the other hand I think that the vets take a text book approach to some extent. Also from what I understand this particular drug is not even FDA approved in the USA???
Logically, my thought is if there is no symptoms why give drugs?
If the recomended drug is not a cure but a way to lower his liver enzyme count which is done to releive symptoms .... then what symptoms are we trying to releive?
Most of posts on this site have indicated some form of cushings symptoms. Many have noted concerns with the dosages and the
corresponding side effects. Some people have said that the drug was reasonably well tolerated. So the drug approach does not seem
compelling to me.
I know that I still do not have the diagnosis and am antipating the worst case scenario results. I guess I am looking for some feedback to determine whether my preference to seek a holistic approach
is correct for Max.
This is all so confusing and I want to do the right thing but I am torn
between the traditional approach that I am likely to be recommended and the holitical approach which is not always widely accepted.
I talked to a vet on the phone who is listed as offering natural pathic solutions and he told me on the phone that based on Max's age and
lack of syptoms he would not recommed the Testone drug.
Sometimes too much information creates more confusion.
So that is my dilemma at the moment. I will keep u all posted
with Max's test results and the treatment that will embark on.
Thanks for all u other cushing mums and dads for listening.
Laura & Max
like so many times even with humans the doctor is not
Hi again Laura,
At this point, I think you are correct in holding off on treatment. In fact, I WOULD NOT start or buy anything before coming back here to post and get more input. I would want you to consult with "the experts" before doing anything. I am not familiar with that drug, but since I have not used one with Hannah, I am not the most knowledgeable about the medications. I just don't think you should start anything without Max showing symptoms. As I said, I have not done anything with Hannah and it has been over a year and she is the same as she was a year ago. At my vet the ALKP normal range only goes up to 212 so Hannah was WAY over at almost 1800. And now, after a few months on a liver supplement, it is normal.
From what I know, there are really no holistic approaches. The liver supplement would be good just to support the liver though. If Max has no symptoms, you don't have anything to treat or monitor right now. I know it is hard to go against your vet, but I think you should take time to think, ask questions, and learn all you can before you make a decision.
Julie & Hannah
frijole
05-23-2012, 09:14 PM
Hi Laura! I've been here 7 years and you would not believe the high % of false positives so you just sit back and relax and we'll help you thru all this... do not lose sleep - do some tests and give us results - tell us as much about Max and his story etc. We will help you with how to deal with the vet and questions to ask. Never treat a dog without symptoms - we will give you links to world renown experts in the industry who give lectures to vets on this... don't fear.
Glad you and your friend found us. Give Max a hug. Don't worry about trying anything holistic yet - you don't know what you are even treating :D Kim
Squirt's Mom
05-24-2012, 08:57 AM
Hi Laura,
With no signs, you are on the right track with not treating just now. The drug your vet is talking about is Trilostane, the generic form of Vetoryl. There are two primary drugs used to treat Cushing's - Trilostane (Vetoryl) and Lysodren (Mitotane). Both are miracle drugs for our cush babies but they deserve respect, just as any drug does, and should not be used without a definitive diagnosis, of which the signs are an important part of the package. ;) You are right to wonder if they relieve signs and Max has no signs, then why start it now.
The Holistic doc may have some things to offer that will help hold off the time when either of these meds is needed. There are herbs, diets, and supplements that some have used to a certain level of success. The problem comes when the testing isn't continued. Just because neither of the above drugs are used to treat, doesn't mean the cortisol, and treatment effects in general, won't need to be monitored. Treatment has two purposes - controlling the signs AND controlling the cortisol. It is vital to know both, to treat both, and not assume just because the signs are controlled no damage is being done by the cortisol. So if you choose to try the Holistic route, have Max tested from time to time just to make sure his cortisol, and other blood chemistry, is still alright.
The really good part about where Max is today, is that you have lots of time to learn all you can before tackling either Trilo or Lyso. ;)
You are doing a great job, Mom! Keep up the good work!
Hugs,
Leslie and the gang
Hi everyone - Laura here - max's mum
I just took max in to the vet for the first blood draw for the
suppression test. I have to take him back in 4 hours then
8 hrs.
At the initial visit i told the vet that I did not notice any symptoms yet
re water, unrination etc.
He said the following;
1) that I may not be noticing that he is drinking excessive - ie I may think the amount is normal but it may not be.
Max is 22 lbs and he said 1 cup or less is normal. That sounds low to me but I am not sure if that is correct or not. Any thoughts????
2)He said he the appearance of a pot belly so that was an indication.
Does a pot belly mean cushings?
3)I also mentioned that Max twitches his legs sometimes when he is sleeping. He said the excess cortisoids may be causing this???
Really???
4)He said that the his numbers will remain high thru out the test today if he has cushings. A normal dogs numbers will drop?
Is that the normal concensus?
Looking for some info today.
I am hoping he does not have it but vet seems convinced he does
even without todays test results based on historical high liver enzymes and pot belly.
Thanks for listening everyone.
Wishing everyone a good day.
Laura & Max
(Administrative Note: Hi Laura! You'll see that I've moved your new post here, so that it can join all the other replies about Max. This way, it will be easier for us to keep his history and important information all in one place. Marianne ("labblab")
Hi everyone - Laura here - max's mum
I just took max in to the vet for the first blood draw for the
suppression test. I have to take him back in 4 hours then
8 hrs.
At the initial visit i told the vet that I did not notice any symptoms yet
re water, unrination etc.
He said the following;
1) that I may not be noticing that he is drinking excessive - ie I may think the amount is normal but it may not be.
Max is 22 lbs and he said 1 cup or less is normal. That sounds low to me but I am not sure if that is correct or not. Any thoughts????
2)He said he the appearance of a pot belly so that was an indication.
Does a pot belly mean cushings?
3)I also mentioned that Max twitches his legs sometimes when he is sleeping. He said the excess cortisoids may be causing this???
Really???
4)He said that the his numbers will remain high thru out the test today if he has cushings. A normal dogs numbers will drop?
Is that the normal concensus?
Looking for some info today.
I am hoping he does not have it but vet seems convinced he does
even without todays test results based on historical high liver enzymes and pot belly.
Thanks for listening everyone.
Wishing everyone a good day.
Laura & Max
(Administrative Note: Hi Laura! You'll see that I've moved your new post here, so that it can join all the other replies about Max. This way, it will be easier for us to keep his history and important information all in one place. Marianne ("labblab")
ok - thanks was not sure on how the process worked with posts.
Squirt's Mom
05-24-2012, 01:36 PM
Hi Laura,
Here is a pretty good list of the most common signs of Cushing's in our pups -
The most common symptoms include:
• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures
This list if from Kate Connick's site -
http://www.kateconnick.com/library/cushingsdisease.html
Now to try to answer some of your questions -
Replies in blue:
He said the following;
1) that I may not be noticing that he is drinking excessive - ie I may think the amount is normal but it may not be.
Max is 22 lbs and he said 1 cup or less is normal. That sounds low to me but I am not sure if that is correct or not. Any thoughts????
Normal daily water intake is from 1/2 to 1 oz per pound of body weight (BW). So at 22 lbs, normal water consumption for Max would be between 11 and 22 ozs per day.
2)He said he the appearance of a pot belly so that was an indication.
Does a pot belly mean cushings?
Pot bellies are a classic sign of Cushing's - but it is not unique or isolated to Cushing's only.
3)I also mentioned that Max twitches his legs sometimes when he is sleeping. He said the excess cortisoids may be causing this???
Really???
Cortisol is a bit of an upper and can cause some restlessness in our babies and can disrupt their normal sleep patterns and behaviors. So yes, this is a possibility. If you have ever had to take prednisone or other steriods yourself you may remember the extra energy you felt - this is how cortisol, a natural "steriod", acts as well.
4)He said that the his numbers will remain high thru out the test today if he has cushings. A normal dogs numbers will drop?
Is that the normal concensus?
The suppression test he is having today does just what the name implies - it suppresses the natural production of cortisol. In a normal pup, the cortisol will remain suppressed. But in a cushing's dog, the suppression will not hold so the cortisol level continues to rise in spite of the suppression agent telling it not to.
Hope that helps!
Hugs,
Leslie and the gang
Hi Laura,
With no signs, you are on the right track with not treating just now. The drug your vet is talking about is Trilostane, the generic form of Vetoryl. There are two primary drugs used to treat Cushing's - Trilostane (Vetoryl) and Lysodren (Mitotane). Both are miracle drugs for our cush babies but they deserve respect, just as any drug does, and should not be used without a definitive diagnosis, of which the signs are an important part of the package. ;) You are right to wonder if they relieve signs and Max has no signs, then why start it now.
The Holistic doc may have some things to offer that will help hold off the time when either of these meds is needed. There are herbs, diets, and supplements that some have used to a certain level of success. The problem comes when the testing isn't continued. Just because neither of the above drugs are used to treat, doesn't mean the cortisol, and treatment effects in general, won't need to be monitored. Treatment has two purposes - controlling the signs AND controlling the cortisol. It is vital to know both, to treat both, and not assume just because the signs are controlled no damage is being done by the cortisol. So if you choose to try the Holistic route, have Max tested from time to time just to make sure his cortisol, and other blood chemistry, is still alright.
The really good part about where Max is today, is that you have lots of time to learn all you can before tackling either Trilo or Lyso. ;)
You are doing a great job, Mom! Keep up the good work!
Hugs,
Leslie and the gang
Thank you for your reply. I have one qustiont to clarify....
when u say he needs to be retested periodically - do u mean having
another suppression test done.???
I hope I am not asking too many qustions.
Laura
Squirt's Mom
05-24-2012, 04:23 PM
No such thing as too many question, Laura! :) That's how we all learn! ;)
As for keeping up testing, I had the ACTH in mind more than the LDDS. The ACTH is a stimulation test while the LDDS is a suppression test, what Max is probably having today.
The ACTH works kinda opposite from the LDDS, or suppression, test. It stimulates the adrenals to release all the cortisol they possibly can, sort of like squeezing a sponge to see how much water it holds as one of our admins says, instead of trying to hold a suppressed level. The ACTH is used as a diagnostic test by some vets but it's primary use is to monitor how well the treatment is working, ie, how well the treatment is doing at keeping the cortisol at acceptable levels.
Hugs,
Leslie and the gang
Hello everyone
I am very releived to report that the results of Max suppression
test was negative. My vet was surprised at the results but
after reading the stories on this forum I really did not feel
that Max exhibited the symptoms many others described for the illness. It is so stressful waiting for the results and everyone here
was so supportive and informative.
I guess I would say to others that u know your dog best so u have to
go with your gut on how to proceed.
MAX was tested for cushings because his liver enzymes have
increased above the normal range for the past 2 annual check ups.
He had an ultra sound last year which was normal.
Does anyone have any information on what would be causing the
liver enzymes in Max a 12.5 to climb and not exhibit any observable
symptoms other than high liver enzyme account of 1200.
Does anyone know of a liver supplment which could help Max.
I saw something on the internet called NHV milk thistle - Does anyone know if this is suitable.
Does Max need a diet change. I give MAX a dog food purchased from the vet called medical - gasto-intestinal, I also add a combination boiled chicken, broccoli carrots sweet potatoes brown rice to the mix.
For treats he likes greenies and ben and bully liver treats.
Does liver treats cause high liver enzymes.
Now that cushings is ruled out for the time being I am looking for
a possible reason for the high liver enzymes.
Any input would be very much appreciated.
Thanks for the support during the past few days while
on pins and needles waiting for the results.
I am so grateful to my good friend Dave for directing me to this site.
Laura & Max
Hi Laura,
Welcome to you and Max. I can totally relate to how you are feeling and want you to know you have PLENTY of time to figure things out and do not need to be thinking about treatment at this point. First, can you tell the normal range for the liver enzyme you mentioned? Also, is the level that was elevated the Alk Phostphate? Was it routine blood work, or why was it checked? Also, why did Max have an ultrasound done? Can you tell us if Max is on any medications, and if he has any other health issues?
It is very common for dogs with Cushing's to have an elevated ALKP level, and that is actually the only reason my dog, Hannah, a now 13 year-old Shih Tzu, was diagnosed. She was in for her yearly dental procedure and her ALKP level was 1770 so my vet did not perform the dental and asked me about Cushing's symptoms and did the LDDS test that day instead. Hannah was drinking a little more than normal, but she was not a big drinker to begin with. She was begging for food a little more, but her appetite was not voracious. She also had become hesitant about jumping onto furniture. (I found out later she also had some disc issues in her back).
According to the LDDS test, she did have Cushing's (the pituitary form). She had (and still has) very minimal symptoms. My vet told me I did not have to do anything for treatment at that point, especially since you basically monitor their eating and drinking to know if treatment is working. If the eating and drinking is not excessive, you have nothing to monitor and therefore, could harm your pet with the medication.
I initially tried Anipryl with Hannah because there are basically no risks. It is also used for canine dimentia. It is only considered effective in a small number of dogs, but I wanted to give it a try. Her ALKP level did drop but I didn't notice a huge difference in eating and drinking....but, like I said, it wasn't terrible in the first place. Eventually, I took her off of it. We then tried Denamarin, a liver supplement, for about 4 months. Her ALKP level was back down to about 200 (which is normal) as of 6 weeks ago. Her ALKP has not been normal in over a year, so that was a huge success. I would definitely recommend a liver supplement at this point.
As I mentioned on your friend's thread earlier, I was a nervous wreck and was totally devastated with Hannah's Cushing's diagnosis. As you said, there are false positives as well. Also, if a dog is not exhibiting symptoms, most people would not recommend treatment. Hannah was diagnosed about 15 months ago, and I have never tried either drug. I am too worried it would do more harm than good at this point. Know that you have time and that treating Cushing's right now may not even make sense for Max.
I look forward to hearing more about him and to getting tomorrow's test results. I am so glad you found us! We will now be here to support and guide you. I know I would not have made it without this wonderful group!
Julie & Hannah
Hi Julie & Hannah
WEll we got the cushings results and it was good news - no cushing
disease at this time.
So now we are back with the original symptom - 1200 level of liver
enzymes which are high.
In your respond u said u tried Hannah on denamarin a liver supplement. Do u think that Max should give that a try.
I recently purchased a mik thistle on line NHV milk thistle. This supplement is promoted my a vet trained in North America's best
vet schools here in Ontario. Univesity of Guelph.
I was thinking of trying that supplement.
Any thoughts on either of thesen2 supplements?
Also do u think I should take to a holistic vet to change his diet.
Right now he enjoys a vet prescribed food called medi-cal gastro intenstinal. Max used to have a problem with loose stools and his glands would become impacted.
YOur comments would be very much appreciated.
All the very best to you and Hannah.
Kind regards
Laura & MAX
lulusmom
05-27-2012, 01:28 PM
Hi Laura and a belated welcome to you, Max and your good friend, Dave.
I’m sorry for the circumstances that made it necessary for you and Dave to join our family but I’m glad you found us.
"If max has no cushings symptoms, then why the liver enzyme issues. and what is causing the liver enzyme elevations?"
Does anyone have any information on what would be causing the
liver enzymes in Max a 12.5 to climb and not exhibit any observable symptoms other than high liver enzyme account of 1200.
If the elevations are caused by excess steroids, the cause is accumulation of glycogen in the liver tissues. The liver has to work harder because of this but the disease does not damage the liver cells. Vets who are familiar with steroid hepatopathy aren’t that concerned if this is the only lab abnormality and the dog is otherwise healthy.
Mild, moderate or even a severe elevation in ALKP is usually the first tip off that a perfectly normal, happy dog, may be looking at a cushing’s diagnosis in their future. Based on what I’ve seen here and what I’ve read over the years, I believe dogs with persistent elevated ALKP, particularly those breeds who seem to be predisposed, will eventually be diagnosed with cushing’s as symptoms become apparent. I believe Max is probably one of those dogs and how long it will take for him to become symptomatic is anyone’s guess.
There is something called idiopathic vacuolar hepatopathy, usually found in older dogs. If a biopsy or fine needle aspirate is done, the findings are usually consistent with typical changes in liver cells caused by steroids, yet the dog has no physical or laboratory evidence of cushing’s. If the usual diagnostic tests, acth stimulation and ldds are negative, it is thought that these dog probably have other adrenal hormones that are causing the same excess stores of glycogen in the liver. I’ve read that most of these dogs can enjoy life with no adverse problems and no treatment for their liver abnormality.
I suspect that if Max were to have a full adrenal panel done by the University of Tennessee, his cortisol would probably be within normal limits but he would have elevations in other adrenal hormones. Does that mean he will develop physical symptoms due to excess amounts of these other adrenal hormone or will his cortisol levels eventually increase enough to manifest the typical symptoms associated cushing’s…..only time will tell.
As far as liver support like milk thistle, I haven’t seen any studies on it’s effect on reducing glycogen but I have read about a study done with Denamarin (key ingredients are SAMe and milk thistle). They found that it had no impact on reducing the ALKP caused by excess glycogen but that it did improve the health of liver tissue. In my very unprofessional opinion, I think that’s still a plus, so if Max were my dog, I’d definitely put him on liver support.
I'm wondering what would happen if I do nothing at this point in time. Should i wait till actual symptoms are visible or obvious.
In the absence of symptoms and other concerning lab abnormalities that aren’t consistent with cushing’s, if/until he starts to eat like a pig, drink excessive amounts of water, pee buckets, develop skin problems, experience a loss or thinning of coat, then I think the best prescription would be enjoy your boy to the fullest every day and don’t worry about cushing’s until he gives you sign that you need to.
You mentioned that Max had an ultrasound last year and that his adrenal glands were a little enlarged. Can you get a copy of the ultrasound findings and let us know what comments were made about the liver and other surrounding organs?
No matter what Max has in store for him in the future, if anything, we’ll be right here to help you both through it.
Glynda
P.S. I believe the gastrointestinal food you mentioned is made by Royal Canin. If he's doing well on it and likes it, then I wouldn't rock the boat. IMO, it is far superior to the Hills prescription gastrointestinal food. First ingredient in Royal Canin is chicken meal. The first three ingredients in Hills are, whole grain corn, brewers rice, and dried egg product, with any meaningful protein being way down in fourth place. If that's not bad enough, this scant amount of protein is chicken by product so yuck! Royal Canin makes three gastrointestinal foods. Which one is he on? Since cushing's is a concern, the low fat one would be recommended, so if Max isn't on that one, you may want to talk to your vet about it.
Hi Laura and a belated welcome to you, Max and your good friend, Dave.
I’m sorry for the circumstances that made it necessary for you and Dave to join our family but I’m glad you found us.
If the elevations are caused by excess steroids, the cause is accumulation of glycogen in the liver tissues. The liver has to work harder because of this but the disease does not damage the liver cells. Vets who are familiar with steroid hepatopathy aren’t that concerned if this is the only lab abnormality and the dog is otherwise healthy.
Mild, moderate or even a severe elevation in ALKP is usually the first tip off that a perfectly normal, happy dog, may be looking at a cushing’s diagnosis in their future. Based on what I’ve seen here and what I’ve read over the years, I believe dogs with persistent elevated ALKP, particularly those breeds who seem to be predisposed, will eventually be diagnosed with cushing’s as symptoms become apparent. I believe Max is probably one of those dogs and how long it will take for him to become symptomatic is anyone’s guess.
There is something called idiopathic vacuolar hepatopathy, usually found in older dogs. If a biopsy or fine needle aspirate is done, the findings are usually consistent with typical changes in liver cells caused by steroids, yet the dog has no physical or laboratory evidence of cushing’s. If the usual diagnostic tests, acth stimulation and ldds are negative, it is thought that these dog probably have other adrenal hormones that are causing the same excess stores of glycogen in the liver. I’ve read that most of these dogs can enjoy life with no adverse problems and no treatment for their liver abnormality.
I suspect that if Max were to have a full adrenal panel done by the University of Tennessee, his cortisol would probably be within normal limits but he would have elevations in other adrenal hormones. Does that mean he will develop physical symptoms due to excess amounts of these other adrenal hormone or will his cortisol levels eventually increase enough to manifest the typical symptoms associated cushing’s…..only time will tell.
As far as liver support like milk thistle, I haven’t seen any studies on it’s effect on reducing glycogen but I have read about a study done with Denamarin (key ingredients are SAMe and milk thistle). They found that it had no impact on reducing the ALKP caused by excess glycogen but that it did improve the health of liver tissue. In my very unprofessional opinion, I think that’s still a plus, so if Max were my dog, I’d definitely put him on liver support.
In the absence of symptoms and other concerning lab abnormalities that aren’t consistent with cushing’s, if/until he starts to eat like a pig, drink excessive amounts of water, pee buckets, develop skin problems, experience a loss or thinning of coat, then I think the best prescription would be enjoy your boy to the fullest every day and don’t worry about cushing’s until he gives you sign that you need to.
You mentioned that Max had an ultrasound last year and that his adrenal glands were a little enlarged. Can you get a copy of the ultrasound findings and let us know what comments were made about the liver and other surrounding organs?
No matter what Max has in store for him in the future, if anything, we’ll be right here to help you both through it.
Glynda
P.S. I believe the gastrointestinal food you mentioned is made by Royal Canin. If he's doing well on it and likes it, then I wouldn't rock the boat. IMO, it is far superior to the Hills prescription gastrointestinal food. First ingredient in Royal Canin is chicken meal. The first three ingredients in Hills are, whole grain corn, brewers rice, and dried egg product, with any meaningful protein being way down in fourth place. If that's not bad enough, this scant amount of protein is chicken by product so yuck! Royal Canin makes three gastrointestinal foods. Which one is he on? Since cushing's is a concern, the low fat one would be recommended, so if Max isn't on that one, you may want to talk to your vet about it.
Hi Glynda
Thank you so much for your reply. I am releived that
Max's results for cushions is negative so my mission is to
do whatever I can to prevent the occurence is possible'
I will try the denamarin as you have suggested.
Is that something that u can purchase from my vet or online?
Also, what it be advisable to give Max both the danamarin as well as]
the NHV Milk thistle? this product is a liquid formulation.\
Also, re diet what is your opinion on discontinuing dog food all together and giving Max only organic chicken, turkey, salmon,]
brown rice and vegies such as carrots, yams , brocolli, pumpkin.
The present dog food is gastrinol intestive formuation which Max like
( not sure if it has too much fat) which has been successful with respect to health stools.??
Also Max likes treats such greenies and ben and bully liver treats.
He eats these daily. Is this excessive.
I would appreciate your input. I feel so grateful that Max has
been given a repreive for the time being and I just want to do everything I can to keep him happy and healthy.
Thanks for caring.
Laura & Max
frijole
05-27-2012, 10:07 PM
Laura, I'm not Glynda but I've used Denamarin as well as other liver supplements. You can get from your vet but it doesn't require a prescription so if you search you can probably save money online. I think I purchased some from Amazon.
My problem with it was that the pills are just huge. Chewables. Well my dog would not eat them. I opted to go back to what I had been using which was a milkthistle capsule - simply poured the powder over her food every meal. I also used glucosamine chondr. with SAME
There is always debate about the effectiveness of supplements. All I know is my Haley had liver values from her cushings over 2000 even after treatment and after a few months on milk thistle she was down to 780. I wanted to do cartwheels. So that made me a believer (there was no other change during that period in her meds)
Re the diet - if its' working I wouldn't change a thing. There really are no real requirements for cush dogs other than keep the fat contact low and protein high. If you want to take on cooking and making sure that all the nutritional aspects are handled - go for it. But it isn't necessary for cush dogs. I had to do it for another of my babies... lots of work but you do what you have to do when they refuse foods.
The only thing I will mention is I would skip the greenies due to Max's digestive issues... I've read they are not 100% digestable and have caused problems for some dogs... here's a link.
http://www.petplace.com/dogs/are-greenies-safe/page1.aspx
Kim
Hi there,
I am so glad to hear that Max is Cushing's free for now. That's great news!
I would definitely try the Denamarin. Hannah has been on it for about 3 months and it has helped tremendously. I got it from my vet, but I also found it online. I just felt more comfortable getting it from the vet at first to be sure it was the real stuff. She weighs 12 lbs. and I break the chewable tablets in half. (I can't remember how many mg the tablets are; my vet gave the dosage). She loves them and thinks they are treats. She has no problem eating them and she doesn't have many teeth either. I also tried the pills that she had to swallow first. I had to put it in a little peanut butter, but she took it. It wasn't too big.
You give it an hour before they eat in order to make it work, so I just have it by the bed and give it to her before I get up in the morning. I can't advise you on whether or not to use something else with the Denamarin. I would think the Denamarin alone would be enough though. Hannah's ALKP level was up to almost 1800 and it was 204 about 2 months ago.
Also, I don't know what to tell you about the diet. Hannah is on an RX diet because of having struvite crystals in her urine years ago, so we have not changed. My other dog is on a food for GI issues as well and it has been really helpful. Others may have more advice to give you on this, but I would think if Max is okay now I wouldn't worry about it. I would also ask your vet.
Hannah also doesn't show strong Cushing's symptoms, but I assume we caught it early with the pre-surgical blood work at the vet. I'm hoping I may not ever need to treat her since she is 13 years-old, but if the time comes then I will. The liver supplement has been wonderful for us for the time being though.
Let us know if you have other questions!
Julie & Hannah
Hello everyone
Thanks for all of your input. I will be speaking to the vet tomorrow and will discuss what needs to be done about the high liver enzymes.
I will definately discuss the supplements suggested. I guess we will
see what happens over the next few months and hope Max remains sypmtom free.
Thanks for all of the great info and kind words.
Best wishes and optimism to all.
Laura & Max
Squirt's Mom
05-28-2012, 09:19 AM
Hi Laura,
Like Kim said, if what you are feeding now is working, I wouldn't change. However, if you want to cook for Max be sure to get some help so that his diet is balanced. Using human foods is fine in spite of what our vets say but if you use only those foods, our babies need vitamins and minerals added to balance the food. Otherwise they can develop some issues from things like zinc or calcium deficiencies or induced hypothyroidism if the iodine isn't correct.
What you can do is cut his kibble (dry feed) back by about a third and top it with the fresh foods. Use white meats, not dark as they have more fats. Don't use any canned items or foods that have been seasoned for your table. Feed only fresh or frozen veggies and fruits; raw or cooked veggies and fruits while the meats are boiled, baked or broiled, no fried foods. Add one ingredient at a time unless you already know he can eat it with no problems. That way, if he does have a digestive reaction, you can more easily pinpoint the problem. ;)
Hugs,
Leslie and the gang
Hi Laura,
Like Kim said, if what you are feeding now is working, I wouldn't change. However, if you want to cook for Max be sure to get some help so that his diet is balanced. Using human foods is fine in spite of what our vets say but if you use only those foods, our babies need vitamins and minerals added to balance the food. Otherwise they can develop some issues from things like zinc or calcium deficiencies or induced hypothyroidism if the iodine isn't correct.
What you can do is cut his kibble (dry feed) back by about a third and top it with the fresh foods. Use white meats, not dark as they have more fats. Don't use any canned items or foods that have been seasoned for your table. Feed only fresh or frozen veggies and fruits; raw or cooked veggies and fruits while the meats are boiled, baked or broiled, no fried foods. Add one ingredient at a time unless you already know he can eat it with no problems. That way, if he does have a digestive reaction, you can more easily pinpoint the problem. ;)
Hugs,
Leslie and the gang
Hi Leslie and the gang
One quick question re diet.
Is organic gorund chicken and turkey ok?
What about organic salmon?
I have always cooked for Max - maybe not as careful about spicing tho.
Could diet cause high liver enzymes and or cushings?
Thanks for your input.
Laura & MAX
lulusmom
05-28-2012, 11:59 AM
Could diet cause high liver enzymes and or cushings?
No. There is no scientific evidence that diet causes cushing's or that diet alone can cause elevation in liver enzymes. If a dog has advanced primary liver disease a diet high in protein, can adversely affect liver enzymes.
Hi Leslie and the gang
One quick question re diet.
Is organic gorund chicken and turkey ok?
What about organic salmon?
I have always cooked for Max - maybe not as careful about spicing tho.
Could diet cause high liver enzymes and or cushings?
Thanks for your input.
Laura & MAX
PS I missed one other diet questions. With the denamarin he requires
food in the mornings . Is 1/2 egg ok? Max has never liked to eat in th
mornings - currently eats 1 time a day at about 6pm.
Laura & MAX
Squirt's Mom
05-28-2012, 12:16 PM
Eggs are good! The whites, when cooked, provide great biotin and the whole egg is chock full of protein, so yes, an egg is fine. :)
Eggs are good! The whites, when cooked, provide great biotin and the whole egg is chock full of protein, so yes, an egg is fine. :)
Thanks - What about wild salmon?
Squirt's Mom
05-28-2012, 01:35 PM
Salmon also good - just watch where it comes from. Do NOT purchase anything that has "China" on it anywhere - as I'm sure you know. I try to use US or Canadian products as much as possible. Most of the salmon I get is from the Atlantic. With any fish, keep in mind the heavy metal factor. Sadly, all our wild food fish is contaminated so moderation with wild fish. ;)
I also use Cod and water packed sardines with my babies feed. Those along with liver will really stink up a house in a hurry! :p
Just about any meat is ok except for lamb and pork; these are typically quite fatty so use them sparingly.
Use broccoli, cauliflower, spinach, kale, etc. - the Brassicaceae and Amaranthaceae familys - sparingly as well. The Brassicaceae can affect thyroid function and the Amaranthaceae can cause stone growth in the urinary system.
Hope this helps!
Hugs,
Leslie and the gang
Salmon also good - just watch where it comes from. Do NOT purchase anything that has "China" on it anywhere - as I'm sure you know. I try to use US or Canadian products as much as possible. Most of the salmon I get is from the Atlantic. With any fish, keep in mind the heavy metal factor. Sadly, all our wild food fish is contaminated so moderation with wild fish. ;)
I also use Cod and water packed sardines with my babies feed. Those along with liver will really stink up a house in a hurry! :p
Just about any meat is ok except for lamb and pork; these are typically quite fatty so use them sparingly.
Use broccoli, cauliflower, spinach, kale, etc. - the Brassicaceae and Amaranthaceae familys - sparingly as well. The Brassicaceae can affect thyroid function and the Amaranthaceae can cause stone growth in the urinary system.
Hope this helps!
Hugs,
Leslie and the gang
Leslie and the gang
I am a little concerned.... If I give him the wrong amounts will I cause further damage to his liver enzyme problem.
My vet said the existing royal canine gastro-intestinal was fine as he had no other problems noted in his blood profile. I have always added
the above to his dog food.
Sorry if I seem to be repetative. I need your opinion again..
1) do u think that i should i feed him what i always did? a mix of dog food and people food. - 50/50 mix or
2) give max no dog food - 100 % above. or
3) reduce dog food to 1/3 dog food 2/3 people food.
Sorry for being so detailed but now I am concerned with the diet.
I hope I am not causing his liver enzyme problems by the diet??
We will be trying denamarin for 3 month and then will go back for another liver enzyme repeat test.
Thanks again for your input.
Laura & Max
Boober
05-28-2012, 05:01 PM
Hi Laura & Max
I posted last week about my dog Boober with highly elevated ALP of 2400 and ALT of 150. Back in 2011 she just had an elevated ALP of 777 which was discovered on a routine senior exam and it was suggested that she might have cushings. We did bile acid test and it was negative, ACTH which came back in the pre-cushings range, ultrasound was also clear. She showed no symptoms so we left things. Feb 2012 at another routine CBC showed ALP at 1900 and ALT now at 190. Low dex supp. test came back negative. Another ultrasound was normal, ACTH test normal so diagnosis was now Chronic active hepatitis. I changed Boober to a liver diet, Denamarin and liver support supplements. Another CBC 6 weeks later showed an ALP off the charts and ALT at 290. Vet wanted to do biopsy and gave me no other options. I declined at Boober is 11.5 and asymptomatic. 4 weeks later I did another CBC with my other vet in town and the ALP was 2400 even higher and the ALT lower now at 150. I was given no other options by my 2nd vet in town but to look at the dog and not the numbers. I thought that was a ridiculous answer as obviously something is elevating the ALP. Today we took blood for the Adrenal Panel for the Univ. Tenn to test for Atypical Cyushings. I was just notified that enough blood was not taken so we need to do this again tomorrow.
Sue and Boober
frijole
05-28-2012, 05:05 PM
Laura - I went back and reread the replies and my take is that Glynda, Leslie and I all said to leave it alone which simply means keep on doing what you have been doing. Hope this helps. Kim
Hi Laura & Max
I posted last week about my dog Boober with highly elevated ALP of 2400 and ALT of 150. Back in 2011 she just had an elevated ALP of 777 which was discovered on a routine senior exam and it was suggested that she might have cushings. We did bile acid test and it was negative, ACTH which came back in the pre-cushings range, ultrasound was also clear. She showed no symptoms so we left things. Feb 2012 at another routine CBC showed ALP at 1900 and ALT now at 190. Low dex supp. test came back negative. Another ultrasound was normal, ACTH test normal so diagnosis was now Chronic active hepatitis. I changed Boober to a liver diet, Denamarin and liver support supplements. Another CBC 6 weeks later showed an ALP off the charts and ALT at 290. Vet wanted to do biopsy and gave me no other options. I declined at Boober is 11.5 and asymptomatic. 4 weeks later I did another CBC with my other vet in town and the ALP was 2400 even higher and the ALT lower now at 150. I was given no other options by my 2nd vet in town but to look at the dog and not the numbers. I thought that was a ridiculous answer as obviously something is elevating the ALP. Today we took blood for the Adrenal Panel for the Univ. Tenn to test for Atypical Cyushings. I was just notified that enough blood was not taken so we need to do this again tomorrow.
Sue and Boober
Hi Sue and Boober
I am sorry to hear about all the confusion that you and Boober are enduring. This sounds very similar to what Max and I are finding.
No symptoms but high liver enzyme count and no cushings diagnosis.
I am debating on whether to see a holistic vet in order to see what
dietary changes would be recommended. Max will try the denamarin this week and possibly another supplement of milk thistle.
I am not sure whether diet really has any bearing on the liver enzymes but it may help.
I am anxious to learn what the results of todays tests will show for
Boober. I feel the same as you do that I dont want to subject Max
to unnecessary testing if he is showing no symtoms and as far i see
doing great.
I hope that the results u get from the U of Ten will provide you with
some answers - hopefully good ones.
I will thinking about you and will be anxious to find out how things go so keep us posted.
Best wishes
Laura & Max
Boober
05-28-2012, 05:38 PM
Laura, I got some great information and advice from the dog liver forum also. Presently Boober is on the Denamarin, L-carnitine, Cucurvet 150, VSL#3 probiotic (evidence has been shown to lower ALT levels with this I was told), Vit B6, zinc, fish oil and dry vitamin E. One of these or a combination of these has helped to lower Boober's ALT level. I'm also making homemade liver diet and using Royal Canin Hepatic. Since I don't know what the cause of the highly elevated ALP enzyme it's kind of a needle in the haystack approach. It sound like you might have better Vet options in Ont. than I do here in Manitoba.
I'll keep you posted on the results. I'm also getting Boober tested for Leptostirosis which is highly unlikely but this has known to highly elevate ALP.
Sue & Boober
Boober
05-28-2012, 05:43 PM
Laura, is it just Max's ALP that's elevated or is his ALT elevated also? I went back thru your posts but you had just mentioned liver enzymes.
Sue & Boober
Squirt's Mom
05-28-2012, 05:48 PM
Hi Laura,
Diet has not been connected to Cushing's in any way other than a reaction some pups on Trilostane seem to have that is handled by the timing of the dose but diet does not cause true Cushing's as far as I know. What you are feeding should be fine for his liver as well based on what we know so far. I think I would just keep on with what you've been doing and see how he does with the med changes first. ;)
Hugs,
Leslie and the gang
Laura, is it just Max's ALP that's elevated or is his ALT elevated also? I went back thru your posts but you had just mentioned liver enzymes.
Sue & Boober
Hi Sue and Boober
I dont have the actual numbers. I will ask for his file when I pick up the Denamarin. I was a little confused by your above post re the supplements noted. Are u giving Boober all those things u listed above - ie about six items i think - zinc , b6 etc in addition to the denamarin.
The other supplrment I had been using on a sporadic basis ( ie before I went for the vet and learned his liver enzymes were high -1200
was NHV milk thistle - (Canadian made in a liquid form).
So I was debating on whether to continue with milk thistle or try the denamarin. they dont recommend both.
What do u think?
Laura & Max
Hi Laura,
Diet has not been connected to Cushing's in any way other than a reaction some pups on Trilostane seem to have that is handled by the timing of the dose but diet does not cause true Cushing's as far as I know. What you are feeding should be fine for his liver as well based on what we know so far. I think I would just keep on with what you've been doing and see how he does with the med changes first. ;)
Hugs,
Leslie and the gang
Leslie and the gang
I think I will continue with the same diet as suggested. Max enjoys his meals so no sense messing that up for him if there is no research that indicates it increases the chances for developing cushings.
Thanks again!!!
Laura
Boober
05-28-2012, 08:01 PM
Hi Laura
I'm assuming and just assuming that if your Vet is suggesting that you use the Denamarin than Max must have elevated ALT. I was under the assumption from the research that I've done that denamarin does not work to reduce ALP as it's not a liver specific enzyme. I was only told to use the denamarin with Boober once the ALT was also elevated. And yes I'm giving Boober all those supplements listed above as I'm being told that she has chronic active hepatitis now and not Cushings since her ALT is now elevated. To be honest I don't know what she has and neither do the Vets like I said earlier the only option I got from one Vet was a liver biopsy and the other Vet told me to get it go and let her be. So on my own and with help from these forums I'm trying to eliminate anything I can from the list of possibilities without having to do a liver biopsy. I'm not even sure this is liver related at this point that's why I'm doing the Adrenal Panel to check for Atypical Cyshings. Something secondary is causing the enymes to be elevated. Something in that list of supplements along with the diet is working thou to reduce the elevated ALT.
If Max has an elevated ALT along with ALP then his issue could be liver related...I'm intersted to see if it's both.
I think the denimarin works better than just plain milk thistle as it also contains SAMe. If you used both SAMe and the milk thistle that could work also. Denamarin is very expensive $63.00 for 30 chewables that last Boober 15 days...
Sue & Boober
Hi Laura
I'm assuming and just assuming that if your Vet is suggesting that you use the Denamarin than Max must have elevated ALT. I was under the assumption from the research that I've done that denamarin does not work to reduce ALP as it's not a liver specific enzyme. I was only told to use the denamarin with Boober once the ALT was also elevated. And yes I'm giving Boober all those supplements listed above as I'm being told that she has chronic active hepatitis now and not Cushings since her ALT is now elevated. To be honest I don't know what she has and neither do the Vets like I said earlier the only option I got from one Vet was a liver biopsy and the other Vet told me to get it go and let her be. So on my own and with help from these forums I'm trying to eliminate anything I can from the list of possibilities without having to do a liver biopsy. I'm not even sure this is liver related at this point that's why I'm doing the Adrenal Panel to check for Atypical Cyshings. Something secondary is causing the enymes to be elevated. Something in that list of supplements along with the diet is working thou to reduce the elevated ALT.
If Max has an elevated ALT along with ALP then his issue could be liver related...I'm intersted to see if it's both.
I think the denimarin works better than just plain milk thistle as it also contains SAMe. If you used both SAMe and the milk thistle that could work also. Denamarin is very expensive $63.00 for 30 chewables that last Boober 15 days...
Sue & Boober
Hi Sue
I think is ALT that is 1200 but not sure. My vet did not specifically
suggest denamarin. I asked him based on the comments from this site. I did not realize it was that expensive. I think it cheaper than
$ 63 on line. I will see what the vet cost is for the first order.
Did u ever consider going to a natural pathic or homeopathic vet
for another perspective. I too would not be inclined to have any thing too invasive done for Max. The lack of symptoms is bewildering.
You mentioned that u were from Manitoba(I think u did) but how did u
go about arranging for a blood panel to be sent to U of Ten?
What about Guelph Ontario - they have a pretty well respected
teaching centre.
Anyways I hope u learned something from these tests.
Laura
Hi Laura
I'm assuming and just assuming that if your Vet is suggesting that you use the Denamarin than Max must have elevated ALT. I was under the assumption from the research that I've done that denamarin does not work to reduce ALP as it's not a liver specific enzyme. I was only told to use the denamarin with Boober once the ALT was also elevated. And yes I'm giving Boober all those supplements listed above as I'm being told that she has chronic active hepatitis now and not Cushings since her ALT is now elevated. To be honest I don't know what she has and neither do the Vets like I said earlier the only option I got from one Vet was a liver biopsy and the other Vet told me to get it go and let her be. So on my own and with help from these forums I'm trying to eliminate anything I can from the list of possibilities without having to do a liver biopsy. I'm not even sure this is liver related at this point that's why I'm doing the Adrenal Panel to check for Atypical Cyshings. Something secondary is causing the enymes to be elevated. Something in that list of supplements along with the diet is working thou to reduce the elevated ALT.
If Max has an elevated ALT along with ALP then his issue could be liver related...I'm intersted to see if it's both.
I think the denimarin works better than just plain milk thistle as it also contains SAMe. If you used both SAMe and the milk thistle that could work also. Denamarin is very expensive $63.00 for 30 chewables that last Boober 15 days...
Sue & Boober
Hi Sue
One further point- Dont' u have a diagnosis - ie chronic hepatitis?
Laura
Hi Laura and Sue,
Just wanted to stop by quickly to let you know that Hannah only had an elevated ALKP; her ALT has never been elevated and she has been on Denamarin for a few months. After about 8 weeks it had cut the ALKP level in half from where it was. And then about 8 weeks after that it dropped again and was in the normal range. She'll get tested again next month, but I just wanted to let you know it did help the Alk Phos for her.
Good luck to you both!
Julie & Hannah
Boober
05-28-2012, 10:37 PM
Hi Laura
I'd find out if it's Max's ALT that's elevated or his ALP or both as they are totally different liver enzymes. If the ALT is 1200 that is very elevated for that as Boober's ALT at the highest was 290 and is now 150 as of last week. ALT elevated means that the liver cells are dying and not regenerating and eventually fibrous takes over. This would mean that Max most likely has a liver issue going on. If that's the case then you'd want to get him on liver support supplements and probably change his diet more geared for a dog with liver disease.
Liver disease and Cushings are 2 different things. The only way to tell what type of issue is happening with the liver is usually thru a biopsy. The ultrasound specialist gave the diagnosis to Boober's issue as Chronic Active Hepatitis meaning that it's inflammation of the liver caused by one of a few things. (Copper storage disease, canine hepatitis, liver cancer, bacterial, viral etc.). There are also other things that cause liver issues like liver shunts or it could be something secondary casuing it. I would only know if it's one of those thru the biopsy which I thought way to risky to do on a asymptomatic dog of 11.5 years.
I live in amall town about 4 hours from Winnipeg and Regina so it's difficult to get to another vet. I also went to Brandon 160km away for a 2nd opinion and in the end he only wanted to do the biopsy and when I cancelled it I never heard from him again. The University of Saskatchewan Vet College is about 6 hours away. They would probably suggest the biopsy.
Chronic active hepatitis really isn't a diagnosis...plus if the ALT (liver specific enzyme) goes back to the normal range as it's getting lower and the ALP is still off the charts what does she have now? ALP elevated can be caused by some drugs, bile duct obstruction, bone disease or Cushings. ALT is specifically liver related.
After doing some research I found some info on the University of Tenn and their test for Atypical Cushings so I asked my Vet to do it. It's the only place to test for it and I need to rule that out as I';m not sold on the diagnosis of CAH.
Denamarin is somewhat cheaper in the US but by the time it's shipped here with duty and such it's going to cost the same.
If you find anything else out about Max I'm very interested as it seems similiar to Boobers issue.
Sue & Boober
Boober
05-28-2012, 11:04 PM
Julie your right about the Denamarin, I've been doing so much reading over the last 6 months on ALT, ALP, liver disease and cushings that my head is spinning. What I read was something to do with if the Denamarin helps lower the ALT but not the ALP then it's not a liver issue or something like that. I'll have to find that...that's why I'm doing the Atypical Cushings test as Boober's ALT is lowering but her ALP is going higher. Does anyone know anything about this?
Sue & Boober
Hi Laura
I'm assuming and just assuming that if your Vet is suggesting that you use the Denamarin than Max must have elevated ALT. I was under the assumption from the research that I've done that denamarin does not work to reduce ALP as it's not a liver specific enzyme. I was only told to use the denamarin with Boober once the ALT was also elevated. And yes I'm giving Boober all those supplements listed above as I'm being told that she has chronic active hepatitis now and not Cushings since her ALT is now elevated. To be honest I don't know what she has and neither do the Vets like I said earlier the only option I got from one Vet was a liver biopsy and the other Vet told me to get it go and let her be. So on my own and with help from these forums I'm trying to eliminate anything I can from the list of possibilities without having to do a liver biopsy. I'm not even sure this is liver related at this point that's why I'm doing the Adrenal Panel to check for Atypical Cyshings. Something secondary is causing the enymes to be elevated. Something in that list of supplements along with the diet is working thou to reduce the elevated ALT.
If Max has an elevated ALT along with ALP then his issue could be liver related...I'm intersted to see if it's both.
I think the denimarin works better than just plain milk thistle as it also contains SAMe. If you used both SAMe and the milk thistle that could work also. Denamarin is very expensive $63.00 for 30 chewables that last Boober 15 days...
Sue & Boober
Hi Sue
I was just reviewing my post from jmac which noted that with the
use of denamarin the ALKP went down so it works on that enyme also
apparently.
Will need to confirm which enzyme is elevated and will let u know.
Laura & MAx
Hi Laura
I'd find out if it's Max's ALT that's elevated or his ALP or both as they are totally different liver enzymes. If the ALT is 1200 that is very elevated for that as Boober's ALT at the highest was 290 and is now 150 as of last week. ALT elevated means that the liver cells are dying and not regenerating and eventually fibrous takes over. This would mean that Max most likely has a liver issue going on. If that's the case then you'd want to get him on liver support supplements and probably change his diet more geared for a dog with liver disease.
Liver disease and Cushings are 2 different things. The only way to tell what type of issue is happening with the liver is usually thru a biopsy. The ultrasound specialist gave the diagnosis to Boober's issue as Chronic Active Hepatitis meaning that it's inflammation of the liver caused by one of a few things. (Copper storage disease, canine hepatitis, liver cancer, bacterial, viral etc.). There are also other things that cause liver issues like liver shunts or it could be something secondary casuing it. I would only know if it's one of those thru the biopsy which I thought way to risky to do on a asymptomatic dog of 11.5 years.
I live in amall town about 4 hours from Winnipeg and Regina so it's difficult to get to another vet. I also went to Brandon 160km away for a 2nd opinion and in the end he only wanted to do the biopsy and when I cancelled it I never heard from him again. The University of Saskatchewan Vet College is about 6 hours away. They would probably suggest the biopsy.
Chronic active hepatitis really isn't a diagnosis...plus if the ALT (liver specific enzyme) goes back to the normal range as it's getting lower and the ALP is still off the charts what does she have now? ALP elevated can be caused by some drugs, bile duct obstruction, bone disease or Cushings. ALT is specifically liver related.
After doing some research I found some info on the University of Tenn and their test for Atypical Cushings so I asked my Vet to do it. It's the only place to test for it and I need to rule that out as I';m not sold on the diagnosis of CAH.
Denamarin is somewhat cheaper in the US but by the time it's shipped here with duty and such it's going to cost the same.
If you find anything else out about Max I'm very interested as it seems similiar to Boobers issue.
Sue & Boober
Hi Sue & Boober
I was just wondering how your tests results turned out from
the U of Tenn. Hopefully favourably and will provide you with
answers.
I also wanted to let u know that Max started with denamarin.
The liver enzyme which was elevated was the ALKP at 1215.
All others were normal.
I have one question re denamarin. How long is this safe to take.
How long does it take to see if it will benefit in terms of reducing the
ALKP count? ( assuming that it will help).
Look forward to hearing back from u.
Thanks
Laura & MAx
Hi Laura
I'm assuming and just assuming that if your Vet is suggesting that you use the Denamarin than Max must have elevated ALT. I was under the assumption from the research that I've done that denamarin does not work to reduce ALP as it's not a liver specific enzyme. I was only told to use the denamarin with Boober once the ALT was also elevated. And yes I'm giving Boober all those supplements listed above as I'm being told that she has chronic active hepatitis now and not Cushings since her ALT is now elevated. To be honest I don't know what she has and neither do the Vets like I said earlier the only option I got from one Vet was a liver biopsy and the other Vet told me to get it go and let her be. So on my own and with help from these forums I'm trying to eliminate anything I can from the list of possibilities without having to do a liver biopsy. I'm not even sure this is liver related at this point that's why I'm doing the Adrenal Panel to check for Atypical Cyshings. Something secondary is causing the enymes to be elevated. Something in that list of supplements along with the diet is working thou to reduce the elevated ALT.
If Max has an elevated ALT along with ALP then his issue could be liver related...I'm intersted to see if it's both.
I think the denimarin works better than just plain milk thistle as it also contains SAMe. If you used both SAMe and the milk thistle that could work also. Denamarin is very expensive $63.00 for 30 chewables that last Boober 15 days...
Sue & Boober
Sue & Boober
I just noticed on one of your posts re dernamarin-
U said Boober takes 2 a day ? Does that mean
he weighs 46- 60 lbs. For under 30 lbs the dosage
says 1 tablet per day which is what Max was prescribed.
Also to let u know u can purchase 75 tablets for $89.95
so that may be useful to u - just look up denamarin on google.
I paid $ 136 for 6o tablets from my vet.
So if we need to be ordering more I think I will be ordering online.
Hope this info helps.
Laura & MAx
Boober
06-04-2012, 12:27 PM
Hi Laura
We haven't gotten the results back from the Univ. Tenn of the adrenal panel yet as we had to re-do the ACTH test as not enough serum was available after the blood was spun. The results should be back this week. Boober weighs 58 lbs so she get's 2 of the Denamarin daily. I'm assuming that she will be taking it for life as long as her enzymes are elevated. I did see that Denamarin was cheaper somewhat in the US but the time I get it shipped to me and pay the duty it will probably amount to the same. 60 tabs would be about the same you paid from your vet as I'm paying from mine.
I'm not sure how long it takes for ALP to be lowered using Denamarin and maybe all ALP doesn't lower with Denamarin depending what's causing the ALP to be elevated to begin with. My Vet doesn't even think I should bother doing CBC's to check her enzyme levels in the future. How ridiculous is that? I so wish I had other options in town for Vets.
Hi Laura
We haven't gotten the results back from the Univ. Tenn of the adrenal panel yet as we had to re-do the ACTH test as not enough serum was available after the blood was spun. The results should be back this week. Boober weighs 58 lbs so she get's 2 of the Denamarin daily. I'm assuming that she will be taking it for life as long as her enzymes are elevated. I did see that Denamarin was cheaper somewhat in the US but the time I get it shipped to me and pay the duty it will probably amount to the same. 60 tabs would be about the same you paid from your vet as I'm paying from mine.
I'm not sure how long it takes for ALP to be lowered using Denamarin and maybe all ALP doesn't lower with Denamarin depending what's causing the ALP to be elevated to begin with. My Vet doesn't even think I should bother doing CBC's to check her enzyme levels in the future. How ridiculous is that? I so wish I had other options in town for Vets.
Hi Sue
I did see denamarin for $89.95 for 75 capsules and that is defintely cheaper than what I paid so u may want to check it out.
Good Luck with the Blood Panel results.
I would interested to learn how thing work out.
Laura
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