Overwhelmed! (13 y/o maltese "Puffy")

[dmwozniak]

My 13 year old maltese "Puffy" was recently diagnosed with Cushings disease. I don't know what medication is the best. When I read about each medication the side effects are horrible. It seems my dog will be sick vomiting, lethargic, etc. I'm so nervous. I want her to continue to be her happy self for whatever time she has left. I'm told if she goes on Vetroyl for the first two weeks I must monitor her and bring her to the vet every two days to check her potassium levels or she can go into crisis. My dog also has a heart murmur and enlarged heart. I don't know what to treat first! I'm so distraught. Please give me your thoughts. Thank you.

[dmwozniak]

Hi! I posted something last night but I might have done it wrong so here goes again. My poor little girl who is a 13 year old maltese was recently diagnosed with Cushings Disease. I'm devastated. I'm overwhelmed with information and really not quite sure about all the drugs prescribed for this disease. She also has an enlarged heart and had a little bout with a kidney problem years ago. Recently they thought she had diabetes insipidus. She was on meds for that the past week but she starting shivering(shaking) so I bought her to the vet and her potassium levels were up. So then they proceeded to check for Addison's Disease or Cushings. They did the ACTH test and decided it was cushings but I'm not 100% convinced because it could have a false positive reading. The vet wants to put her on Vetoryl. I have read up on this drug and it says not to give a dog this medication if they have kidney, liver problems or take blood pressure medicine. My dog "Puffy" is on blood pressure medicine. Why would I give her this medication? Plus the side effects will make her worse then the three symptoms she has such as excessive drinking, peeing and always hungry - no other symptoms. She hasn't had any accidents on the floor. She's so happy I don't want to give her meds that will make her sick or die too soon! Please help!

[labblab]

Hello and welcome to you and Puffy! I have just now offiially approved your forum membership, so both of your previously written replies are now visible for public viewing -- the one you wrote last night and the one you wrote today.

I'm sorry I don't have more time to write to you now, but I will come back later. And I'm certain that other folks will also be by shortly to welcome you, too, and to give you their thoughts.

Marianne

[Max]

Hi! I posted something last night but I might have done it wrong so here goes again. My poor little girl who is a 13 year old maltese was recently diagnosed with Cushings Disease. I'm devastated. I'm overwhelmed with information and really not quite sure about all the drugs prescribed for this disease. She also has an enlarged heart and had a little bout with a kidney problem years ago. Recently they thought she had diabetes insipidus. She was on meds for that the past week but she starting shivering(shaking) so I bought her to the vet and her potassium levels were up. So then they proceeded to check for Addison's Disease or Cushings. They did the ACTH test and decided it was cushings but I'm not 100% convinced because it could have a false positive reading. The vet wants to put her on Vetoryl. I have read up on this drug and it says not to give a dog this medication if they have kidney, liver problems or take blood pressure medicine. My dog "Puffy" is on blood pressure medicine. Why would I give her this medication? Plus the side effects will make her worse then the three symptoms she has such as excessive drinking, peeing and always hungry - no other symptoms. She hasn't had any accidents on the floor. She's so happy I don't want to give her meds that will make her sick or die too soon! Please help!

Hi my name is Laura -
I am in the same position as u are today.I just took max in for the cushings test - suppression test they call it. We need to go back in
4 hours to draw blood again. max is a 12.5 shipoo and the vet
has also indicated to put him on vetoryl if the diagnosis is positive.
I too have a reluctance to put him on the drugs. Max has no symptoms other than a pot belly as assessed by the vet. No other
obvious symptoms to me.
If I get the diagnosis nas positive I may do the following;
take him to a specialist at the university of Guelph ( ie we live in Toronto Canada). I also may take him to a holistic vet to obtain another perspective. Just going by own personal perference for medical treatment ( ie for my self) I tend to have a tendency to opt for less pills , less vacines etc .
I am not an expert but I think I am inclined to evaulate alterntive options for jumping in to the vetoryl.

Thats my thought at this junction.

Good luck to you and your girl.

Laura

[Steph n' Ella]

Keep reading even if you are overwhelmed! You will see it is ok to take your time to get diagnosed and start medication for Cushings. Most people here who have treated with medication see great improvement in their dogs...side effects mostly when dosage is incorrect. Get coppies of all your tests and post the numbers here!

[dmwozniak]

Thank you for your replies and suggestions. I'm not rushing into anything - I still want more testing done! I might put her on the flax seed hulls and melatonin to start because it won't harm her.

[apollo6]

Lost post I did.
WElcome. Slow down. Don't start giving additional herbs ,etc, until you know the exact cushing you are dealing with. There are three types of cushings, find out which one your baby has. Read up about it also. Hold off on the flaxseed and melatonin for now with an upset tummy you don't want to add more to the mix. Plain low fat or fat free yogurt is good for an set tummy. Check with the stomach issues began. Read up about Cushing before you make a decision about any kind of medication. The tests that should have been done are a full blood panel(would show extremely elevated results in the various
Organs,etc.,an ACH STim test(to show how high the cortisol readings are), an ultrasound to show if one or both adrenal glands are enlarged,also show if the organs are enlarged would help to determine if it is pituitary based Cushing)
Also read up about TRilostane if you should decide on it. Go to the manifacturer's website DECHRA- read the brochure on TRilostane/
VEtroyl.You can even email their vet about questions you have. I have never heard of the protocol for TRilostane about every two weeks testing for potassium. Also the weight of you dog is very important as to dosage. Apollo is 13.5 years old weighs 10.45 lbs. and is on 10.mg of TRilostane on and off for two years. BEcause you have other issues,go slow. Also get a second opinion with an internal medicine sealift if you can afford it. I went for a second opinion. IT took me a few months before I could make a decision. When I did , I
Posted every day each day I gave Apollo his first dosage. Also I went by my gut feeling and started at a lower dosage then the vet told me to because of my fears and Apollo's stomach issues.
Bottom line you know your baby better than anyone,if you are not comfortable with the vet ,change, if you like the vet don't be afraid to ask questions and always get a copy of all lab and tests for future reference.
The stomach issues could be a number of things-if on the medication it could be the cause,it could be pancreatis, intestional inflammation,etc,
Slippery elm is good for stomach issues. It comes in a powder form, can be ordered on line(amazon
Or other site) not sure if you can get in a regular pharmacy, you bowl a 1/2cup of water add a 1teaspoon, simmer for 2 minutes,until thickens, cool off,then refrigerate. 5 minutes before a meal give a teaspoon (for a 10lb )to soothe digestive tract .
Apollo does have elevated liver enzymes which I need to watch. EACh dog is different and each medication is different. So when you do decide, run it by us before you start. We have some of the best vet techs. On this site and a mass of knowledge here.
You are not alone.

Hugs Sonja and Apollo

[marie adams]

Welcome to you and Puffy :)

Take some deep breaths. Research is a good thing, but we are all here to help.

Marianne has been by, but there are many more experts that will be along. Please list all your test results so they can take a look at them.

You do have time to make an informed decision on the medication so do not worry. They aren't as bad as they are said to be, I was nervous to give Lysodren, but it helped my Maddie and she didn't have any side effects.

Hang in there you are not alone.

[Squirt's Mom]

Hi and welcome to you and Puffy! :)

Ok, you can relax now. You have found the very best group of folks you could ask for when it comes to finding your way through the Cushing's jungle. There are pups here who have been treated with both Lysodren and Trilostane for several years and they are still strong, happy, and healthier than many pups the same age. Cushing's is not necessarily a death sentence. Many cush pups live well past their expected life-span with treatment. So take a deep breath and relax. This is not as bad as it sounds....and I remember full well how it sounded when my Sweet Bebe was first diagnosed. Like my world was ending and there was nothing I could do about it. Many of us felt the same way at first but as we have learned more about this condition and the treatments available for our babies, we become more confident...and I'm sure you will as well. ;)

Take your time before starting Puffy on either med - Trilostane or Lysodren. Both are life-saving medications for our babies but like any drug they deserve respect. You want to make sure the diagnosis is as firm as possible, that other causes for the signs you are seeing have been ruled out, and that the treatment will work with the other medications she needs, or that those medications can be changed to something that may work better under the new circumstances.

Flax lignans and melatonin shouldn't be an issue (as long as there is nothing saying they shouldn't be used with her current meds) but as Sonja said, if she is having some digestive issues you might want to take it slow with the lignans; build up to the dose she needs. You don't have to use the flax hulls; you can purchase flax lignans in capsule form as well as a powdered form - just don't use the oils as our pups are prone to pancreatitis so watching fats is important. The melatonin may make her sleepy for a while but she should adjust. This is a slow treatment so don't get discouraged when you don't see improvements right away - it can take 3-4 months for this approach to help, if it helps. It doesn't help all pups but my Squirt did well on it for over 3 years. :)

It would help us a great deal if you could get copies of the actual test results that have been done so far in diagnosing Puffy and post them here. Also, any other medical history and medications, the names and amounts she takes, as well as any herbs or supplements, that will help us help you as well.

Keep asking questions! Keep reading! Then ask more questions! :D We will do our best to help you understand. As Marie said, you and Puffy are no longer alone. We will walk with you every step of this journey.

I'm glad you found us and look forward to learning more in the time to come.

Hugs,
Leslie and the gang

[dmwozniak]

When I took my dog to Vet in April it was for excessive drinking and peeing but no accidents in house. He put her on desmopressin. Then she had an episode like she was shivering and staring into space for about 5 minutes two days in a row. The first day she slept all day after the episode I thought she had a stroke or something. She had two blood tests one in April and one in May. The only high numbers in April before this episode was Baso .23 norm .10, PLT 486 norm 484, BUN 28 norm 27 and ALKP 272 norm 212. May numbers BUN 38 norm 27, ALKP 337 norm 212, K 6.4 norm 5.8, Cl 124 norm 122, MONO 1.30 norm 1.12 and BASO .15 norm .10. My concern more so is her enlarged heart and is on blood pressure meds 2.5 enapril. From my readings if a dog has issues with heart, kidney, liver or on blood pressure you shouldn't give the dog vetoryl but the one vet said it wouldn't interfere. She also had the ACTH test resting rate 9, after injection 27 and then 17. Not comfortable with this because it could have been a false positive considering the dog was so nervous. Vet said she also had enlarged jugulars?? Also, when she had the episode and I brought her into the vet he gave her fluids and she was like new, playing, happy, etc. Going back today to see my normal vet who was on vacation - will get back to you on findings. Thanks everyone!

[dmwozniak]

Also, forgot one thing when she had the episode I brought her into the vet and they gave her fluids because of the high potassium reading. After that she was like new, playing happy, etc. Thanks!

[dmwozniak]

Sorry, the computer froze and I forgot to post the most important test for Puffy the ACTH test. I'm a little leary on the findings because I left the dog there for the test and she was probably very nervous could have caused a false positive. The resting rate was 9 after an hour went up to 27 and then back down to 17. I know those numbers aren't good but I think more testing should be done. The vet said that Puffy's jugular veins were enlarged more so then normal?? Thank you.

[addy]

Hi and Welcome from me, sorry a bit late with that:o:o

Remember to breathe. We all seem to arrive her in a state of panic, terrified for our pups. I cried every day for over a month. The thing is, you have time to decide what is best for Puffy when it comes to Cushings. The most important thing is to feel confident in the diagnosis. Now we can be in a state of denial (I sure was) but you need a vet with experience which is usually a specialist, an internal medicine vet, we call them IMS.

No one test for Cushings is perfect. Non adrenal illnesses can cause false readings. A vet familiar with Cushings will allow history and symptoms to be part of the diagnosis and since controlling symptoms that are worrisome is a big reason to start treatment.

I am concerned about kidney and heart problems that Puffy may have so perhaps our experts as we fondly call them will start with you there to try to sort those issues out first.

You are here now, with tons of support, we will help however we can.
Just remember to slow down and breathe

[dmwozniak]

Puffy also had a ACTH test. Resting rate 9, one our later after injection 27, then 17. I'm not at ease with this because my dog was probably very nervous which could cause a false positive. Right then he wanted to put her on vetoryl. When she went in after her episode in May her potassium level was up so he gave her fluids. After that she was like new, playing, happy etc. Like I said going back today to my normal vet will post results. Sorry computer froze so I couldn't post this part to my other post. Thanks everyone!