I'm new here, and this is a long post. I apologize in advance.

[Bosco'sMom]

Hi everybody. I'm so glad I found this forum. I'm hoping you can give me some advice on how I should proceed with my little man, Bosco. I'll give you the quick (make that not so-quick) run-down.

Bosco is a 14 1/2 Pekingese.

He has:

Flaking, peeling skin around the inside of and behind his ears. This could be related to an ear infection that ruptured his eardrum a few months ago, but that issue is supposedly done with.

Reddened flaking skin around his neck and chest.

Sparse non-growing patches of hair along his back about where his adrenal glands would be.

A recent ear infection when he's never had one before, ever.

Swayed back & pot-bellied appearance.

Increased requests for food. I cannot determine whether this is due to impaired cognitive function or actual increased hunger.

Hip and back leg problems, mainly lack of strength. His legs and feet kind of flop like they're along for the ride.

Pain when attempting to get into a side sleeping position (but not once he's in it).

Increased anxiety behavior. Working his lower jaw up and down as though he's trying to say something that won't come out while emitting this high-pitched short series of whines that drive me f***ing INSANE (then I feel guilty for getting irritated by my beloved companion's suffering.)

His thirst and urination are 100% normal, though. So I don't know what to think.

His last urinalysis came back completely normal, but I know that doesn't mean he doesn't have Cushing's.

He still likes to go out for walks and spends lots of time sniffing around everything. But even on walks, sometimes he just missteps and goes tumbling down sometimes all the way onto his back. He will wind up stumbling and choosing to stay seated rather than stand at least 2 times on a walk.

He hasn't been able to jump up on anything for many years, but he will walk on an inclined ramp, take a small leap to reach the sidewalk from the front threshold (maybe 1") or walk over a belgian block curb stone onto or off of the grass.

Congitively, he's never been especially sharp. Obedience school was a wash, and he never could do tricks besides begging on his hind legs. Now I can't tell if his malaise is boredom, confusion, or the Gabapentin.

He currently takes:

AM: Cosequin DS, 100mg Theophylline, Claritin, .25 Tramadol.
PM: Cosequin DS, 100mg Theophylline, .25 Tramadol, 100mg Gabapentin

He recently finished a course of antibiotics (which I have forgotten the name of) for an infected injury between two of his toes.


Other, antecdotal information:


I bought Bosco from a mall pet store 14 1/4 years ago. I wouldn't have if I'd known about puppy mills, but I can't imagine life without him. He is extremely friendly, loves people and other animals regardless of species, is very stubborn, independent, and always hungry. As a young dog, he loved to play and bugged us all the time to throw toys for him or play tug-o-war. He's always been fluffy and silky, and I keep his hair cut short myself to save money and grooming time, causing a few disasterous results along the way. At around age 12 (his age, not mine), I buzzed his hair so short it was like stubble, and some of it never fully grew back, leaving a patch of sparse hair about the size of my palm on both sides of his upper back.

He has always been "husky". People have always commented on his fatness (I've learned to just agree instead of getting offended), and as he aged, it got more pronounced. By the time he was a senior, he was up to a staggering 23.5 lbs. I'd been trying to get my vet to help me figure out why he was so heavy, even though I was only feeding him about 1/3 cup of food at meals, and restricting his treats. I could not convince my parents that he couldn't be given treats and biscuits all the time whenever the mood struck them (it was a hard habit for me to break, but I did), so I tried to give him as much exercise as his furry little body wanted. He couldn't take much, and I would catch him wheezing and coughing even at rest. My regular vet referred me to a very reputable animal hospital here in NJ to have his bronchia checked out. The Vet there said we should get his weight under control before we start worrying about underlying problems, and that the cough and wheezing would likely go away if we got his weight down. We met with the nutritionist at the hospital, who summed things up quickly. Bosco's hair was most likely sparse, and he was so heavy, because in trying to reduce his weight with small portion sizes (the size recommended by my vet), I'd also deprived him of his nutritional requirements. She prescribed Purina OM canned food. 2/3 of a can, twice a day. Bosco began to slim down, getting down to 19lbs. Still way to big as far as the AKA is concerned, but he was in a healthy range. Then, as the months went by, his weight started increasing again. He was still on the same diet, so I blamed it on my parents giving him under-the-table snacks. But now, I'm living in an apartment with just him, me, and the cat, and his weight is still slowly increasing.

He was diagnosed with arthritic issues in his hips, but it had never really held him back until 3 months ago, when he started having problems walking in a straight line (one back leg walks faster than the other, causing him to walk at a sort of angle), and now in the past month or so it's gotten so that inside the apartment, his legs just slip out from under him and he often can't get them back underneath his body to raise himself. There was an emergency visit to the animal hospital an hour's drive away at 1 in the morning because he wasn't able to use them at all. He just pulled himself in a circle with his front legs, anxious and whining. Of course, the minute I got him out of the car, he was walking everywhere). The vet we saw that night strongly suspects Cushing's , and Bosco has many of the symptoms, but not the most indicative one, increased thirst.


Yes, this is probably too long. But I always figure the more information you have, the more you have to work with. :)

I should also mention that I'm a 40 year old woman who suffers from mental illness, which keeps me unemployed. I get roughly $1200 a month from Medicare, which has to cover half of my rent, plus all of the cable/internet/phone bills, electricity, vet bills, therapy bills, psychopharmacologist bills, my medication costs, The medication costs of the animals, food for me, and food for the animals.

So what do I do now? How expensive do Cushing's tests and treatment get? How far do I go to help a dog who's almost 15 and probably won't live more than a year or two even if the therapies work? How could I ever justify not doing everything it is humanly possible to do to save the life of someone who's given me so much?

[Harley PoMMom]

Hi and welcome to you and Bosco,

So sorry for the circumstances that brought you here but glad you found us.

Cushing's is one of the most difficult diseases to diagnose because other non-adrenal illnesses share some of the same symptoms of Cushing's and there is not one test that is 100% accurate at diagnosing it.

Thyroid issues and diabetes are two health issues that have many similiar clinical signs as Cushing's and therefore, should be ruled out, have these two illnesses been checked and ruled out?

It would help us a great deal if you could get copies of all tests that were done on Bosco and post any abnormalities listed with the reference ranges and units of measurements...Thanks!

Please know you are not alone on this journey and we will help in any way we can, so do not hesitate to ask any and all questions, ok?

Love and hugs,
Lori

[frijole]

Welcome from me also. While your dog has alot of symptoms we like to see test results just to make sure that the diagnosis is confirmed. We see alot of cases where the dog doesn't have cushings - it is tricky to diagnose. So please go get copies of the tests done including bloodwork and post it here so we can take a look and better help you.

The high pitched whining and the pain you describe from laying down are NOT cushings symptoms. The lack of appetite and thirst make me really suspect this diagnosis.

The skin issues could be cushings OR something else.

Obviously something is going on - just not sure it's cushings. So please get copies of the tests for us and we'll help you out. Hang in there. Kim

[Bosco'sMom]

The lack of appetite and thirst make me really suspect this diagnosis.

Obviously something is going on - just not sure it's cushings. So please get copies of the tests for us and we'll help you out. Hang in there. Kim

Thanks, Kim. Just to clarify, Bosco's thirst and urination are absolutely normal. It's just his hunger that seems to have increased. I wonder if this could be a side effect of me assuming he was hungry when he whined or barked at night, and responding to his cries with food.

[Bosco'sMom]

Thank you both. I'm relieved to have found support.

Bosco had a standard urine test done about 6 months ago to rule out thyroid problems. I was told his thyroid numbers were perfectly normal, but did not get a copy of the test results to take home. His glucose was abnormally high, but the urine had been collected in a rinsed out Snapple bottle, which likely affected the test.

I believe they will be doing another urinalysis tomorrow, along with bloodwork. I will ask in advance that a copy of the test results be set aside for me, along with any previous test results.

Update: The areas of mostly hairless skin (happened during treatment for the ear infection) behind Bosco's ears has turned deep pink, and it looks like it must be painful, but shows no scabbing or crusting beyond the peeling skin he's had. The inside of his ears looks pinkish, but not worrysome. I am wondering if it could be a contact dermatitis thing. There are about 6 middle school age neighborhood kids who love to come over and pet him and scratch his ears when I take him out for a walk. Goodness only knows where their hands have been or when they were last washed.

Bosco seems distressed in a non-specific way when awake, but when he's asleep, everything seems okay. His legs and nose twitch like he's dreaming, but he periodically wakes up with a bit of a start, looking around as if to say, "What? What was that? Is there food here for me? No? I'm going back to sleep." He then takes about a minute to sack out on his side again.

I'm starting to feel guilty about leaving him alone in the apartment without my company and hovering.

[molly muffin]

Hi and welcome to you and Boscoe.

When we first were told cushings for our dog, we asked for copies of all medical tests going back 2 years at least. I just said, I want to start keeping a file on her at home. What if she has to go to an emergency vet or something in the middle of the night, plus I like to be able to review them when I have time. No problem at all. Most vets are understanding.

Kim and Lori have given you the gist on what is needed to evaluate where Boscoe might be at with his problems. Test results of abnormal high lows, along with the ranges. A Urine test for cortisol/creatine can be done, to rule out cushings. It's relatively inexpensive and while it can't say that it Is cushings, a negative result can determine that it isn't. (hope that made sense) Since you're doing a urinalysis anyway tomorrow. Mention UCCR. test.

I'm so glad you found us. It's good to have people to share the anxiety and worry who have been through the same things. Don't despair. We all just do the best we can.

Hugs.
Sharlene

[Bosco'sMom]

Hi and welcome to you and Boscoe.

When we first were told cushings for our dog, we asked for copies of all medical tests going back 2 years at least. I just said, I want to start keeping a file on her at home. What if she has to go to an emergency vet or something in the middle of the night, plus I like to be able to review them when I have time. No problem at all. Most vets are understanding.

Kim and Lori have given you the gist on what is needed to evaluate where Boscoe might be at with his problems. Test results of abnormal high lows, along with the ranges. A Urine test for cortisol/creatine can be done, to rule out cushings. It's relatively inexpensive and while it can't say that it Is cushings, a negative result can determine that it isn't. (hope that made sense) Since you're doing a urinalysis anyway tomorrow. Mention UCCR. test.

I'm so glad you found us. It's good to have people to share the anxiety and worry who have been through the same things. Don't despair. We all just do the best we can.

Hugs.
Sharlene

Thanks Sharlene. Bosco had a vet appt. today and I asked about copies of the records and tests. They said no problem, but I was so distracted with last minute vaccinations and such that I forgot to mention it at the desk. I'll call them tomorrow and ask if they can mail them along with the new results when they get them.

I'm so grateful to have somewhere to fret about this. My family knows its stressing, but aren't very empathetic. It's nice to discuss with people who are as passionate about their pets as I am. :)

[Harley PoMMom]

Bosco had a standard urine test done about 6 months ago to rule out thyroid problems. I was told his thyroid numbers were perfectly normal, but did not get a copy of the test results to take home. His glucose was abnormally high, but the urine had been collected in a rinsed out Snapple bottle, which likely affected the test.



Thyroid problems are usually diagnosed via a blood panel. A free T4 is one test that can help a doctor evaluate thyroid function.

Was a blood panel done? If so, could you post any abnormalities that are listed...Thanks!

Love and hugs,
Lori

[Squirt's Mom]

Hi and welcome to you and Bosco! :)
pink
I kept trying to pop back and forth from your post to my reply and got confused. :p So...see my replies in pink below -


Hi everybody. I'm so glad I found this forum.

I'm very glad you and Bosco found us, too! You are now family and will never be alone again.

I'm hoping you can give me some advice on how I should proceed with my little man, Bosco. I'll give you the quick (make that not so-quick) run-down.

Bosco is a 14 1/2 Pekingese.

He has:

Flaking, peeling skin around the inside of and behind his ears. This could be related to an ear infection that ruptured his eardrum a few months ago, but that issue is supposedly done with.

This is not a typical cush sign.

Reddened flaking skin around his neck and chest.

This is not a typical cush sign.

Sparse non-growing patches of hair along his back about where his adrenal glands would be.

Typical hair loss patterns for a cush pup are along the back portion of the body, in particular the tail, flanks and legs. A "rat tail" is common for a cush pup. Hair loss in the area Bosco is showing could be from Cushing's.

A recent ear infection when he's never had one before, ever.

Infections in general are common in cush pups; we often see pups with frequent UTIs as a result of Cushing's.

Swayed back & pot-bellied appearance.

The pot belly is certainly in keeping with Cushing's as the disease causes a redistribution of fat as well as an enlarged liver in many cases.

Increased requests for food. I cannot determine whether this is due to impaired cognitive function or actual increased hunger.

A cush appetite is impossible to miss. My Squirt has always been a Miss Piggy and I just knew that I wouldn't be able to use this sign for her. But, MAN, was I wrong! When her cortisol started rising, it was truly pitiful to see. She would wolf down her food then look at me as if asking, "Are you never going to feed me!?" She spent every waking hour trying to find something, anything, to eat. The look in her eyes was haunting as they told me very clearly she was suffering from hunger - that she truly felt she was starving. Because that is one of the things excess cortisol makes them feel like - that they are literally starving to death.

Hip and back leg problems, mainly lack of strength. His legs and feet kind of flop like they're along for the ride.

Weakness in the hind legs is common in cush pups but the flopping feet and legs are a bit disconcerting to me. Has his spine and hips been checked out? If not, I would want that done.

Pain when attempting to get into a side sleeping position (but not once he's in it).

Cortisol is a natural anti-inflammatory so we don't often see pain in our pups from inflammatory conditions until the cortisol has been lowered back to a more normal range with treatment. Another reason to have his spine/hips look at.

Increased anxiety behavior. Working his lower jaw up and down as though he's trying to say something that won't come out while emitting this high-pitched short series of whines that drive me f***ing INSANE (then I feel guilty for getting irritated by my beloved companion's suffering.)

Excess cortisol can cause them to be restless especially at night because the cortisol does not lower as it does in a normal body. However, the whining could be an indication of pain or discomfort as well as anxiety. Are there particular times of the day you see this or is it all the time? Does he display any behavior like circling, getting stuck in corners or behind furniture, etc, pressing his head against things? Does he ever appear confused or lost in familiar surroundings?

His thirst and urination are 100% normal, though. So I don't know what to think.

This is NOT typical of a cush pup at all. The excess cortisol causes the kidneys become hyperactive resulting in the bladder constantly emptying - ie they pee allll the time, often losing house breaking training, having accidents in the house, etc. Cush pups do not pee all the time because they drink all the time - it is just the opposite. They HAVE to pee all the time so they have to drink all the time to stay hydrated. Excess urination and drinking are one of the hallmarks of Cushing's disease.

His last urinalysis came back completely normal, but I know that doesn't mean he doesn't have Cushing's.

Could you tell us what kind of urinalysis he had. Were they looking for infection and crystals or did they to a test called the UC:CR? If the UC:CR was done, please post those results, too. The UC:CR is a simply test that can rule Cushing's out but cannot diagnose it so if that was done, we would be most interested in seeing those results as well. Was there any mention of his urine being dilute?

He still likes to go out for walks and spends lots of time sniffing around everything. But even on walks, sometimes he just missteps and goes tumbling down sometimes all the way onto his back. He will wind up stumbling and choosing to stay seated rather than stand at least 2 times on a walk.

Exercise intolerance is common in cush pups...but the stumbling and falling concerns me. Again, I would want to make sure his spine and hips were not playing a role in what you are seeing.

He hasn't been able to jump up on anything for many years, but he will walk on an inclined ramp, take a small leap to reach the sidewalk from the front threshold (maybe 1") or walk over a belgian block curb stone onto or off of the grass.

This is what we often see in our cush babies. They can no longer do simple steps, jump, or climb very well if at all.

Congitively, he's never been especially sharp. Obedience school was a wash, and he never could do tricks besides begging on his hind legs. Now I can't tell if his malaise is boredom, confusion, or the Gabapentin.

Gabapentin can make you feel a bit drunk when your frist start taking it (I've had to be on it for years now) but the body should adjust fairly quickly. How long has he been on the Gabapentin?

Are you seeing signs of confusion? If so, what have you seen?

He currently takes:

AM: Cosequin DS, 100mg Theophylline, Claritin, .25 Tramadol.
PM: Cosequin DS, 100mg Theophylline, .25 Tramadol, 100mg Gabapentin

He recently finished a course of antibiotics (which I have forgotten the name of) for an infected injury between two of his toes.


Other, antecdotal information:


I bought Bosco from a mall pet store 14 1/4 years ago. I wouldn't have if I'd known about puppy mills, but I can't imagine life without him.

It is unfortunate, but many, many pups bought in pet stores and from disreputable breeders are simply riddled with health problems. Puppy mill breeders do not care about anything except the money they will make from litters. They do not check the parents for conditions that can be passed down...and if they become aware of a problem - they still don't care and keep breeding those adults until they no longer can breed, sending 100's of pups out into the world with health problems. So, you will never be able to find out if Bosco might have some genetic condition from his parents via the breeder. Only testing when problems arise will help find the cause. For this reason alone, I would want Bosco checked from head to toe, inside and out, for ANYTHING other than Cushing's BEFORE I started treatment of any kind for Cushing's.

I am ever so glad he ended up with you as his mom! It is obvious that you love him to distraction and did not get him in order to make money off of him yourself via breeding, which is sadly what often happens - the evil of backyard/puppy mills simply continues. Simple love is what he deserves and what you are giving him. Would that every pup in those horrid conditions could know such love.

He is extremely friendly, loves people and other animals regardless of species, is very stubborn, independent, and always hungry. As a young dog, he loved to play and bugged us all the time to throw toys for him or play tug-o-war. He's always been fluffy and silky, and I keep his hair cut short myself to save money and grooming time, causing a few disasterous results along the way. At around age 12 (his age, not mine), I buzzed his hair so short it was like stubble, and some of it never fully grew back, leaving a patch of sparse hair about the size of my palm on both sides of his upper back.

He has always been "husky". People have always commented on his fatness (I've learned to just agree instead of getting offended), and as he aged, it got more pronounced. By the time he was a senior, he was up to a staggering 23.5 lbs. I'd been trying to get my vet to help me figure out why he was so heavy, even though I was only feeding him about 1/3 cup of food at meals, and restricting his treats.

Some good, healthy, non-fattening treats you can try are things like raw carrots, green beans, apples, bananas, oranges - just about any fresh veggie or fruit he will eat. Be sure to check and make sure the food is ok for pups. Nothing like grapes, raisins, chocolate, onions...there are many places you can find via Google that will give you a list of foods to avoid in dogs. What feed is he eating now? Does he eat on a schedule -ie 1-4 times a day or is he free-fed - ie food left out all the time? Free-feeding is one of the leading causes of obesity in dogs so if that is how he is fed, you might think about going to a scheduled feeding - morning and evening, or even include a lunch time meal. You will not increase the amount of feed he gets, but simply divide it into smaller portions. Also, if you are feeding according the package directions, you are probably feeding too much. They want you to go through that bag as fast a possible so you go buy another one! Most of the time, we can reduce what the manufacturer recommends by at least 1/3 per day.

I could not convince my parents that he couldn't be given treats and biscuits all the time whenever the mood struck them (it was a hard habit for me to break, but I did), so I tried to give him as much exercise as his furry little body wanted. He couldn't take much, and I would catch him wheezing and coughing even at rest. My regular vet referred me to a very reputable animal hospital here in NJ to have his bronchia checked out. The Vet there said we should get his weight under control before we start worrying about underlying problems, and that the cough and wheezing would likely go away if we got his weight down. We met with the nutritionist at the hospital, who summed things up quickly. Bosco's hair was most likely sparse, and he was so heavy, because in trying to reduce his weight with small portion sizes (the size recommended by my vet), I'd also deprived him of his nutritional requirements. She prescribed Purina OM canned food. 2/3 of a can, twice a day. Bosco began to slim down, getting down to 19lbs. Still way to big as far as the AKA is concerned, but he was in a healthy range. Then, as the months went by, his weight started increasing again. He was still on the same diet, so I blamed it on my parents giving him under-the-table snacks. But now, I'm living in an apartment with just him, me, and the cat, and his weight is still slowly increasing.

Weight gain is typical in cush pups. They can no longer process fats as well as they should so it is stored in the body, often in the abdomen resulting in the pot belly.

Is there any chance he is sneaking the cat's food? :D

And I really wish I could say something good about the Purina feeds of any kind, but I can't. So I will simply say you can find a MUCH better feed. It is very sad, but the vast majority of vets know very little about nutrition - the ones I have talked with have told me they got maybe a day of nutrition during their studies. They rely on the sales reps to tell them what is good.

He was diagnosed with arthritic issues in his hips, but it had never really held him back until 3 months ago, when he started having problems walking in a straight line (one back leg walks faster than the other, causing him to walk at a sort of angle), and now in the past month or so it's gotten so that inside the apartment, his legs just slip out from under him and he often can't get them back underneath his body to raise himself. There was an emergency visit to the animal hospital an hour's drive away at 1 in the morning because he wasn't able to use them at all. He just pulled himself in a circle with his front legs, anxious and whining. Of course, the minute I got him out of the car, he was walking everywhere). The vet we saw that night strongly suspects Cushing's , and Bosco has many of the symptoms, but not the most indicative one, increased thirst.

Did they look at his spine this visit? Did they do any neurological testing?

Yes, this is probably too long. But I always figure the more information you have, the more you have to work with. :)

We just LOVE details! No such thing as too long! ;)

I should also mention that I'm a 40 year old woman who suffers from mental illness, which keeps me unemployed. I get roughly $1200 a month from Medicare, which has to cover half of my rent, plus all of the cable/internet/phone bills, electricity, vet bills, therapy bills, psychopharmacologist bills, my medication costs, The medication costs of the animals, food for me, and food for the animals.

I am a ....well, let's just say I could be your mother! :D And I am just mental - period! Ask anyone here, they will be happy to fill you in! Or, you can just stick around and see for yourself! :p I am on disability so I fully understand the financial strain, too. I will give you a link to our Helpful Resource section that may be able to offer some aid in this area.

So what do I do now? How expensive do Cushing's tests and treatment get? How far do I go to help a dog who's almost 15 and probably won't live more than a year or two even if the therapies work? How could I ever justify not doing everything it is humanly possible to do to save the life of someone who's given me so much?

The most expensive part of this is the testing phase - and you can do as much or as little as you can. However, Cushing's is one of, if not THE most difficult canine disease to correctly diagnose because so many other conditions have the same signs and can cause false-positives on the tests. So relying on one positive test can be a bit risky. The facts are this - the treatments will not cure Cushing's, they simply help control the signs. If the signs are not a problem for you or for Bosco, then you may choose not to treat. At 15, a GREAT age and one for which you deserve a huge hug, deciding to treat is a bit more difficult than it is with a pup at 10, or even 13. Treatment can and does improve the quality of life when the signs are making them miserable. I couldn't have let Squirt continue feeling as if she were dying of starvation - nor could I have lived with that look in her eyes. You may have read about the "2-year" myth in your research - that is simply that, a myth. Dogs can and do often live well past that two year mark and some well past their normal life span.

However, while Bosco does display some of the common signs we see in Cushing's, there are enough questions for me to wonder if he does have it or if other things could be behind what you are seeing.

If you can get copies of all the lab work he has had done and all the other testing done and post the actual result here, that will help us a great deal. If he has not had a SuperChem, Senior Wellness panel, or full blood work up recently, that is where I would start. I would also want his spine checked out. If you can see an IMS, Internal Medicine Specialist, that would be wonderful as they can go into more depth than the GP vets can.

As for doing all you can for Bosco, I would say you have done a wonderful job of caring for him all his life and that is so much more than many pups can even dream of. The fact that you are here says oh so much about your love for him. We all do what we can - for some, that is any and everything, for others it is the bare minimum...but we all can do the most important thing of all and that is love our babies, keep them safe and happy. You have done this and continue to do this. ;)

As I said earlier, you and Bosco are no longer alone. We will walk every step of this journey with you. Please ask any question you may have and we will do our best to help you understand. We are family at K9C and so glad you and Bosco have joined us.

Hugs,
Leslie and the gang

Here are some links just so you have plenty to keep you occupied! :D

Financial resources -
http://www.k9cushings.com/forum/showthread.php?t=212

Cushing's links -

Kate Connick*
http://www.kateconnick.com/library/cushingsdisease.html

Long Beach Animal Hospital*
http://www.lbah.com/canine/cushings.htm

Newman Veterinary*
http://www.newmanveterinary.com/CushingDiag.html

Cushing’s signs and pics*
http://www.newmanveterinary.com/CushSignFrame.html

[Bosco'sMom]

Lori - Yes, blood panels have been done. I don't know the names of them because I have always left it to the doctors to explain what they mean, which in my mind is the important part. I am waiting on the results of the most recent bloodwork, which was taken yesterday evening. I will post the results when I have them, along with the urine test results.

When I collect my copies of these tests, I will also be picking up copies of previous tests, and will post the relevant ones. I will also be checking with my other vet, Red Bank Veterinary Hospital, for results of any tests they have, though I believe they should be in my regular vet's files as well.

[Bosco'sMom]

Weakness in the hind legs is common in cush pups but the flopping feet and legs are a bit disconcerting to me. Has his spine and hips been checked out? If not, I would want that done.” [/I]

Yes, Bosco first had his spine checked when he was young. He has always had some issues in that area. If I remember, the x-rays showed some slight compression of the vertebrae, but I cannot recall which ones. It’s already been established that he has arthritic hips as well. That’s an ongoing issue. The spine and hips were most recently checked at a highly regarded animal hospital, Red Bank Veterinary Hospital in Red Bank, NJ. That was the 1:00AM visit I spoke of before. The doctor I saw at that time took him out of the room to do some neurological tests that I didn’t see. One of those tests involved flexing his hips backwards and raising the legs while he was lying down. Bosco had a lot of pain when that test was done. This same doctor was the one who was really pushing for me to investigate the possibility of Cushing’s with my regular vet.


“Excess cortisol can cause them to be restless especially at night because the cortisol does not lower as it does in a normal body. However, the whining could be an indication of pain or discomfort as well as anxiety. Are there particular times of the day you see this or is it all the time? Does he display any behavior like circling, getting stuck in corners or behind furniture, etc, pressing his head against things? Does he ever appear confused or lost in familiar surroundings?”

Yes, I’m aware that the whining could be pain or discomfort. That was my assumption. The only thing that calms him is me sitting on the floor with him stroking his head. When I’m home, and he’s not sleeping, he’s breathing quickly (but not so much that it’s alarming) and sometimes doing the jaw/whiny thing. I have seen no pattern to it regarding time of day or surroundings. I’m not sure what you mean by circling. Sometimes he gets up and walks around in a circle, then gets up and does it again several more times, like he’s restless, even though he doesn’t want to go out. He has not reached a point where he gets lost or stuck in corners, though I can imagine that day is coming. He is in a new environment, and he seems to remember where things are and where to look for me. Sometimes the elevator confuses him. He sits in front of the door so I can’t open it (seriously old school elevator), or stands at the entrance to it like he’s perfectly content to stand there instead of walk in. I took him back to my folk’s house where he’d been living for the past 9 years (it’s near the vet), and he had no problem at all remembering what to do or where to go or how to beg for scraps.


Could you tell us what kind of urinalysis he had. Were they looking for infection and crystals or did they to a test called the UC:CR? If the UC:CR was done, please post those results, too. The UC:CR is a simply test that can rule Cushing's out but cannot diagnose it so if that was done, we would be most interested in seeing those results as well. Was there any mention of his urine being dilute? The test he had yesterday was definitely not dilute. I do not have the results for that in front of me, but will report on them when I do.


"Gabapentin can make you feel a bit drunk when your frist start taking it (I've had to be on it for years now) but the body should adjust fairly quickly. How long has he been on the Gabapentin?"Less than a week.


Are you seeing signs of confusion? If so, what have you seen?
He’s spacier than usual, if you know what I mean.

[
I]It is unfortunate, but many, many pups bought in pet stores and from disreputable breeders are simply riddled with health problems. Puppy mill breeders do not care about anything except the money they will make from litters. They do not check the parents for conditions that can be passed down...and if they become aware of a problem - they still don't care and keep breeding those adults until they no longer can breed, sending 100's of pups out into the world with health problems. So, you will never be able to find out if Bosco might have some genetic condition from his parents via the breeder. Only testing when problems arise will help find the cause. For this reason alone, I would want Bosco checked from head to toe, inside and out, for ANYTHING other than Cushing's BEFORE I started treatment of any kind for Cushing's.[/I]

Yes, I learned all about puppy mills after the fact, and do attribute much of his health issues to poor genetics. He’s never been a typical purebred Peke in most respects. I won’t be treating him for Cushing’s until I know for sure he has it. Again, he’s almost 15, and I wonder if the treatment would really be doing him any favors. The Vet seems to think there’s some cognitive issues going on as well.

[
I]I am ever so glad he ended up with you as his mom! It is obvious that you love him to distraction and did not get him in order to make money off of him yourself via breeding, which is sadly what often happens - the evil of backyard/puppy mills simply continues. Simple love is what he deserves and what you are giving him. Would that every pup in those horrid conditions could know such love.[/I]

Oh my God no! I got him because he stole my heart. I would never have bred him, and I doubt I could have anyway, since he’s so unusual. (Not a super squished nose, overall size, etc.)


"Is there any chance he is sneaking the cat's food?"

Nope. I keep the cat food on a table or windowsill at all times. Caught him eating out of the littlerbox, but I've arranged things so he can't do that anymore.


"And I really wish I could say something good about the Purina feeds of any kind, but I can't. So I will simply say you can find a MUCH better feed. It is very sad, but the vast majority of vets know very little about nutrition - the ones I have talked with have told me they got maybe a day of nutrition during their studies. They rely on the sales reps to tell them what is good."

I can tell you that is not the case here. I was not prescribed the food by just a vet, but an actual Nutritionist at RBVH. She’s monitored his weight loss from the beginning with this food, and it worked. Unfortunately, he doesn’t like to walk as much or for as long as he did once. The food isn’t over the counter Purina, mind you. This is stuff you have to have a prescription for and pick up at the vet only. He gets 2/3 of a can, twice a day, and that’s it.


In case you're curious, this is Bosco: http://annearchist.deviantart.com/gallery/4315992#/dtu0mx

[molly muffin]

Oh my gosh! Bosco is simply beautiful! Truly. I mean, like, wow, that little face, how can you not just want to kiss him all over. You take lovely pictures by the way. (Course I do admit to giving molly belly kisses, which makes her tail go ninety miles an hour)

Was that urine test the UC:CR to rule out cushings?

Poor little guy with the hip and back problems, he sure is a trooper.

Well, he's just adorable and I hope that they can get this figured out really soon.

We sure do have the most adorable bunch of dogs on this site. It is heart breaking that any of them have problems to go through in this life.

Take care,
hugs,
Sharlene and molly muffin

[Squirt's Mom]

Mornin' Bosco's Mom,

Another of the hallmarks of Cushing's is dilute urine - the kidneys simply can no longer concentrate the urine in cush pups so this adds yet another reason to ponder whether he has Cushing's or not.

He is certainly a handsome fellow! I love his coloring and those precious eyes! :)

I don't know where "here" is, but Purina ingredients are the same no matter where the package is....or who sells it. ;)


Oh my God no! I got him because he stole my heart. I would never have bred him, and I doubt I could have anyway, since he’s so unusual. (Not a super squished nose, overall size, etc.)

Oh, I knew that....which is why I said I was so glad he was with someone, you, who only wanted to love him as he deserves. My Squirt is a bit unusual as well and she would have made a wonderful mom based on how she treated her toys and how she treats puppies even now. But I just LOVE her weird hair..."unusual" is what typically catches my eye. :D

Hugs,
Leslie and the gang

[Bosco'sMom]

Mornin' Bosco's Mom,

Another of the hallmarks of Cushing's is dilute urine - the kidneys simply can no longer concentrate the urine in cush pups so this adds yet another reason to ponder whether he has Cushing's or not.

He is certainly a handsome fellow! I love his coloring and those precious eyes! :)

I don't know where "here" is, but Purina ingredients are the same no matter where the package is....or who sells it. ;)



Oh, I knew that....which is why I said I was so glad he was with someone, you, who only wanted to love him as he deserves. My Squirt is a bit unusual as well and she would have made a wonderful mom based on how she treated her toys and how she treats puppies even now. But I just LOVE her weird hair..."unusual" is what typically catches my eye. :D

Hugs,
Leslie and the gang

Heh. By "here", I meant "in this specific case". This is the food I was referring to: http://www.purinaveterinarydiets.com/Product/OMOverweightManagementDogFood.aspx As I said, I was dealing with a nutritionist regarding his weight issues, and the diet did put him in a healthy weight range, but with problems walking, he obviously walks less, which may keep him from burning off enough calories. I am trying 2 things to deal with this. First, I plan to set aside a day's worth of food, and dole it out to him in small increments throughout the day so he doesn't feel deprived. In addition, I've been increasing the length of his walks, just letting him amble around outside up and down the apartment driveways and sidewalks for as long as he likes, only heading in when he starts heading in that direction. I'm hoping the extra exercise will help tire him out so he's less likely to be up and stressed later.

This is the nutritionist I have worked with in the past: http://www.rbvh.net/bio.php?Lisa-P.-Weeth-DVM-Diplomate-ACVN-12

Today I spoke to my regular vet, and she used a lot of words and test names that I can't remember, but what I took away from it was, the tests don't specifically indicate he DOESN'T have it, so we're on to the next round.

I know no test can say "yes" or "no", but these are the ones that can give indication.

The testing options suggested were:

Ultrasound, which would look for enlarged adrenal glands, but isn't a definitive test. Ultrasound has the added benefit of getting a look at other organs in the abdominal area for potention other issues that could be causing his symptoms. Cost - guesstimated at somewhere around $500.

Blood test #1 - Would require Bosco to go into the hospital for the day, which would be stressful, but the test can be a good indicator. Cost - around $300.

Blood test #2 - Doesn't require a hospital stay, a better indicator, but also crazy expensive.

Since most of Bosco's symptoms are manageable, and many aren't necessarily Cushing's indicators, I'm thinking the ultrasound would be best. It can look for other issues besides adrenal glands, doesn't require hospitalization, and while not cheap, won't cost me my rent money.

I'll keep you posted on what happens.

Thank you for all of your kind words. Bosco has always been photogenic, and as a completely biased photographer, I think he's been a wonderful subject. He's still cute now, but a lot rougher around the edges, and the edges are rounder. :D

Thanks again for all of the encouragement.

[Steph n' Ella]

Good luck! Hugs to Bosco!

[molly muffin]

I was thinking, if I remember correctly, the urine test UC:CR can rule it out if it is negative, but if it's positive it still doesn't mean it's necessarily cushings. It can help to rule out and is one of the cheaper test to get done.

We had the ACTH, which was positive, but then ruled out cushings currently with the LDDS. So ended up doing both test. They were both under 200. each. And I didn't do them all at the same time but sort of spaced it out. We'll be retesting the LDDS in nov/dec. Unless symptoms appear.

Hope all is going well with Bosco.

hugs,
Sharlene