overwhelemed by the news

[karabella]

H! I found this forum when I was trying to find info about cushing's disease. I had heard of it but didn't know that much about it. Now I've read a lot but now I just feel overwhelemed. A couple weeks ago I didn't realize my dog was having a problem. Looking at everything seperately I thought I had an explanation why things were happening. Like her raiding the trash and stealing food I thought was because she was thrown off her normal feeding schedule. Her drinking more and panting was due to the heat. Her couple of accidents was due to drinking more. Until I talked to a friend whose daughter was a vet tech. She started asking questions and the seperate problems fell into place like a puzzle. I called my vets office and got an appt. for her. She took blood and urine-ran a chem27, cbc and a t4. When she called the next day she said with the results and how she was presenting she felt it was cushing's. She told me she would need a ldds. She had that done on Tues 9/4. Dr Robyn called today and said with the results she has pituitary dependent cushings. She told me my options. She told me she knew my head was spinning from the news to take the time for it to sink in. She said I should think about it and write down any questions and call her back on monday.
I feel like I'm rambling and not making any sense but I have to say this is how it feels. It has all been moving so fast.
I go tomorrow to pick up the copies of her lab work and a script for lysodern? (so I can call around and get a good price).
I guess I should tell you about my girl. Her name is Ava-she is a shep/lab mix. She will be 9 in November. She weighs about 71lbs. I was not ready for this-I know no one ever is but it is so soon after putting my cat to sleep in March. I don't think I have recovered from that yet. She was 15 and that loss has left a hole in my heart.
Ava is my baby. She and her sidekick (buster-my son's dog)follow me around the house esp since I have been out of work since last Aug.
I need some info that makes sense and I need to know if she is going to be ok. Until now she has had no health issues. I needed to get this all out. I hope I made some kind of sense. Thank you for being here.

[frijole]

Welcome and let me tell you that your dog can live a very happy normal life. So deep breaths ok? Over 7 yrs ago I found this group and my thread title had overwhelmed in it also... it really did. My dog was treated with lysodren for 4 1/2 yrs and she lived to be 16 1/2 and died of old age unrelated to cushings. So I know what I'm talking about. :D;):D;)

Please get copies of the tests done to diagnose cushings so we can just double check it all. It helps us understand and on occasion members have dogs that were misdiagnosed so we like to have the facts.

Know that there is absolutely no rush to treat cushings. So take your time and get up to speed and comfy with it. Ignore people who say your dog has 2 yrs to live - it's hogwash. Ignore articles that describe the meds as toxic - again hogwash. Lysodren has been used to treat cushings for decades. It is a strong drug and it works when used properly. Problems occur when vets and/or owners are asleep at the wheel and don't follow instructions/protocol on how to use it. But that's why we are here! To help guide you.

So you can sleep better tonight and know that you aren't alone. You will need to get up to speed on the disease and I'll give you some links to our resource section which help. Ask questions. Good luck! Kim

http://www.k9cushings.com/forum/showthread.php?t=180
http://www.k9cushings.com/forum/showthread.php?t=181

[molly muffin]

Hello and welcome. It's true, it is all overwhelming when you get the diagnosis and then start reading about it. It's just too much information, too fast, no time or idea which way to look. So, deep breaths to start with. Next thing is to know that there is a lot of information on the internet and some is good and some is not. Start simple. Copies of the tests. Anything abnormal, whether high or low and what the range is. That includes the LDDS tests, blood work, etc. This is all good stuff to have a handle on and know what it means prior to starting treatment.

I think you'll get some ideas on what sort of questions you might want to talk with your vet about.
Making lists is a good idea. Another idea is you could make your own spreadsheet with the lab results of abnormals, highs/lows because in your future will be many years we all hope of blood test, ACTH, etc. that you'll want to keep track of and it'll help you to feel like you are more on track of knowing what is going on with Ava.

I'm so sorry that you lost your baby a few months ago too. :( 15 years is a good long life, but it is always going to be too soon. I know, I lost my beloved cat, and and few months later my golden retreiver. Those two had been inseparable their entire lives. On the other hand it took me 2 days just to get out of bed and stop crying long enough to go downstairs and start all over again. I do understand. Ava however, is not going to follow that path. She is going to get treatment and hopefully live a nice long life. :)

deep breaths!
hugs,
Sharlene

[Jenny & Judi in MN]

googling cushings is terrifying. It really is manageable. Just hang in there!

[karabella]

I am so glad I found this forum. Thank you for your support and advice. I am taking a step back and letting the news sink in before making any decisions. Taking a deep breath and relaxing.
I will be getting the test results the script and some info dr. robyn has for me later today. I really love the vet I take them to see. She treats my babies like they are hers. I trust her which I don't ever say about doctors. I go out of my way to see her but feel it's worth the extra time and miles. But I still love the idea of being able to get advice from people who have either been through this or going through this-people who can understand how you are feeling.
I will post the results as soon as I get them. Again thank you!

[Boriss McCall]

Hi & Welcome...
Your story sounds like mine. Our oldest pup of 12 years died in July & then 3 weeks later we found out our sweet 8 year old almost 9 year old boy Boriss probably had Cushing's disease. It was a huge blow to just get over having to put a sick dog to sleep & immediately start worrying about the next.. My head was & still is occasionally spinning. :( So, I really feel for you. It is a hard thing to swallow.

But, you have found awesome people who will help you. I start my dog on his meds tomorrow. I am no longer afraid & am ready to get this ball rolling & help him be more comfortable. Those feelings of security & comfort are only because everyone here & of course the amazing Internal Medicine Dr. that is treating Boriss. So you are in good hands here..

Everyone is here to help you anytime you need. I don't have any treatment advice since I am basically in the same boat as you. But, the minute I found out about Boriss I started my research. The more you know about Cushing's the more you will be able to help your baby.


hugs..

[addy]

I think I cried for the first six months. I got the news on my pup's birthday:eek::eek:

The best thing is- you are no longer alone and we all walk in similiar shoes so support here is amazing.

Slow down, keep breathing, Cushings is seldom an emergency.

[Steph n' Ella]

Relax and welcome! You will get some great advice here!

[karabella]

I know I've said this already but I am so glad I found this forum. Everyone here is so supportive. I will try to remember to slow down and breath. I have also been doing a lot of reading-with knowledge comes power. I think the problem is that I feel that it is out of my control. Maybe once I reach the point where I feel comfortable enough to know I am making the right decisions I will feel more in control. It's going to be a long journey and I am glad I don't have to face it alone.

[karabella]

I picked up Ava's results yesterday from the vets office.

Chem 27 (abnormal results)

alk phosphatase 725 range 10-150 u/l high
alt (sgpt) 283 range 5-107 u/l high
ast (sgot) 56 range 5-55 u/l high
albumin 4.4 range 2.5-4.0 g/dl high
cholesterol 426 range 112-328 mg/dl high
Also I'm not sure what this means
Hemolysis index ++++
lipemia index ++++
index of ++++ may increase ast and cpk by 25-50%, and decrease alp values by >50%??

cbc results (abnormal)

rbc 8.57 range 5.5-8.5 M/ul high
hgb 21.3 range 12-18 g/dl high
hct 64 range 37-55% high

t4 1.2 range 1.0-4.0 ug/dl

urinalysis
color straw
clarity clear
specific gravity 1.014
glucose neg
bilirubin neg
ketones neg
blood 1+ range negative high
ph 6.0
protein neg range negative-trace
wbc 0-2 range 0-5 hpf
rbc 0-2 range 0-5 hpf

Based on these results Dr Robyn suggested an LDDS.

ldds results
pre dex 4.7 range 1.0-6.0 ug/dl
post 4 hr dex 0.7 range less than 1.5 ug/dl
post 8 hr dex 2.4 range less than 1.5 ug/dl

With these results she feels that Ava has pdh. I also picked up a script for lysodren. She suggested I take my time and let everything sink in before making a decision. Also to call around to see where I can get the best price.
The dose she has written for is: Lysodren 500 mg 1/2 tab am, 1/2 tab pm. and to schedule bloodwork on day 7 of treatment. with a total of 10 tabs.
Everyone's input is greatly appreciated. I have no idea how to interpret these results and will be doing a great deal of reading. Does this sound like my vet is taking the proper measures? Are there other test that should be done? I see a lot of people talking about ultrasounds. I'm not sure if she is not suggesting this because she knows my financial situation. I know she tries to keep cost down when possible. I will be looking forward to hearing what everyones opinons are regarding her results and the course of treatment recommended.

[frijole]

Thanks. I am no blood panel expert but I can tell you that the elevations are typical of what we see in cush dogs. There are some that are abnormal that aren't necessarily cushings but I can't offer input as I'm not qualified. I can tell you that the ++++ note is when something happens with the testing that results in potential inaccuracies. In your case it states that the alk phos could be higher and the alp could be lower.

This is the testing that usually leads to tests that are specific for cushings. You can't diagnose cushings from a blood panel. You said you had the low dose dex suppression (ldds) test done. I don't see those results here. It is a test that has 3 numbers on it. Could you please get the results and post?

It is a good test for cushings however it CAN result in false positives when other illnesses are going on - in other words dogs can be misdiagnosed if only this test is done.

There is NO rush to treat cushings - so you could have an acth test done to measure the cortisol. This is a test that you have done after starting lysodren also to determine how it is working. If you do it before you have a better feel for how high the cortisol is and how long it might take as well as how the lysodren is working after starting it. It also could confirm that the diagnosis is accurate.

Please repost your dog's weight and the dosage of lysodren you were told to give. I want to make sure it is within range of what is recommended.

Also before starting it is helpful if you measure water intake before starting. This way you know for sure if it is less or not. I poured water into a bowl and marked it with tape. Every day I put the same amount in and at the end of the day I measured it.

I also watched how my dog ate food. Sounds crazy but if you are looking for subtle changes in eating or drinking as a sign of loading you have to know for sure what 'normal' was before treatment.

I already posted a link on how lysodren works and what to look for so be sure to have read that.

Kim

[karabella]

Hi Kim! Thanks for your response. Ava weighed in at 70lbs at the vets office on wednesday. The dose of lysodern is 500 mg 1/2 tab in am and 1/2 tab in pm and she wants me to schedule bloodwork on day 7.

ldds results
pre dex 4.7 range 1.0-6.0 ug/dl
post 4 hr dex 0.7 range less than 1.5 ug/dl
post 8 hr dex 2.4 range less than 1.5 ug/dl

And nothing sounds crazy to me any more I find I am doing a lot of watching-how she's eating, drinking, peeing, pooing and how she is behaving. The only problem with measuring the water is both of my dogs drink from the same water bowl so it would be hard to judge just how much of the drinking Ava is doing.
It helps to know I don't have to rush into any decisions about treatment-that it isn't a life and death situation. The best advice I have been receiving that has helped me is to relax and breath.
I will be checking out the post regarding how lysodren works. Thanks.

[frijole]

THanks! I had two dogs too. Measure the water and assume the other dog won't have any changes and you can assume the difference is your cush dog. A normal dog drink 1 oz of water per lb of weight approx. (just for reference)

That is one LOW dose of lysodren. The recommended dosage is between 25 and 50 mgs per kg of weight. Your dog is 31.8 kgs so if you multiply that by 25 the LOWEST effective dose would be 796 mgs per DAY. The highest would be 1590 (3 pills) a day.

My only concern is that you will waste time and money by starting that low. The acth test that you will have to have to determine progress (in 7 days per your vet) will cost somewhere between $150 and $500 depending on your vet's office (yeah that is crazy isn't it) and you have to keep doing this test until you are at the desired range and then afterwards to maintain it... so you can see what I mean.

When people use trilostane it is best to go low and tweek upwards but with lysodren we have seen that most dogs need the highest dose (50 mgs per kg or in your case 3 pills) in order to load.

You might want to ask your vet about the dosage. You can tell her you got the information from reading recommendations by cushings experts such as Feldman. If she knows anything about cushings she'll recognize that name.

Kim

[marie adams]

A little late with the welcome, but welcome to you and Ava!!:)

My Maddie girl was on Lysodren and my first vet was good on the loading amount, but then so off on the maintenance. I was on the forum so the experts helped me all the way--giving me the advice that made sense. Not that you shouldn't trust your vet, but like Kim said use the name Feldman from UC Davis. :)

Maddie weighed in, at the time, at 70 lbs and she was on 1500 per day for the loading. She did great and it was about 7 days and then I saw her hesitate with her food or look at me--where as before she couldn't down it fast enough. :D

You are doing a great job--please keep asking questions here at the forum. :) You are in the best hands ever here!!!!

[karabella]

Thank you to everyone for all the great advice. I've decided to take it slow and make sure what I'm really dealing with here is cushing's disease. I am so confused. I have really been watching Ava the last couple of days and all the symptoms that pointed to cushing's seem to have subsided. In fact the last couple of days I was worried to wasn't drinking enough(didn't see her go near the water bowl yesterday and got worried and gave her ice cubes to get fluid in her)I had to practically drag her outside to go potty and her eating seems to be back to normal-no more trash raiding. Does this make sense to anyone? Does this ever happen or does it just mean she never had cushing's? I am more confused then ever.

[frijole]

It's weird... 7 yrs ago when my dog was diagnosed with cushings vets were shy and slow to dx it. Now it seems like they often rush to judgement... keep in mind it is an excellent revenue stream ;) Anyway... because there is no rush to treat AND the experts in the field say NEVER treat a cush dog unless symptoms are present.... anyone being presented with the dx and drugs need to sit back just as you are ....

Let's start off with thirst. Not all cush dogs have this problem - mine didn't.. but those that do drink BUCKETS not just 'alot' of water. Normal water intake is an oz of water per lb of weight approx.. so start out by measuring water intake. Take a bowl and mark it with tape. At the end of the day measure consumption. Repeat until you have an average. If you have more than one dog it doesn't matter really - just assume your normal dog drinks for one normal dog.

Hunger - most cush dogs present with this symptom. IT isn't just that they like food it is that they LIVE for food. They not only chow but they do not even chew it - seriously - they inhale food. They do things like knock down trash cans that they never did before in search of food, they fight with other dogs for food, they spend the entire day like a vaccuum cleaner in search of morsels.

Rounded tummy - cush dogs look pudgy. I was always pissed at my vets because they told me my dog was overweight when she wasn't. It was her cush tummy and they failed to recognize it.

Weakness in hind legs - as cushings progresses dogs no longer jump up on chairs/sofas and sometimes can't go up and down steps. My dog did this on occassion and I was massively confused. Still I'd never heard of cushings so I shrugged it off as it wasn't all the time. Then her hind legs started shaking (trembling) from time to time.

I never had hair shedding issues either but that is a sign as well.

Read in our resource section about the symptoms and see if your dog even has them. If they aren't serious you can always treat later. Hope this helps. Kim

[karabella]

All of the symptoms that you mention are the reasons I brought Ava to the vet.
Thirst-it seemed like everytime I looked at her she was drinking and I was refilling the water bowl. It wasn't just drinking water she was eating a lot of ice cubes also. She was starting to go in my house-something she never did.
Hunger-like she was starved all the time. Not only raiding the trash-something she had never done before but taking food off my table. I mean things she would never have touched before-bread still in the bag, pizza in the box. The one thing I was worried about she had gotten into the trash and had gotten the bones from my son's chicken wings I know how bad they are for dogs.
Her skin was very dry. When I brushed her I noticed she was very flaky. Not normal for her.
Her stomach seemed bloated. I guess it could have been from everything she was getting into.
Also she would normally sleep in bed with me and she had started to sleep on the floor at the end of my bed. When she did get up on my bed she seemed to have trouble getting up.
It was because of all of this and the results of her bloodwork that my vet had suggested the ldds test. And when those results came in she felt that she had cushing's. Were her test results consistent with a dog having cushings? Like I said I am more confused now more than ever.
All I can do now is keep a close watch on her to make sure the symptoms don't reappear.
Thanks to everyone here for all your support. It is greatly appreciated.

[frijole]

That is wierd because with cushings the symptoms don't come and go (as in thirst, hunger, hair etc) ... regardless - no rush and in the mean time you have time to hang out with us just in case. :D;) Kim

[karabella]

Kim, you are so right. I am going to take my time and keep an eye on Ava. I think I still feel so guilty over having to put my cat to sleep. I feel that I should have realized sooner she was having a problem. I don't want to make that same mistake with Ava. I don't know what I would do if anything happened to her. I got Ava right after having to put my Jingles to sleep. Jingles was the first dog we got when my kids were little. She was such a sweetheart. After she was gone there was such a void-the house seemed so empty. I went out after only a week and Ava found me. I was actually looking at another dog when Ava got my attention. I knew right away she was the one. Crazy little Ava. It turned out another family had adopted her but felt she was a handful(and she was!) so they brought her back to the shelter. Their loss was my gain. They didn't realize with lots of love and patience(lots of patience!) what a great dog they could have had. But they weren't meant to keep her because she was supposed to be with me and my family. I can't imagine what my life would have been like without her. She has helped me through some tough times.
So when I got the news about the cushing's like the title says I was completely overwhelemed-devastated actually. Finding this website was the best thing that has happened in a long time. So thank you for being there for me and my baby girl.

[frijole]

No problem! I met this group over 7 years ago when Haley (the dog in the front of my avatar) was diagnosed with cushings. I treated her for 4 1/2 yrs with lysodren with no problems. She passed 2 yrs ago at the age of 16 1/2 of old age. My other gal, Annie (back of photo) got sick 1 month before Haley passed. She was MISdiagnosed with cushings... I had everyone on this forum stumped for a year with lots of strange things noone could figure out.. til I drove 5 hrs to K State Univ's vet hospital.... a very rare tumor. Anyway... she fought it for 2 yrs and passed this February. So I am dogless and healing right now. This group has helped me so much I could never repay them all for the love and help they've given. Glad you found us. Kim

[Boriss McCall]

Kim, I am curious..
My Boriss doesn't really show signs of Cushing's until around 6pm in the evening on most days. His symptoms are really mild. He doesn't start on his "food hunts" until the evening time.

The IMS told me something to the effect that the gland could be sporadic & releasing higher cortisol at different times. Does that sound right at all to you?

[karabella]

I was going over Ava's test results again and I noticed on her urinalysis under blood results 1+ reference range negative flag high. Can anyone tell me what this means? Does it mean they found blood in her urine? I'm assuming it was not something to be concerned about since my vet never mentioned it. I was just curious.

[Harley PoMMom]

Was Ava's urinalysis done via free catch or cystocentesis?

[karabella]

Free-catch

[lulusmom]

I was going over Ava's test results again and I noticed on her urinalysis under blood results 1+ reference range negative flag high. Can anyone tell me what this means? Does it mean they found blood in her urine? I'm assuming it was not something to be concerned about since my vet never mentioned it. I was just curious.

There is a small amount of blood in the urine but I bet that your vet may not have been too concerned because there were no other urine abnormalities that were big red flags for him. Also it is not an uncommon occurrence to find traces of blood in the urine when the urine specimen has been contaminated. Free catch specimens aren't the most desirable collection for this reason.

[karabella]

I have been observing Ava and she seems fine. According to my vet the ldds says she has cushing's disease-how can this be? Is there such a thing as a dog just having an episode of cushing's? Could something else have caused the symptoms and then cleared up? I think I will call my vet tomorrow and see what she has to say. I will not be starting treatment if she is not showing any signs. Hoping to get some opinions. Thank you.

[frijole]

The LDDS test frequently results in false positives if there are non adrenal illnesses present. In other words, other ailments can cause this test to present a false positive. Given that you aren't seeing cushing like symptoms I'd assume something else might be going on. I would not start any meds unless the dx was confirmed by an acth test AND an abdominal ultrasound was done.

I have to leave now so don't have time to re-read your thread to see if original bloodwork could point to some other ailment. But that is where I would actually start - well your vet should. :) No, cushing's is for life - no episodes. No need to rush into anything - you can throw out names like Drs. Feldman, Bruyette, Peterson as endocrine experts that write articles on cushings. Very simply you do multiple tests and you do NOT begin treatment if there are no serious symptoms.

Kim