maybe cushings

[Boomers Mom]

Hello fellow animal lovers. My 10 year old boy Boomer ( a golden retriever) was just "sort of" diagnosed with cushings disease. The vet said his levels were in the gray area. He has been on prednisolone for about 2 years for severe allergies. At this stage, we don't know yet if it was the pred or if he has a tumor. I am a little confused by all this. How will I know for sure whether or not he has a tumor? Is it a common practice to operate to remove a pituitary or adrenal tumor? This sweet boy is my sunshine, my joy, laughter, and everything in between but I want to know what I'm facing so I can make sure he is comfortable. We are testing again in a week to see if the levels have changed since he's been off his pred for about 3 1/2 weeks at that point.

[labblab]

Hello and welcome.

It will help us a great deal if you can contact your vet and find out exactly which diagnostic tests have been run and which "levels" are pointing to Cushing's. Also, what symptoms have made your vet suspect there is a problem?

Do you know whether an ACTH stimulation test has been run yet? This is a two-hour test that involves two different blood draws, and it does a really good job of identifying the form of Cushing's that is caused by steroid treatment ("Iatrogenic Cushing's). This would likely be one of the first best tests in your situation.

Looking forward to hearing more about you Boomer and his test results.

Marianne

[molly muffin]

Hello and welcome to the group. :)

Okay, first, you must be absolutely terrified and upset. That is how we all came to be here. So, take a very deep breath and lets go step by step. As Marianne said, we need to know what tests have been done, what the values (abnormal high or low, with ranges) are. ACTH, LDDS, UCCR, Ultrasound and a blood panel are some of the tests that can be done to determine, if and or what kind you are looking at dealing with.

So, lets get those results posted on here and take a look at them and talk about what they mean.

Understanding what cushings is and what it isn't, is very helpful in both settling down the rolling stomach (that is for you not Boomer) and deciding what possible next steps should be taken.

So more deep breaths. Either way, you are looking at what is normally a slow processing disease if it is cushings, and the possibility that it isn't cushings at all. You never know till you go down the road to find out. :)

hugs and welcome again,

Sharlene and Molly Muffin

[Nikki]

Just wanted to say welcome!! I know it's scary but you have found a great group of people that will offer you so much support and knowledge!!!

[Boomers Mom]

Thank you all so much. I will be talking to Boomers vet today to get the information and to see what the test will be next week. It is so wonderful to know all of you and to experience the comfort of knowing we can travel this road together.
I'll be posting more info today and thanks again!

[goldengirl88]

Boomer's Mom:
Wanted to welcome you, and tell you I have the most wonderful Jack Russell Terrier Tipper, and she too had allergies. Due to the use of prednisone she developed cushings. These people on this forum are wonderful, and have a tremendous amount of insight on this disease-probably more than the average Vet knows! You will get a lot of information, and support here. Be strong for your goldens sake, and get a good Dr. that knows about this disease. I will pray for you both.

[Boomers Mom]

Hello again. Could some of you give me some insight about what to expect with this disease and the treatment, side effects, etc?
Thank you so much.

[Boomers Mom]

Hi, me again.........Boomer's symptoms so far are excessive panting, and severe muscle weakness in his back legs. He does also appear to have a bit of a pot belly. For a while he was ferociously hungry all the time but since he's been off the pred for about 3 weeks now, he's not nearly as hungry and I don't see excessive thirst in him.

[Squirt's Mom]

Hi,

First, welcome to you and Boomer! :) I am glad you found us and hope we can help you both.

Since Boomer has been on a steroid for some time, it is possible that what you are seeing as Cushing's signs are all due to the medication, not true Cushing's. Iatrogenic Cushing's is a form that is caused by external influences, typically medications that contain steroids either orally or topically. It is "cured" by removing the steroid, if possible. Once the steroid is out of the system, the signs disappear. This is not true Cushing's. In true Cushing's, the signs do not come and go - they come and get stronger and stronger without treatment.

True Cushing's always means a tumor is present - either on the pituitary or the adrenal glands. In very rare cases, a pup can have tumors in both places, or two adrenal tumors, one on each gland. These are extremely rare cases. The majority of cush pups have the pituitary form, PDH, approximately 85%. The remaining percent are mostly adrenal based Cushing's, ADH.

Removal of adrenal tumors will typically affect a cure IF the pup is a candidate for the surgery. This is a very serious surgery but at the moment is the only real possibility of a cure. Pituitary tumors typically remain microscopic, causing no further problems than the usual with Cushing's. A small percentage of PDH pups will experience growth in the pituitary tumor, becoming what is called a pituitary macroadenoma, and causes a multitude of neurological signs and discomfort. In The Netherlands a surgery called Hypophysectomy is often performed in which the pituitary tumor is removed. This surgery is new in the US however and we have not had many who chose that route when a macro was diagnosed. Radiation is another option for macros.

For the vast majority of cush pups, controlling the signs will give them the chance to live out their full life span and often beyond due to the depth of care the pup receives. Ravenous appetite (as if they are literally starving), unending thirst, constant urination including loss of house-training, panting for no reason, seeking cool spots to lay even in the dead of winter, pot-belly from redistribution of fat, hair loss on the tail and back region, loss of the ability to jump and/or climb, listlessness, loss of interest in family or things they used to enjoy - these are the common things we see in an untreated cush pup. Once treatment starts and the dose is correct for that pup, the signs start to go away and the pup feels and acts more like their old selves. Treatment is usually life-long.

There are two main treatments available for our babies - Vetoryl (Trilostane) and Mitotane (Lysodren). Both are very powerful drugs but both are also life-saving drugs. Neither is safer than the other, they both have the same risk factors. The two drugs work differently to achieve the same results - control of the signs. There is no cure - the goal of treatment is to control the signs and minimize organ damage from rampant cortisol coursing through their bodies. The keys to treatment are an experienced vet who has success stories, not failures, and our own education on the disease and its treatments. A team approach between us and our vets is critical.

For some good insight to Cushing's, here is a link to Kate Connick's site.

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

I hope this helps! And let us know what you learn from the next vet visit. Get copies of the testing that has been done, labs plus any Cushing's tests, and post the results here in Boomer's thread. We will do all we can to help.

Hugs,
Leslie and the gang

[Boriss McCall]

Hi i just wanted to drop in & welcome you & Boomer to the board.

[Boomers Mom]

Is there one test that is the gold standard for diagnosing cushings disease?

MODERATOR NOTE: I have merged your latest post concerning a "gold standard" test with Boomer's original thread. We like to keep all the info about each pup in one thread. That way it is easier to look back through the history if needed. Thanks!

[Harley PoMMom]

Probably the LDDS test is the "gold standard," but other issues have to be taken in consideration also.

Strong, obvious symptoms play a huge part in a cushing's diagnosis, however, other health issues need to be ruled out.

[Squirt's Mom]

Dr. Edward Feldman, a leading endocrinologist in canine Cushing's has this to say about the ACTH when Iatrogenic Cushing's is suspected -


Feldman: Iatrogenic and naturally occurring Cushing's are clinically indistinguishable. While the ACTH stimulation test is an inferior screening test for naturally occurring Cushing's, it is the gold standard for the diagnosis of iatrogenic cases. If a dog looks, smells and feels like it has Cushing's and if an iatrogenic source is suspected, an ACTH stimulation test should be performed. Treatment could not be easier: Stop the steroids.

http://veterinarynews.dvm360.com/dvm/Endocrinology/Cushings-disease-and-other-adrenal-gland-disorders/ArticleStandard/Article/detail/672663



Unfortunately, there is not one single test that can diagnose Cushing's and determine which type with 100% accuracy. This is because so many other factors - non-adrenal illnesses (Cushing's always involves the adrenal glands) - can affect the tests, causing false-positives.

Hugs,
Leslie and the gang

[Boomers Mom]

Hello everyone. I have a question.....my Boomer had severe allergies with lots of sores and raw spots on his skin until I started him on prednisone and that helped him a lot. The problem is that I have had to take him off the pred due to the fact that the vet suspects he has cushings disease. He has no quality of life with the allergies as bad as they are when he doesn't take the pred. Does anyone know of someone who has elected not to treat cushings, what happens if you don't, or other ideas what might get his allergies under control? I started him on Atopica last week and I know it takes a few weeks to work but so far no help.
Thanks for your help.

Moderator's Note: I have merged your post concerning Boomer's allergies into Boomer's original thread. We, normally, like to keep all posts on a pup in a single thread as it makes it easier for other members to refer back to the pup's history, if needed.

[Nikki]

Hi!
Before being diagnosed with Cushing's disease, my Boston Terrier Max was diagnosed with severe allergies. His fur was literally falling out to the point where he had big open sores, his skin was infected and oozing. I mean it was gross, I was embarrassed to even let people see him because the reaction was usually people being horrified by how bad his skin was. I don't know if your case is any similar than this, but I figured I'd tell you my story! After injections prednisone, repeated rounds of prednisone, it continued to get worse and worse. Finally after months my vet recommended we do a biopsy. Turned out he had calcinosis cutis, which pretty much is how we found out he had Cushing's disease. Take a look at my pictures, if you haven't had a skin biopsy done then maybe this is the case with your dog? Within a week of starting treatment for Cushing's disease, his skin started to look better. He still looks awful and has missing fur, but it is no longer open infected wounds.

p.s. look under my pictures from January, they are from right before we started treatment and show his skin at its worst.

[Steph n' Ella]

Poor Boomer and his allergies! Hopefully between us and your vet you can find a good treatment plan for the little guy soon!