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View Full Version : Hello everybody. New here. Siberian Husky --pre-diagnosis: cushings.



Tundra's Mom
11-05-2012, 05:48 PM
Hello. My beautiful best friend has been "pre"-diagnosed with cushings (our vet says all things so far point to cushings, and she will gather estimates on further tests needed to make the diagnosis).

So far, Tundra's symptoms are:
lethargy and a depressed manner
excessive thirst/drinking of water
excessive urination
"leaking" small amounts urine in the house
increased appetite/weight gain (failure to lose weight after 1 yr on diet)
diluted urine (do to excessive water consumption)
exercise intolerance -- he's tired and develops a strange gate after walking about 2 blocks
pale gums and under-eyes on occasion
potbellied appearance (his tummy has become distended/enlarged from what it used to be)
his "stance" is different ...his front legs, well, his "wrists" seem to sag, and he has a sway-backed look, just different from what he used to look like


We took Tundra to the vet one week ago because I noticed his gums were very pale, and his under-eyes were also pale, plus he seemed very tired and depressed. I actually suspected diabetes, as Tundra is about 15 lbs overweight (or more) and he will be eight years old in one month.

They took a blood sample, did a basic examination, and sent him home with instructions to get a morning urine sample and bring that in the next day.

Our vet called us when the labs came in. She said that his blood sugar is fine, so no diabetes, he has no bladder/urinary tract infection, and I believe she said his liver panel came out ok as well. I was mistaken about this -- his liver panel DOES have some flags! Tundra's ALK PHOSPHATE is 2014 UL, flagged high (normal looks to be 10-350 (or 150???)UL, copy is very difficult to read). I will post more below regarding flags on his blood/urine panel done last week.

However, she said his blood chemistry is all messed up, and his urine is extremely diluted. Because of this, plus his symptoms, she suspects Cushings, but will need to do further testing to make the proper diagnosis.

She said there are other blood/urine tests, x-rays, ultrasounds ...

(I did my best to take all of this in, but my mind was both reeling and going numb at this point)

She knew she could talk to me matter-of-factly, since I once worked for a veterinarian (as a vet assistant, not a vet tech).

She said the average life expectancy is two years, and that cushings in itself doesn't kill dogs, but that the complications/health problems stemming from cushings can be very serious, and that's what kills the animal (I am sorry, those were NOT her exact words -- at this point I was in a bit of shock, so I am paraphrasing a bit).

We agreed, at the end of the conversation, that she would gather some price quote estimates for the tests necessary (blood/urine, xrays, ultrasound ...etc).

Also, though she is a traditional medicine veterinarian, she does believe in holistic treatments, as long as they do no harm ("above all do no harm"). She said that if Tundra does have cushings, the fact that he is a very large dog (106#) makes it very difficult to treat, and that treatment is very expensive -- over $400 per month. She mentioned several different treatment options. She knows I like to research the internet, so she suggested I learn all that I can during the next week (last week) while she gathered cost estimates for the tests needed. That is basically where we left it, last Tuesday (Oct 30, 2012).

I totally trust our veterinarian, she is extremely knowledgeable and very good with Tundra.

I have had a week to absorb all of this. I cry a lot. I am looking up everything I can about canine cushings. We don't yet know for certain that it is cushings, and if so, what type of cushings (adrenal vs pituitary, malignant tumor that can be removed vs cancer that has spread ... ?)

I vacillate between total tears, crying (How can this happen to Tundra?? He is the sweetest, most gentle and innocent dog/animal I've ever known!!!), being practical (I need to research every single possible option!) and back to the tears. Suddenly, I just start crying, sobbing. Then I "soldier up" and stop myself. Tears won't help my dear, gentle friend. Having said that, just now, somehow releases me to yet another flood of tears. I'm sure you all know this all too well.

I came across this site, after reading so much info that I became very sad and frightened, so I looked for "support" regarding canine cushings, and here I am.

I have read some posts here already. I cried when I read them.

Tundra has been basically at my side since I adopted him at a year and a-half of age. (that's 6-1/2 years we have never been apart!) I don't work, so that's why we are always together.

I am looking for friendly support, hand-holding, and information/education.

Sorry this is so long. Anyway, "Hello, and nice to meet you all." :)

-- Annie, "owner" of Tundra (almost 8-yr old Siberian Husky, neutered male, and gentle, loving companion)

molly muffin
11-05-2012, 08:00 PM
Annie, welcome to you and Tundra. Wow, is he just gorgeous or what! (okay got that out of my system!) LOL

Not one person finds us that isn't scared and worried and everything else that goes along with getting this diagnosis. So, the first thing is remember to breath. Then based upon what you have been told and what you have read probably on the net. I'll start by saying that we have many members here and every dog is different. Some of them have lived out some fairly long lives with cushings, on cushings medication even. So, it's not a death sentence. The next thing is that the disease itself is Usually slowly progressing.

I'd probably have an LDDS done, to see if Tundra is able to suppress cortisol. If this comes back negative, then I wouldn't start any kind of medication now. Ultrasound would be good to know what the liver and adrenal glands are looking like. They are usually one of the more expensive items.

Next if one assumes that he Does in fact have cushings, and that you decide to start on medication, you'll have to decide between two main types, trilostane or lysodren. If you are comfortable with lysodren, then that is a cheaper long term option, as there is less testing and
you don't have to give as frequent medicines.

Check out the resource section here and you can read about these options and also ask
members any questions you might have.

We have a thing here, and it's called, once you come in, sit down, you are family. We stick it out through good and bad. You will always have someone
who is going through or has gone through, everything that you will be going through.

I can tell you that right now, I'm in the state you are in, sort of, with a possible precushings dog. It might tip over that way one day
and it might end up being something else. We really don't know. This is just our lives now. You'll notice yourself watching everything they do and
analysing the heck out of ever poop and pee and belly rumble, how much did they drink, what are they eating. It's consuming.

It's okay to cry, this is a scary disease and anything being wrong with your baby, your best friend, is a very scary prospect.
However, the more you learn, the less stressful it is. I'm not saying it won't be stressful, it will be at times. But not nearly
as much as it is when you first hear about it and start reading everything on the net.

So, lets get copies of blood work that he has had done leading up to this. What are the high/lows and the ranges.
That is a start.

Hang in there!

Sharlene and Molly Muffin

lulusmom
11-05-2012, 08:22 PM
Hi Annie and welcome to you and Tundra.

To keep myself on track I’ve typed my comments and questions in blue within the body of your post below. Between the two of us, we’ve created a short novel. 



So far, Tundra's symptoms are:
lethargy and a depressed manner
excessive thirst/drinking of water
excessive urination
"leaking" small amounts urine in the house
increased appetite/weight gain (failure to lose weight after 1 yr on diet)
diluted urine (do to excessive water consumption)

Did your vet do a urine culture? When urine is diluted out, so are the white blood cells so a standard urinalysis will not always detect an infection/bacteria. FYI, dogs with cushing’s have dilute urine because their kidneys lose the ability to concentrate the urine so these dogs pee a lot and they drink to stay hydrated. Most people think their dog is urinating more because the dog is drinking more. The opposite is true. Just remember to never restrict water as to do so could be dangerous.
exercise intolerance -- he's tired and develops a strange gate after walking about 2 blocks

Is the strange gate a limp or a rigidness in his legs?
pale gums and under-eyes on occasion

This is an indication of anemia and the only time I’ve seen intermittent anemia is when a dog is being starved for oxygen like when the heart is not working properly. Did your vet check Tundra’s heart? Anemia is not a symptom we see around here unless a dog has another issue going on. It is more likely to be a symptom of hyperthyroidism than it is cushing’s. Did your vet rule this out?
potbellied appearance (his tummy has become distended/enlarged from what it used to be)
Dogs with cushing’s have a pot belly due to a combination of enlargement of the liver and muscle wasting. Dogs with hyperthyroidisim can also have a pendulous stomach and are prone to be obese.

his "stance" is different ...his front legs, well, his "wrists" seem to sag, and he has a sway-backed look, just different from what he used to look like


Our vet called us when the labs came in. She said that his blood sugar is fine, so no diabetes, he has no bladder/urinary tract infection, and I believe she said his liver panel came out ok as well.

It would be pretty unusual for a dog with cushing’s to have normal liver values. Most have elevated ALK with mild elevations in ALT. If liver values are normal, it’s more likely that the liver is normal so no enlargement would be contributing to Tundra’s big belly.

However, she said his blood chemistry is all messed up, and his urine is extremely diluted. Because of this, plus his symptoms, she suspects Cushings, but will need to do further testing to make the proper diagnosis.

We would love to see the results of the blood chemistry and the complete blood count. It would be great if you could please get a copy of all testing done thus far and post the results here. With respect to the bloodwork, you need only post the highs and low values and please include the normal reference ranges. Did Tundra’s symptoms come on suddenly or was it over a long period of time?

The symptoms do sound like cushing’s but a lot of other conditions can share the same symptoms so we are the consummate skeptics. :D To be honest, the anemia has me worried because it is not a common symptom of cushing’s.

She said there are other blood/urine tests, x-rays, ultrasounds ...

It is really good that your vet seems to know that most of the diagnostic tests for cushing’s are pretty crappy so you need to do more than one to validate and differentiate between the two forms of cushing’s. Not a lot of general practitioner vets are all that knowledgable about cushing’s so we are always concerned and like to look over their shoulders. Based on the bit of information you have given us thus far, your vet appears to be knowledgeable that most….but again, we are skeptics so the jury is still out. :D
(I did my best to take all of this in, but my mind was both reeling and going numb at this point)

Believe me, you are feeling the same raw emotions most of us did when we got the dreaded diagnosis. Even if you are clear headed, cushing’s is tough to wrap your head around so don’t be surprised if it takes a bit of time for you to start to put the pieces together. We’ll help you do that one day at a time.
She knew she could talk to me matter-of-factly, since I once worked for a veterinarian (as a vet assistant, not a vet tech).

She said the average life expectancy is two years, and that cushings in itself doesn't kill dogs, but that the complications/health problems stemming from cushings can be very serious, and that's what kills the animal (I am sorry, those were NOT her exact words -- at this point I was in a bit of shock, so I am paraphrasing a bit).

Life expectancy after diagnosis depends on how old the dog is at diagnosis. The two year life expectancy deal is basically an average. Most dogs are fairly senior when diagnosed so even if they didn’t have cushing’s, they probably only had a few years left anyway. My dog is one of the rare ones who was diagnosed very young. She was three years old and she is 11 years old now. That kind of blows your vet’s theory huh?Cushing’s is a very graded disease and unless a dog has complications like diabetes, it would take a very long time for cushing’s to kill a dog. Most dogs that die of cushing’s are never diagnosed. A good number of pet owners think the symptoms are just a sign of aging and once the symptoms become too problematic for them, they have the dog euthanized. Sad but true and a contributing factor to these needless deaths are inexperienced vets who are clueless about cushings. My own gp vet couldn’t spell cushing’s which is why he hasn’t seen any of my dogs in the last seven years and won’t ever again.

We agreed, at the end of the conversation, that she would gather some price quote estimates for the tests necessary (blood/urine, xrays, ultrasound ...etc).

The diagnostic phase of this whole ordeal is the most expensive. Like I said, if we only had one test that was credible, your vet wouldn’t have to be writing down a laundry list of tests and related costs.

Also, though she is a traditional medicine veterinarian, she does believe in holistic treatments, as long as they do no harm ("above all do no harm"). She said that if Tundra does have cushings, the fact that he is a very large dog (106#) makes it very difficult to treat, and that treatment is very expensive -- over $400 per month. She mentioned several different treatment options. She knows I like to research the internet, so she suggested I learn all that I can during the next week (last week) while she gathered cost estimates for the tests needed. That is basically where we left it, last Tuesday (Oct 30, 2012).

Big dogs are no more difficult to treat than little dogs. As a matter of fact, if using Vetoryl, some big dogs have been controlled with the same or smaller dose than my 4.5 lb Pom was on. Every dog is different so unless you have a crystal ball, you’ll just have to wait and see how it goes down. However, it can be expensive so do your homework and check prices for whatever treatment you choose. Your vet should be happy to give you a script if you can find the drug cheaper elsewhere. A good number of us purchase our medications, both name brand and compounded, from Diamondback Drugs in Scottsdale, AZ. They are always happy to give you their pricing.
I totally trust our veterinarian, she is extremely knowledgeable and very good with Tundra.

Trust is fine as long as you don’t place blind faith in your vet or anybody to do what is best for Tundra. Us pet owners need to educate ourselves so that we can be active participants in our dog’s treatment. We an help you become the best advocate you can be for Tundra so if there is anything you don’t understand, just ask.

I have had a week to absorb all of this. I cry a lot. I am looking up everything I can about canine cushings. We don't yet know for certain that it is cushings, and if so, what type of cushings (adrenal vs pituitary, malignant tumor that can be removed vs cancer that has spread ... ?)

I vacillate between total tears, crying (How can this happen to Tundra?? He is the sweetest, most gentle and innocent dog/animal I've ever known!!!), being practical (I need to research every single possible option!) and back to the tears. Suddenly, I just start crying, sobbing. Then I "soldier up" and stop myself. Tears won't help my dear, gentle friend. Having said that, just now, somehow releases me to yet another flood of tears. I'm sure you all know this all too well.

Yep, we’ve all been there, done that. Dry your tears because cushing’s is not a death sentence and if Tundra truly does have cushing’s, we’ll get you both through this and you will get your old Tundra back.

I came across this site, after reading so much info that I became very sad and frightened, so I looked for "support" regarding canine cushings, and here I am.

I have read some posts here already. I cried when I read them.

It’s normal to be scared to death but I promise that the more you learn, the calmer you will become and before long, all the pieces of the puzzle will come together and you’ll be answering questions.
Tundra has been basically at my side since I adopted him at a year and a-half of age. (that's 6-1/2 years we have never been apart!) I don't work, so that's why we are always together.

I am looking for friendly support, hand-holding, and information/education.

Lucky for you and Tundra, you have found the best of the best at all of those things.



Glynda

Boriss McCall
11-05-2012, 10:12 PM
hi Annie.. Welcome to you & Tundra!

Bo's Mom
11-05-2012, 10:50 PM
Hi Annie....just stopped by to welcome you and Tundra. I just want to tell you that you have found the most knowledgeable, caring, AND compassionate people out there. You will undoubtedly have tons of questions as you walk the path of getting the cushing's diagnosis. Everyone here will be there every step of the way so please ask as many questions as you have and don't ever feel alone. But, it is okay to cry. I have found myself doing it a lot lately but I know that there are people here who will offer their kind words and will help me get through it all.

Tundra's Mom
11-05-2012, 10:50 PM
Oh my! I never expected such kind responses! Thank you Molly Muffin (Sharlene), lulusmom (Glynda) and Boris McCall ...i hope I got all of your names right!:o

I am so comforted just having read your kind responses. I just took a real breath for the first time in a week. Thank you! :)

Tundra is scheduled tomorrow am (8am) for his ACTH stims (?) test. I will know more after that. I am very curious about the LDDS test that you mentioned -- I will definitely ask my veterinarian about that!!

All of you wrote such heartfelt replies, and thank you so much. Glynda, I will re-read yours, because you have so much info for me to absorb, I really appreciate all of the time you took to go over every single bit of my post (and also Sharlene, and Boris McCall). :)

I am going to re-read and re-read all of your replies, and take notes. For now, I am so tired, and thanks to you and this site, I think I can actually get some sleep tonight, finally.

I just want to say thank you all, again. I feel like I have found the right place, thank you so much for your warm welcome and for your support.

Hugs,
Annie and Tundra

Oh! and while I was writing this, Bo's Mom (Belinda) posted a kind welcome!! Thank you also, Belinda, you are so kind, you are all so kind! Good night all, and thank you ALL once again :)

kaibosmom
11-06-2012, 02:17 AM
Hello to you and welcome. I am also new to the group. Reading your post made me cry. I guess when we found out about Kaibo, I feel as if I already knew so I didn't take time to think about it and react that way. It was more of a yes, that is what I suspected and the test results just confirmed my suspicions. That being said, my vet referred me to this site and now that I am exploring it, I am getting nervous over the treatment and whether or not we have asked our vet enough questions or as someone mentioned, just putting blind faith into our vet. So....I'll keep reading here. The responses you received have also helped me. Hang in there and good luck to you.

Nikki and Kaibo
p.s. how do I put a picture on here? lol

kaibosmom
11-06-2012, 02:22 AM
Oh yes, thank you lulusmom for posting about life expectancy and what not. I've been freaked out since reading about the "2 years" considering Kaibo is only 5. I really can't imagine why my little man has to go through this on top of luxating patella surgeries, liver issues (well, that's likely related to the Cushing's), and his unfortunate love of chocolate in conjunction with his constant hunger...it makes him very persistent for food.

Trish
11-06-2012, 03:34 AM
HI Annie
I am pretty new here too, trying to get to grips with everything. My boy might need surgery. I just wanted to say to you and also Nikki that I totally understand that horrible feeling when our babies are first diagnosed with something we do not really understand. I too have have had that awful gut wrenching feeling this past week, wanting to do everything we can for them and seeing them unwell is just horrible. I have not been sleeping real well, waking in the middle of the night and reaching over the side of my bed to his little bed next to me and just petting him and crying quietly so he cannot see :( I think once they have an established treatment plan and things get underway they (and us!) will feel a lot better! So hang in there and aren't we lucky we have found all these smart, compassionate people to help us on the way.
Trish and Flynn
xx

Tundra's Mom
11-06-2012, 04:18 PM
Thank you, Trish :) I agree, I think an established treatment plan will help to alleviate or at least subdue that "gut wrenching feeling" and sleepless nights. I guess we are at the very beginning of a journey into the unknown, or more like a roller-coaster ride. Hopefully, once we get a little further along, we will be able to breathe a bit easier. :)

Tundra's Mom
11-06-2012, 04:25 PM
Thank you Belinda :) I really feel fortunate to have found this site. I feel at home already.

Tundra's Mom
11-06-2012, 04:35 PM
Thank you, Kaibosmom, I am sorry my replies are out-of order here. I am a bit scattered these last few days. :o

I am glad the responses I've received are helping you as well! I know that we can all help each other here. This looks like the perfect site.

I will try to help you learn how to post a picture here, (I will send you a private message). I will be back online in a bit. (I will post some of Tundra's results that were flagged from his last bloodwork/urinalysis when I come back online.)

Tundra's Mom
11-06-2012, 06:35 PM
Okay, I hope I am back on track here with this thread, I'm sorry some of my responses were a bit out of order. I also don't know how long I should continue this initial post, before I switch to a new thread in a different forum category. Please forgive me if I carry this initial thread on too long :o

First of all, I want to thank all of you for your responses. Glynda, thanks for the "20 questions", lol! Wow! Seriously though, I am amazed and very comforted that you actually took so much time and put so much thought into every bit of my first post/thread here. I cannot thank you enough. It may take me awhile to answer each and all of your questions, but wow, I never expected such consideration and kindness. I totally see now that I am in the right place! :)

This post may be a bit long, but I will try to curb my posts a bit in the future.

This morning Tundra got his ACTH stim test, we will probably get his results by Friday. I did expect it to be an 8 hr test, but we brought him in at 8am and picked him up at 11am. At that time, I picked up a copy of his results from bloodwork/urinalysis done last week.

The copy is not easy to read, very faint -- perhaps the original is blue ink on yellow paper, or maybe it is a low-ink situation?

Anyway, the test was done by IDEXX Labs, and the results have 5 columns: Test; Result; Reference Range; Flag; and Bar Graph.

The part that is most difficult to read is the "Reference Range" numbers. Thus the question marks (?). I can read the rest fairly well.

So here are the results that were flagged (and I was wrong about the liver part -- Tundra DOES have flags there, for one, ALK Phosphatase is extremely elevated, as our vet mentioned today):

ALK. PHOSPHATASE - 2014 UL H (normal range 10 - 350 UL?) This is VERY High!! :(
CK - 248 UL H (normal range 10 - 200 UL?)
NA/K Ratio - 26 L (can't read normal range/unit of meas. ?)

From here I will just post the flagged tests and results on some, because I can't read all of the reference ranges (normal ranges) because they are very faded:

T4 - (can't read the #) L (Bar Graph shows very low!)
RBC- 8.51 H
HGB - 19.5 H
HCT - 35.2 H
NEUTROPHIL SEG - H
EOSINOPHIL - 1.9 L

Plus his urine has a specific gravity of 1.006, which I believe our vet said is low (?)

I can't read the rest, too faded... I will be speaking to our vet by Friday, I hope, so I will ask about these results, and will have the results of Tundra's ACTH Stim test by then, (I hope).

I hope this answers a few of the "twenty questions" :)

Tundra's Mom
11-06-2012, 08:05 PM
help?! Tundra has an ALKp level of 2014 UL, as of last weeks senior dog blood panel. I was so in shock when the vet said he may have cushings that I initially misunderstood, but now I have it in black and white (picked up a copy of the that lab report today, when Tundra went in for his ACTH test, which should come in by Friday, I hope) and our vet reiterated her concern especially about his extremely high ALKp level.

My initial internet search on cushings brought me to the conclusion that a high protein, low fat, grain free natural diet is good for cushings pups.

That was about a week ago, so we've switched his dry food over from Pedigree Weight Management (first ingredient whole wheat) to a very expensive Blue Buffalo Wilderness Chicken (grain/wheat/corn free, first ingredient deboned chicken ...34% crude protein), a very high-quality food.

Now that I see his extremely high ALKp level, I am so worried that he should maybe NOT be eating this high protein food???

I just don't know anymore!! Please help!! I realize that I need to ask my vet, which I will do tomorrow ...but what do I feed him tonight and tomorrow morning? I don't want to do anything to make it worse for him!

Thanks in advance,

annie

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

lulusmom
11-06-2012, 11:19 PM
Hi Annie,

I don't have a lot of time at the moment but I will be back tomorrow to post more. In the meantime, I wanted to assure you that high alkaline phosphatase (ALK) enzyme caused by excess cortisol is not an indication of liver disease. High levels of cortisol doesn't kill liver cells but rather increases the workload on the liver to convert amino acids to glycogen. Because there is so much cortisol in the blood, the liver is over-accumulating glycogen, which is the reason why most cushdogs have an enlarged liver. We've seen ALKP in the 4,000 and 5,000. If a dog with primary liver disease had those kind of values, the ALT would also be seriously high as well as SAT and GGT liver enzymes. All three of these enzymes are liver specific, meaning that cells are being damaged or dying. Luckily the liver is the most forgiving organ we all have and the only one that regenerates new cells.

You can always put Tundra on liver support such as milk thistle and SamE. It doesn't always reduce the ALKP but it does aid in the health of the liver. Unless a dog has serious liver disease with a major loss of function, restricting protein is not a good idea so don't worry about Tundra's new diet causing problems for him. It is more important that you introduce his new diet slowly so as to not cause gastric upset. Give him 3/4 old diet and 1/4 new diet for a few days, then increase to 1/2 and 1/2 and so on.

Glynda

Tundra's Mom
11-06-2012, 11:52 PM
Oh, what a relief! Great info again, Glynda. I will check into milk thistle and SamE for liver support.

-- annie

molly muffin
11-07-2012, 09:42 PM
Hi Annie,

Molly is taking Hepto support for her liver. It has milk thistle in it and I get it from the vet. Just ask about a good liver supplement for Tundra.

Sharlene

Squirt's Mom
11-08-2012, 09:45 AM
Hi Annie,

My Squirt's ALP is also gets very high at times. Her IMS told me he didn't worry about that value unless the others that Glynda mentioned are also elevated because the ALP involves living cells, not dying ones. This value can be elevated due to a multitude of things and as has also been said, the liver is a very forgiving organ with the ability to heal itself in many cases.

As for the feed, you made a GREAT advance moving from the Pedigree to Blue Buffalo; that's like the difference between MacDonald's and a 5 star restaurant. ;) The difference in the quality ingredients between the two is vast - Pedigree is a one star food while Blue Buffalo is one of the higher rated feeds. The higher quality feeds are more expensive to purchase but you feed less of them because the dog uses more of the feed meaning less waste and less need to supply large quantities of feed to keep them full. Also, high quality feeds usually mean less vet visits for things like digestive issues and allergies. So the initial cost of the food is usually offset by the benefits. ;)

The things Glynda suggested can help lower the ALP often so they are worth a try.

Hugs,
Leslie and the gang

labblab
11-08-2012, 10:19 AM
Hi Annie,

What a wonderful job you are doing to take care of your sweet boy! Everything you are doing to enhance the quality of his food and supplements are big pluses, that's for sure.

I do want to voice one caution, though. If your Cushing's diagnostics ends up directing you to medical treatment, I'd encourage you to hold off on introducing other changes in diet/supplement until you've gotten him stablized on the Cushing's drug (either trilostane or Lysodren). That's fine that you've started transitioning him to the Blue Buffalo. But given the fact that you have, I would not start the Cushing's drug until he's totally switched over and you're confident he's tolerating the new food without problem. The reason for this is that changes in appetite, diarrhea, or vomiting are hallmark monitoring signals during Cushing's treatment. So you really don't want to introduce any other GI variables at the same time that you start the Cushing's meds.

I wish you continued good luck as you proceed down the diagnostic trail, and am so glad you've joined our family. :)

Marianne

addy
11-08-2012, 02:25 PM
Hi and Welcome,

Everyone has you off to a good start and I can only reinforce Marianne's comments about not changing everything all at once.

We tend to freak out and worry about everything but the best thing to do right now is to make changes one at a time or you wont know cause and effect.

Dont forget to breathe.:) Slow breathing, asking lots of questions and learing as much as you can will help the most.

Cushings is seldom an emergency.

We are here for you so you are no longer scared and tired and alone, you have lots of company:):):)


(((((((((((hugs)))))))))

Tundra's Mom
11-08-2012, 06:50 PM
Thank you Glynda, Sharlene, Leslie, Marianne and Addy...

I have been doing so much research that I am taking a small break -- it is overwhelming!! This site is the one thing that helps me clarify and have some comfort. :)

I will respond to each of your recent posts to my forum later tonight or tomorrow morning, and thank you all for your caring and informative responses! I'm sorry, I am coming down with a cold (first time in four years!) so I am a bit tired. I just want you all to know how much I appreciate your responses (and questions!).

I emailed my vet a link to these forums (this site) in case she has not yet heard of it. She is a very busy vet, but I think that this site would be so beneficial to any of her clients dealing with canine cushings.

Thanks again, sorry I am not answering all right now, but I will come back on tonight or tomorrow morning :)

sincerely,
--annie
(Tundra's Mom)

addy
11-08-2012, 08:13 PM
Sweetie- you dont have to answer all of us individually, a group hi or update works just fine;):)

I hope you get some rest and feel better soon. Take a break, we are not going anywhere:D:D:D

molly muffin
11-08-2012, 10:36 PM
Annie! I think all this worrying and stress is getting to your immune systems. You Know if you are feeling stressed, then it takes a toll on the body. So, take some time to regroup. There really is no need to go full out all at once. I thought that too when I first heard the word cushings and now that I've been around here for awhile, I know that it just is not something a person is able to maintain all the time. You have to have some down time.
So do that, take the time, get to feeling better, whoop that cold and yea, what Addy said, a group hi, this is what is happening, we're good with that. :)

hugs,
Sharlene

Tundra's Mom
11-10-2012, 04:18 PM
Hi everybody,

Our vet called this morning, she said Tundra "flunked" his ACTH Stim test:

pre level = 4
after stim level = 16, which she said is in the "normal high range"

She would like to get a blood pressure on him, and maybe a few other things, but our next big step will be an ultrasound. This is a small town, and the sonographer (ultrasound tech) our vet generally uses won't be back here again until the first part of January (though there is another, much more expensive sonographer available in December in a nearby town).

So we will probably wait until January for his ultrasound -- that isn't that far away.

Tundra seemed better on his morning walk today, he was pulling and more energetic past the point where he previously started to lag. He went about twice as far before developing what I call a strange gate.

Glynda previously asked me about this strange gate, whether it is a "stiffness" in his back legs, and the answer is no, it is more like a wiggly walk, and kind of like his feet hurt, so maybe his feet do actually hurt. Maybe I am reading too much into his gate, after all, he is almost 8 yrs old, and is overweight.

Anyway, since I am kind of spinning my wheels here, without a concrete diagnosis yet, I probably won't post much regarding Tundra (unless something significant comes up) until after the first of January.

I will definitely hang out here, actively reading others posts every day, and learning all that I can learn, while I wait for more concrete info on Tundra.

Again, you are all so kind, I am so happy to have found this site! My vet says she is going to check this site out this weekend, as I gave her the link so that she could maybe direct any clients dealing with cushings to this site for additional information and support.

So this is my group "hi" and update :D

-- annie

molly muffin
11-10-2012, 07:45 PM
I like that. A group "hi" and update. That works for us. Just don't go off into the big wide blue yonder and disappear! I expect to see more Tundra pictures. :) I do hope that nothing comes up and that the group "hi's" are the norm. :) Has Tundra had his hips looked at? Just in general I mean. Yea, the over weight thing can be hard on the joints. Harder as we and our furbabies get older too.
There doesn't seem to be any immediate reason that an ultrasound needs to be rushed. January is fine, I'd think.
I do hope you have a wonderful, happy holiday season. Stop back and say hello now and then. :)

Hugs,
Sharlene and Molly Muffin

labblab
11-10-2012, 08:10 PM
Hi again, Annie.

Well, it sounds as though you are still kinda in limbo in terms of the diagnostic puzzle. As you've probably already heard or read, Cushing's is a slow-moving disease, so even if Tunda is indeed suffering from Cushing's, there is no need to rush to a diagnosis. So I agree that the input from the ultrasound will be helpful, once you are able to have that performed.

In addition, I want to offer out one cautionary note about the ACTH as a diagnostic test. "Positives" received on the ACTH can actually be more reliable than those on the LDDS, because the ACTH is less likely to be skewed by other, nonadrenal disease. However, the downside is that the ACTH is more likely to result in a "false negative" than is the LDDS. This means that a dog may actually have Cushing's, but end up testing "negative" on the ACTH. The ACTH is especially poor at diagnosing dogs who suffer from the adrenal form of the disease.

So if Tunda's symptoms progress further over the coming weeks, you may opt for LDDS testing in addition to an ultrasound. It is such a shame that there is no single definitive test for Cushing's. But it does come down to fitting in a number of puzzle pieces. If Tundra continues to exhibit symptoms that are consistent with Cushing's and that are not really well-explained otherwise, I'd suggest moving forward with an LDDS test.

Marianne

Tundra's Mom
11-14-2012, 07:40 PM
I will be reading all of the posts, while I wait for an ultrasound and most likely an LDDS test. I'll even post a few more photos here, thanks for the request, Sharlene :D

I just probably won't post much in this thread, unless something drastic happens, because I won't have further information from tests til January.

Thanks, Marianne for the insight into the ACTH test. The results are quite confusing to me. I do agree that an LDDS test is needed, to help clarify.

Sharlene, Tundra has never had his hips x-rayed, but he is almost eight years old and overweight and seemed a bit sore in the hip area in the past, so we have been giving him glucosamine chondroitin for a year and a -half now. I don't know whether he has any dysplasia, but the glucosamine does seem to help.

Anyway, I just wanted to check in and respond, and I will be reading the posts here (and probably posting some comments) while I wait for future tests and results in January.

There is so much to learn from this site! I am so glad that I found it!

Happy Holidays, everyone -- I will be here, listening and learning :)

-- annie (Tundra's Mom)

molly muffin
11-14-2012, 07:49 PM
hi Annie, I don't update very often on Molly's own thread, since for now she is doing okay. I will when more tests are done or just as a cheerful upbeat, this is how we are doing update. :) One hopes it is cheerful anyway.
I do post a lot on others threads who are going through tougher times, as they are the ones in need of support, who are worried and searching for answers. So you are welcome to read and join in. We'd love it in fact! I tend to get notifications, as that makes it easier for me to keep up with current and past threads.
Will be looking forward to more pictures.

Hugs,
Sharlene and Molly Muffin

addy
11-16-2012, 09:09 AM
Well, you dont have to post here if you feel you have nothing to report but please dont mind if we stop in every now and then to give you a hug and say hi:D:D:D:D

You can always use our checking in for the month thread as well. We tend to worry sometimes:rolleyes:;):D

goldengirl88
11-16-2012, 04:07 PM
Hi Annie and Tundra welcome to the very best place in the world to be, with caring and loving friends. The people here will always steer you in the right direction, just get ready to be very involved in your dogs treatment. This is the one thing that I feel will help Tundra the most.

molly muffin
11-20-2012, 10:19 PM
Happy Thanksgiving Annie and Tundra!!!!

Hope you have a wonderful one!

hugs,
Sharlene and Molly Muffin

Tundra's Mom
12-16-2012, 07:46 PM
Hi everybody!

Just checking in for December. We're kind of in limbo here until January, when our veterinarian's ultrasound tech will be here (it's a small town) and Tundra will get an ultrasound and maybe more tests. He's doing well, still has low energy but loves his walks. He seems to have gained weight, so I'd like to take him to the vet's just to weigh him.

Tundra has always been large for a Siberian -- he weighed 78 lbs at a year and 1/2 of age, but now he is eight years old and weighs 105 lbs (or even more, now?). I think our vet said she would like to see him at 90 or 95 lbs... I need to double check with her to know for certain.

I feed him the following, twice per day:
Dry Food (Blue Buffalo Wilderness Chicken) 1 1/2 C (615 cal)
plus 2 Tbs of each of the following:
Organic Plain 1% fat Yogurt (24 cal)
Pure Pumpkin Puree (14 cal)
Canned Wilderness (Turkey & Chicken Grill) (60 cal)

plus a few canned no salt green beans for fiber (10 cal)

also one doggy cookie, for dessert. (115 cal)

He also gets Glucosamine 750 mg/Chondroitin 600 mg with each meal (twice per day)

This adds up to 838 calories per meal, or 1676 calories per day. So I have to find a way to cut down his calories, without totally starving him! The yogurt and pumpkin are for his digestion and healthy urinary tract, the canned (60 cal/meal) is just for flavor, and the doggy cookie is to help clean his teeth. Hmmmm... maybe cut out the canned, and give him a carrot instead of a doggy cookie???

Anyway, we're doing okay, just waiting til January for an ultrasound.

Happy Holidays Everybody!!

Tundra's Mom
12-16-2012, 08:46 PM
Oh no! I just learned from researching on the internet that Tundra will need to be shaved for his ultrasound!

This past Summer, he had to have his entire underside and part-way up his chest shaved because he had several embedded fox tails and had to have surgery to remove them. He got the fox tails from his walks -- this is a rural area in AZ and fox tails are everywhere!!

For those who don't know what fox tails are, they are the seed of a wild grass, and the seed is barbed, so it attaches to the fur of the dog, then travels in only one direction: forward! They penetrate the dog's skin and travel into the body, even into the organs. They don't dissolve in the body, that's why they are so horrible!!

Anyway...

We had to get him shaved at a groomers before the surgery. I had to help the groomer hold him. He didn't cry, he screamed the entire time!! She changed blades and let the clipper cool down as needed, but still he screamed. It was horrible!!

Okay, Tundra has always been a bit of a crier -- if he gets a small burr or "picky" in his paw, you can hear him for miles when we brush it off -- but this shaving experience was a nightmare. Now I see that he will have to go through this again. :(

Do any of you know whether it will just be a small area that needs to be clipped, or will it be his entire belly/underside again? I believe (I think) the ultrasound is mainly to check for liver abnormalities.

Thanks,
Annie (Tundra's Mom)

molly muffin
12-16-2012, 10:57 PM
Hi! Glad that Tundra is doing okay.
My he is a big boy isn't he! hahaha More to love obviously. :)

Yea, they shave most of the belly for the ultrasound. Poor thing.

hugs,
Sharlene and Molly Muffin

Tundra's Mom
12-16-2012, 11:10 PM
Thanks Sharlene (& Molly Muffin!). And awww poo! I wonder if he should just be anesthetized for this, to save him the trauma. I know that stress causes cortisol levels to go up.

I absolutely hate to have him under anesthesia, especially now that I know he has some type of liver problem, be it due to cushings or possible cancer, or I don't know what.

Well, at least I know now, ahead of time. Thanks for your response. Not knowing is really the worst, I would rather be informed and know what to expect.

Thanks!
-- Annie
(Tundra's Mom)

molly muffin
12-16-2012, 11:45 PM
Informed is the name of the game! :) Well, it's possible that it might be less traumatic for him to use anesthesia, but I know your concern. I have the same one with molly and have been putting off tooth issue because I'm scared of it.
At least you have some time to think about it and make a decision.

hugs,
Sharlene and Molly Muffin

molly muffin
12-24-2012, 11:01 PM
Merry Christmas to you and Tundra!!!
Have a happy and safe holiday

hugs,
Sharlene and Molly Muffin

Tundra's Mom
02-16-2014, 09:01 PM
Hi, I haven't posted for so long. It's not that I am ignoring Tundra's Cushings ...It's more that he has developed sooo many other health problems, and, we never got past the ultrasound test here in our small little town -- the test that could have shown whether his liver is enlarged and etc.

Please don't ask me to post Tundra's Test Numbers/Results... because he does have and HAS had all the symptoms of Canine Cushing's, and our vet did test him, and she did suspect Cushing's. All we needed was an ultrasound, but we live in a tiny town and the ultrasound tech used to come in once a month or so from Phoenix...

...then, just when we needed it, she quit coming up here. So we found out we could travel 35 miles and pay a couple hundred $ for a consult with a vet who also gets an occasional visit from an ultrasound tech.. then we could wait and pay over $400 to go back and actually get an ultrasound for Tundra ...

Anyway, I KNOW that Tundra has Cushing's. He has every single symptom. We have decided not to treat with meds, because he is so very sensitive to everything, including Rabies Vaccinations and his yearly vaccinations -- our Veterinrian has even changed his "yearly" vaccination schedule to every THREE years instead of every year because he has bad reactions .

Okay, the point is, that Tundra (a nine year-old siberian husky) has Cushing's and we have been treating it, or at least managing it by feeding him better food (grain-free Wilderness) plus a little boiled chicken breast (no skin/fat) and some plain pureed pumpkin, non-fat plain organic yogurt (at night, not in the AM when he get's antibiotics).

Oh, he is on antibiotics because he developed a tick-borne disease last year. I actually still have the tick in the freezer in a container. He quit eating/drinking, went lame in his hind-end, and really almost died, fever was (105?). But Doxycycline has saved him. He gets 450mg every morning, and when we took him off that for a few weeks he slipped right back into the not eating/drinking and back-end paralysis, so our vet says he needs it for the rest of his life, even though he actually tested negative for the three major tick-borne diseases in our area. (Our vet says there are maybe 100 tick-borne diseases and to test for all would cost some unheard-of immense amount of money.).

So, he has Cushing's, and some tick-borne disease...

...And then the skin tumors started. Some are small, and brown, like a wart, and some are small and pink, like a "skin tag". But they GROW. One grew so big, on his back, literally as big as a baseball!
And one, on his lower eyelid, grew as big as a marble.

So he had surgery, to remove those, and a biopsy. Our vet said the results are a cancer but not a cancer that spreads quickly. I can look it up in our papers if anyone needs to know.

Now he has another, on his cheek. same thing. And on his chest. And on his back left paw/leg.

So now he has Cushing's, AND a tick-borne disease, AND some type of skin cancer ...and ...

...and yesterday something new. His tongue is turning purple. OMG. He normally has a nice pink tongue, but yesterday and today, upon very little exertion (just walking across the yard) his tongue turns purple. I know this means he is not getting the oxygen he needs in his blood.

I am beside myself with grief over this new development. It is Sunday, and we can't even see our vet until tomorrow. We will take him in asap tomorrow. We are two people living on the Social Security of one ($1000/month). We both love Tundra so much.

How can this happen? He is the best dog anyone could ever ask for, so sweet, loving and so good.

So now he has at least 4 horrible problems:
Cushing's
Tick-borne Disease
Skin Cancer/tumors
and now purple tongue (circulation)

I guess I am just looking for comfort, like I found here long ago when I first came to this site.

I am so sad right now.

Any well-wishes, prayers or advice welcome.

Thanks,
Tundra's Mom

doxiesrock912
02-16-2014, 09:13 PM
Honey,

I am so sorry for all that you're going through with Tundra.

Please make the trip for Tundra to be completely checked out. There is a card used for vet bills called Care Credit. They often have promotions that allow you to pay over the span of a year or more without interest.

I have been unemployed for more than 4 years, so I know full well the issues with cost.

I hope that this helps. http://www.carecredit.com/vetmed/

drmvz
02-16-2014, 11:24 PM
Sending prayers your way. Good luck with Tundra tomorrow at the vet. Take care

lulusmom
02-17-2014, 01:46 PM
I'm glad to see you have come back. I have several more questions for you and will try to get them posted later today....so don't go away, okay?

Glynda

Tundra's Mom
02-17-2014, 04:04 PM
Thank you all so much! I really appreciate the care-card link, and the prayers and well-wishings. :) Tundra has an appointment for tomorrow (Tuesday) to get all checked out. I am mainly worried about the purple tongue, which could mean heart troubles. I'll keep everyone posted. Thanks again :)

--Annie
(Tundra's Mom)

molly muffin
02-17-2014, 05:59 PM
Annie!!! Oh my gosh! I hoped when when we hadn't heard from you that things were going well with our beautiful boy Tundra and life was good for you all.
I'm so sorry that things are not in fact going well. I would be worried about oxygen, if the tongue only turns purple after movement, exertion. Is it pink the rest of the time.
I'm happy to see you again, but really sorry as to the reason why.

hugs,
Sharlene and molly muffin

lulusmom
02-18-2014, 12:49 AM
I'm glad you will be seeing the vet to see why Tundra's tongue is turning blue. My little Maltese has had two episodes of blue tongue while at the vet's office. He has severe heart problems so when he gets anxious, he can't get enough oxygen. Luckily it's only happened while he was with the vet. Good luck tomorrow.

In going back through your thread, I see that one of the abnormal values on the bloodwork you posted on 11/6 was the T-4. You could not read the normal reference range but you said that the bar graph looked very low. Did your vet feel the T-4 was low, secondary to non-thyroidal illness that may be suppressing the thyroid hormone or was there a discussion of further testing to see if Tundra has primary hypothyroidism? You had Tundra's belly shaved by the groomers back in November in preparation for an abdominal ultrasound. Did Tundra's coat grow back okay? I also see that the results of the acth stimulation test you also posted in November are normal and therefore unless other testing was done with results consistent with cushing's, diagnosis cannot be confirmed.

I understand that Tundra has a chronic tick borne disease that is requiring treatment for life. That makes confirming a cushing's diagnosis more difficult as most, if not all, of the symptoms you have posted can be attributed to any number of tick borne diseases. Which tick borne disease does Tundra have? Weight gain is not usual though but it is common with hypothyroidism.

I'll be looking forward to hearing about Tundra's appointment with the vet tomorrow as well as your responses to my questions.

Glynda