Lilly (12 y/o sharpei cross)

[Lyndsey Lewis]

Hi all, I'm a new member. My 12 year old sharpei cross spayed female has just been diagnosed with cushings by her symptoms and a urine sample.
I've been reading others posts and realise I need to post blood results etc but was wondering if I could get some help first.

The vet told me to bring her in tomorrow to do complete blood work and a dex..?? test where she will take blood at 8am, noon and again at 4 pm. That will tell us if it's pituitary or adrenal.

My question is should I do this? And is there anything else I should ask for?

Also while waiting for blood results, is there anything I can be doing to help her with her symptoms. She is drinking a lot and peeing a lot and seems revved up. Way over excited about food. She is shedding hair at an alarming amount also.

I ordered something called Cushex drops by PetAlive that is supposed to be herbal support for adrenal and pituitary issues. It should be here by Monday.

I'm still freaking out a bit and feel brain dead from the stress of this...I have dealt with cushing in horses and it seems very different for dogs and much more complicated from what I've been reading.

Anyhow, thank goodness for this forum and thanks in advance for any thoughts on what I need to do right now.

[Harley PoMMom]

Hi and welcome to you and Lilly,

As long as Lilly does not have any other health issues I believe the low-dose dexamethasone suppression (LDDS) test would be the test that should be done next.

Regarding the Cushex drops by PetAlive, they are a waste of money and will do nothing to lower a dog's elevated cortisol, which Cushing is, a dog with elevated cortsiol.

The drugs Lysodren/Mitotane and Trilostane/Vetoryl are the two most Rx'd medicines that are used for treatment of Cushing's. They are strong drugs and one needs to follow the proper protocols while using them.

Since Cushing is one of the most difficult diseases to get a confirmed diagnosis for a vet/IMS well versed in Cushing's is vital.

A dog with Cushing's usually does drink/urinate excessively and it is very important not to restrict water intake.

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori


MODERATOR NOTE: Your post has been manually approved so that members can start responding to you. Please check your email for a message from k9cushings. You will need to reply to that email so that your post go directly to the board and are not delayed waiting for approval. If you have already received and responded to the confirmatory email, please be patient. Your registration will be finalized shortly. Thanks and welcome!

[Boriss McCall]

Hi,
Welcome to the group. Sorry to hear about your pup. You will get good advice from very experienced folks here.

I saw that site for cushex just like you when I was learning all about this disease. But, from everything I have learned it won't help at all. Luckily I found this forum early on before my dog had all the test. All the great people on this site helped me become informed & held my hand as I learned how to take the best care of my dog.

hugs

[lulusmom]

Hi and welcome to the forum.

I have validated your membership so there is no need for you to spend time searching your inbox for our email asking you to validate.

Your vet cannot confirm a diagnosis based just on symptoms and a urinalysis. FYI, your vet should do a urine culture as a good number of dogs with cushing's have a urinary tract infection at the dime of diagnosis. A normal urinalysis will not pick up the various bacteria as the urine is diluted out. A complete blood chemistry and cbc should also have been done. All of these are screening tests and if any abnormalities consistent with cushing's are found, then your vet needs to do the actual diagnostic tests which are the low dose dexamethasone suppression test (LDDS) and/or an acth stimulation test. The LDDS often times will tell you if a dog has pituitary dependent disease but not always. An abdominal ultrasound is normally done to make this differentiation as well as take a look at surrounding organs.

We'll look forward to your posting test results.

Glynda

[Lyndsey Lewis]

Thanks everyone! I was guessing the Cushex was a waste of money but you know how you just want to DO something...ugh....

Glynda if I understand you right, the vet should do the blood workup BEFORE going ahead with the Dex test? She wants to do it all at once. I guess she's pretty convinced from the symptoms that it's cushings. I took in some urine but they didn't culture it...that takes a day or two right?? Should I take some more urine in tomorrow and ask them to do that?

My neighbour has recommended another vet who is highly recommended as a specialist for older dogs. I will call them tomorrow and ask if he is also experienced with this sort of thing.

Ok I won't restrict water! Can I feed her more? She seems ravenous. She's not overweight. She looks perfect actually. Should I feed her smaller meals more often? Right now she gets two meals a day with the odd throughout the day. I figured she is so animated that she must be burning more energy???

Also what about exercise? Should I try and keep her quiet?

Again thanks in advance for any other thoughts.

[Lyndsey Lewis]

I forgot to ask...I read on some website that Lignans in flaxseed hulls and melatonin can help with symptoms. Any ideas on that?

Thanks!

[Harley PoMMom]

Lignans and melatonin is the treatment for a dog having Atypical Cushing's, which means that one or more of the sex hormones are elevated but the dog's cortisol is not, so if it were me I would not start this.

An urine and culture sensitivity test does take at least one or two days, and is highly recommended when a dog has diluted urine with increased drinking/urinating.

Dog's with Cushing's do have an ravenous appetite, so maybe giving her green beans, carrots would ebb her appetite.

Exercise such as walking is fine, since dog's with elevated cortisol are more prone to tearing ligaments any vigorous exercise is not recommended.

[molly muffin]

Hi and welcome. :) You've gotten a lot of good clinical advice on the testing.

I will only add that obtaining a firm diagnosis of cushings seems to be one of the hardest things to do, most vets with experience with cushings will acknowledge that. Other things have to be eliminated before starting medication, so that is why you want to have a complete blood chemistry work up done and then a diagnostic tests for cushings specific like the LDDS and/or ACTH. Most suggest both, for one thing, if the LDDS does come back as positive for cushings, then you'll want to have some sort of baseline on the cortisol before you go into treatment.

Check our our resource site to read up on treatment options.

The other thing is that if it comes up as possibly an adrenal and not pituitary cushings, then you do want to have an ultrasound to see size and if it is operable and/or if that is something you'd want to pursue.

So there is a lot going on to get a firm diagnosis and the good thing is that this is usually a slow progressing disease, so you have time to have the test done and make decisions.

I know the buying the cushex stuff is a gut reaction to what do I do for my baby and how I can I fix this Now. We've all been there and feel the same way. However, the more you learn about this disease the more you will be able to do deal with it both emotionally and clinically. So, take a few deep breaths, go away from the computer for a bit and do something none cushings related, then come back to it. I have literally lost hours and perhaps days (hard to say since I'm not even sure any more) on researching and learning about this disease. (and in our case, still no answers)

You have time and you need to know that this isn't a death sentence even if it is the true diagnosis.

Sharlene and Molly Muffin

[Lyndsey Lewis]

I just was reading more and it said that when you do the dex test, the dog should be fasted??? My vet said it was ok for her to eat breakfast??

Can anyone tell me if she should fast or not. The test is 8am tomorrow morning.

Thanks!!

[frijole]

Yes she should not eat. Here's a well known specialist who agrees with me. :D

http://veterinarymedicine.dvm360.com/vetmed/ArticleStandard/Article/detail/580093

Kim

[Harley PoMMom]

A small meal is fine. If a dog's cholesterol is high or if a high value of lipids are found, then sometimes fasting is suggested.

[Lyndsey Lewis]

Oh no! Poor Lilly is so ravenous I can't imagine not feeding her breakfast. I could feed her at midnight right and then it's 8 hours before her test...??

It's not clear if I can then feed her through the day between her next two tests...??

Again, thanks in advance for help here.

[frijole]

:D If she has cushings that is the reason she SEEMS ravenous. To put it simply there are 'wires' that are crossed and they are sending false messages that she is starving while in fact she is not. She can totally live thru the tests without eating - lots of cush dogs before her have including my little piglet Haley. She'll be fine.

Once you treat the cushings she'll still appreciate food but she won't seem starved... so don't worry.

It's a shame they didn't do the blood panel first because if it's diabetes and not cushings (they have same symptoms) then you are spending $ on ldds test for nothing... Kim

[Lyndsey Lewis]

Thanks Kim! Makes sense.

I did take a urine sample in a couple of days ago and the vet said there was no sign of diabetes. So I guess that's why she wanted to go ahead with the dex test.

I took her in at 8 this morning for blood for a full workup and the baseline for the dex test etc. She was soooo stressed!!! Shaking and crying. Ugh.

So it brings up another question. If the first blood drawn is a baseline for her normal cortisol, wouldn't it be thrown out of whack by the fact that she is at the vets and stressed out? Or does that not matter?

Thanks again for all the help here!!!

[frijole]

Yep the first number can be high due to stress but it's the over all relationship of the 3 numbers that counts.... so post them all when you get them in a few days. Thanks Kim

[Lyndsey Lewis]

I finally got the blood work back for Lilly.

Apparently all the panel stuff was within normal except for EOS which was just under normal and the vet didn't even mention it.

The endocrinology was as follows:

Pre-Dex: 6.74 ug/dl
Post Dex 1: 1.03 ug/dl
Post Dex 2: 0.534 ug/dl

The Reference interval given was:

Pre-Dex: 1.8 - 4
Post Dex 1: 0 - 0.05
Post Dex 2: 0 - 0.05

So the vet said all tests were good. And told me we just need to test furthur but now Lilly seems fine. When I told the vet that Lilly seems back to normal, she said then she couldn't have cushings because that wouldn't happen and that she has no idea what could of caused all the cushings symptoms.

I have been monitering Lilly's water and keeping a close eye on her and she does seem quite normal.

Does anyone have any ideas? The vet suggested a bladder infection but she didn't see anything in the urine when I took it in when Lilly was so symptomatic.

I know this is great news especially the blood work being good but I am worrying about what could have caused this episode.

So any ideas would be great. Thanks so much in advance!

Lyndsey

[cheydogger]

That is great news that her blood tests were normal and the symptoms resolved. I would just continue to monitor. You will know if something seems off since you are monitoring the water intake, etc.

I agree with your vet, the Cushing's symptoms would not just go away.

You mentioned your vet diagnosed Cushing's by symptoms and a urine test. What showed up in the urine to trigger a Cushing's diagnosis?

[Lyndsey Lewis]

The vet said diagnosed cushings just on the symptoms of drinking and peeing a lot. Also insane appetite and acting like a puppy. Leaping all over the place and doing the happy dance more and also playing with my younger dog which she hasn't done in years.

She did say that the urine was very dilute but otherwise ok.

So in others experience, if it's not cushings, any ideas what could have triggered an episode like that? Give the appetite and increased activity, it seems it must have been more than just a bladder issue...???

Looking back I think it came on over a period of a couple of months. What really seems strange to me, is that she seemed to be almost overnight better the day of the dex test...??? The day she had that test, she was calm and almost normal. I thought that it would be a temporary thing but she pretty much symptom clear after that.

Lyndsey

[mytil]

I wanted to ask has your vet tested for hyperthyroidism? One symptom can be increased hunger and a much higher than normal metabolic rate (high energy). You will need to test the levels of thyroxine. Is Lilly loosing weight at all over these months?

Terry

[Lyndsey Lewis]

Hi Terry,

Thanks for the idea...Lilly has actually put on a little although looks like she has a little muscle wasting...but very slight really and considering she is now 12, I guess it's normal to see a little change...??

But I will have thyroid tested!! I'm crossing my fingers that we are out of the woods although I'm not at all convinced. Another sign that all is not well is that she is still so well...I know that sounds silly but she is still acting physically well whereas before, she was much more slowed down and even had some episodes of bad back and pain etc. Xrays showed a possible cause in her neck of narrowing spaces but she seems to have bounced right back from that.

Very odd.

Thanks again for the support here. Great list! I have learned so much about cushings...it will be ironic if it turns out to be something else.

[molly muffin]

Merry Christmas Lyndsey to you and Lilly.
Have a safe and wonderful holiday.

Hi hope Lilly continues doing okay

hugs,
Sharlene and Molly Muffin