New to Forum - Drooling and Eyeboogers?

[Pinskies]

Hello!

I am new to the forum - this is my first post :o (I have posted to the facebook group before).

My fiancee's Black and Tan Coonhound, Homer, was diagnosed with Cushing's at the end of January 2013. I apologize in advance, as I do not have any of his test results to report. He has been on 60 mg of trilostane 1x a day since February 1. He is doing much better - we finally decided to have him tested for Cushing's after he was having accidents in the house due to excessive water drinking. Since he has been on the medication, the accidents have stopped.

One thing I have noticed is that Homer seems more drooly than he was prior to taking the trilostane - often times, his bed will be wet with drool, and he walks around the house drooling. He also has a lot of eye boogers and his nose is running. I was wondering if this was common with the trilostane as a side effect (could not find any information on this). He also has hyperthyroidism and is on .6 mg of soloxine 2x a day, not sure if something is reacting that is causing the excessive drooling and eye boogers. If anyone has encountered this or has any advice, I would appreciate it!

Thank you! Homer just had another ACTH stim test today and it would be his 1 month test, so as soon as I get the results I will post them.

Marissa

[Harley PoMMom]

Hi Marissa,

Welcome to you and Homer. Sorry for the circumstances that brought you to us but so glad you found your way here and that you have started a Thread about Homer. ;)

The drooling might be from nausea, many members give their furbabies Pepcid AC 20-30 minutes before their dose of the Cushing medicine, so maybe ask your vet about this.

When you get copies of Homer's ACTH tests we sure would like to see those results and if you could get copies of all tests that were done on Homer and post any abnormalities that are listed that would be a big help also.

How much does Homer weigh? Besides the thyroid issue does Homer have any other health problems? Did Homer have other Cushing symptoms other than the increased drinking/urinating? Does he have adrenal or pituitary Cushing's? Was an ultrasound done? Gosh, I am so sorry for all these questions but the more we know about sweet Homer the better our feedback can be.

Again, I am so happy that you have come out of the shadows and posted about Homer and please know we will help in any way we can.

Love and hugs,
Lori

[Trish]

Hi Marissa, fiancee and Homer the Hound! Welcome to you all :) Hope you get some answers here, I am not one of the smart ones who will be along to reply about your medication questions. But I do want to ask, what is the facebook group is? Am I missing out on something ?? :D:D:D

Trish

[labblab]

Hi and welcome from me, too!

I've been told that excessive drooling can be an allergic reaction, or the result of infection in the mouth or head. Either of these options would seem possible to me since Homer is also having discharge from his eyes and nose.

Aside from starting the trilostane, have you made any other changes in Homer's routine: food, other supplements or medications, even household cleansers? Does the drooling seem worse at any particular time of day, like soon after you give him his trilostane?

Also, is there any unusual color or odor to any of his discharge? If so, this can also point to infection as being the culprit. I am hoping the vet checked out Homer's head carefully when he had his testing yesterday -- what did the vet have to say about things?

Marianne

[molly muffin]

Hi Marissa!! Great to see you hear on the forum. :) I'd ask the vet to take a look inside his mouth, at the eyes and also ears. It might be nothing, but you never know. Cushings babies are certainly susceptible to all sorts of things. I haven't head of that as a side affect of vetroyl/trilostane though.

Trish, there is a Cushings Disease Awareness Group on Facebook.
http://www.facebook.com/groups/89435412886/

Nice to see you hear too Marissa,

Sharlene and Molly Muffin

[addy]

I'm thinking the same thing, that it is another problem, how are the teeth? An infected tooth can cause sinus issues which can cause eye discharge, nasal conjestion as well as drooling.

[Squirt's Mom]

Hi Marissa!

Glad to see you and Homer here! You've been given some great ideas to look into as the cause for what you are seeing in Homer. An allergic reaction to something was my first thought, as well. If the only change you have made is the addition of the Trilo, you might try stopping it for a few days and see if the drooling, etc stops. If so, he may be allergic to some portion of the drug itself - fillers, capsule ingredients, ect. But if you have started doing anything else that is different, stop that first to see if it helps, even if it's a new floor cleaner you're trying out. Wash it off with clear water as much as possible and see how that does for him.

Let us know how he is doing!
Hugs,
Leslie and the gang

[goldengirl88]

Marissa:
Welcome, sorry your baby is having problems. My Tipper has been ahving a lot of mucus discharge in the morning also. I will ahve to ccall Dechra and ask them if they know of any cause.

[NoonelovesmelikeNorman]

Hello Marissa and Holmer! Welcome to the group. Norman, my doxie, as been on meds since the end of Dec. He has also been drooling quite a bit, no eyeboogers though. My vet asked me if the drooling with clear? if so it not a huge concern. But, the others in the group are way more knowldgeable than me...so I will just say welcome to the forum and let the "experts" answer you questions.

We wising Holmer the very best!

Peace, Sharon

[SoggyDoggy]

Hi and welcome from me too!

Firstly, I just have to say that I LOVE the title of your thread! :D Eye boogers, Love it! (so descriptively true)

Ok, so I can't comment on the drooling bit, but I can say that my boy Fraser also get's eye boogers, especially stringy sticky ones when I try to wipe them out of his eyes. In his case, it is usually allergy related, but he was tested for dry eye an number of years ago and was put on an immuno-supressant eye drop. The vet told me it would be a life long thing that I would have to keep going twice a day for life. That was nearly 10 years ago. I stopped it 8 yrs ago with no adverse affects, the eye boogers cleared up until recently, but it may be worth seeing an opthamologist if you are concerned.

Also, the increase in eye boogers could be a result of the runny nose, a bit like the sleep we get in our eyes, just a dried eye discharge. My first guess for all three symptoms would be to investigate allergy paths.

[Pinskies]

Hello everyone!

This is my second (I believe) post on here, and I could really use some help.

My fiancee's dog, Homer, is a either 11 or 12 year old black and tan coonhound. We've been told over the past year or so that he probably has Cushing's - he had a lot of the signs - pot belly, increased thirst, accidents in the house, panting. However, he is also hypothyroid and a lot of those signs are also from that issue.

We finally got him tested in January 2013, I believe it was a low-dose dexamethasone test. His pre was 5.9, his 4 hour was 3.2 and his 8 was 4.4. So on February 1, 2013, we started on 60mg of trilostane 1x a day.

As soon as we started giving him the trilo, he started acting really strange. He'd zone out a lot, he started snoring and wheezing when he slept, and he'd still be panting a lot (though the drinking did calm down). We figured it was just due to adjusting to the meds and since his next test was only in a week, we didn't want to jump to conclusions.

His second ACTH stim test was on February 13 - his pre was 5.7 and his post was 7.6. The vet made no changes at this point in the dosage.

Over the next few weeks, we'd have good days and bad - sometimes, Homer would be really out of it - zoning out, not wanting to get out of his bed, going outside and just staring instead of going to the bathroom, falling down (he started to have really bad joint issues and kept falling on our hardwood floors inside and also down the two patio steps). It was like he was overmedicated. We adjusted his trilo to give it to him at night so he could sleep off the effects. This seemed to help somewhat.

March 3 was the next ACTH test. Pre was 1.5, post was 7.6. At this time, Homer also was having accidents in the house (he urinated in his bed a couple times and also in the kitchen - we have a dog walker come 2x a day to walk him and my other dog, so this should not be happening). He was tested for a UTI and it came back positive, so he was then on an antibiotic. No changes to the trilo at this time. We still have good days and bad days, but most of the time, Homer seems out of it when he is on his meds. He is still eating and drinking normally.

Another thing to note is that Homer had an ultrasound back in September 2012 because he had at least 3 UTIs in a row (this was before we found out about the Cushings) and the vet noticed his prostate was enlarged. The prostate has always been a concern for her and she thinks it may be why he keeps having accidents. He also does sort of a pelvic thrust when he urinates (like he is straining). But more on this later...

The next ACTH test was on April 4. Between the last test, Homer had about 6 accidents in the house, had a few zoning out episodes, managed to get stuck under our entertainment center trying to get out of his bed (we have now bolstered his bed with pillows so this doesn't happen again). I expressed concerns about his prostate again. The vet said in addition to the ACTH test, she would feel his prostate and also do another urinalysis to be sure he didn't have another UTI. ACTH test results - pre was 5.2, post was 8.8. UTI was negative.

However, the vet said his prostate is even larger than it was in September, and it is closing off his urethra - which basically means he either feels like he has to go (probably what is causing his accidents in the house) or like he has to go but can't (probably what is causing his straining. She did a basic ultrasound to just see if there were any cells or growths and she said there is a definite tumor on there.

Given Homer's age, the vet suggested that we could biopsy the tumor to see if it was cancerous and then go from there, but she wasn't sure how Homer would handle anesthesia, or if that would even be something we would want to do. Also, she said usually with prostate tumors, they want to just remove the tumor instead of treating it. I didn't want to put Homer through another surgery (he had two on his right front paw to remove a hemangiopericytoma in 2008 and again in 2010 for a regrowth).

So the vet prescribed piroxicam (10mg), which is a NSAID that not only has tumor shrinking properties, but it also helps with joint pain and arthritis. So I figured this was a better choice - we could at least see how it goes. Also, I asked for the incontinence pill pronin (25mg). Homer was on this before we found out he had Cushings - this was mainly because I thought maybe his urination issues were truly incontinence due to old age.

So, to recap, Homer is on these pills as of 4/9/13:
- Soloxine .6mg 2x a day (hypothyroidism)
- Trilostane 60mg 1x a day (Cushings)
- Piroxicam 10mg 1x a day (prostate growth/arthritis)
- Atopica 150mg 1x a week (skin issues)
- Pronin 25mg 1x a day (incontinence)
He is also on heartworm prevention and flea/tick prevention too.

Over the last week, he has really not been doing well. The zoning out is happening more, he seems disoriented and confused. He will go outside and just stare at nothing and forget he has to pee. He has slowed down considerably, and sometimes won't get out of his bed (we have to bribe him with a treat or literally lift him out of bed). He is also standing bowlegged, like his back legs are losing control. It's really sad. On a good note, he is still eating and drinking, and he has his moments where he shows some of the old Homer - the other day, he ran up to the door and met me when I got home from work, and he was playing around with my dog Stella (who is only 4).

I hope I am reading the test results right - I have a PDF from the vet if anyone wants to see it. I'm really at a loss at this point as to what we can do. My fear is we are overmedicating him and that is causing him to just be all doped up and out of it...but I guess I wonder what the alternative would be if we stop all medicines (i.e. how long he will he live, will it be a slow decline or immediate...).

Thank you - I appreciate any and all comments on what I could possibly do. I attached a picture of Homer in his bed for everyone to see...

http://i48.tinypic.com/dr9ily.jpg

Marissa

Moderator's Note: I have merged your update on Homer into Homer'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.

[Harley PoMMom]

Hi Marissa,

When the LDDS test was performed on Homer in Jan. was he also tested for an UTI at that time? Any non-adrenal issue can create false positive results from a LDDS test.

If this were me, I would with hold the Trilostane and see if the zoning out stops.

Love and hugs,
Lori

[Pinskies]

Hello Lori,

No - Homer did not have a UTI in January 2013 when he was tested for Cushings.

However...we did have a lapse in the trilo in late March - I didn't reorder his meds in time so he was off it for two days - in those two days he was absolutely a different dog - no zoning out, no old man tendencies, actually playing with my younger dog and just his old self. So maybe the answer is to cut down the trilo to every other day? It seems to be helping him from not drinking so much water, but the fact he is still having accidents in the house concerns me...but that may be related to the prostate.

[labblab]

If Homer improved markedly during the two days he was "off" the trilostane in March, I agree with Lori and would experiment with discontinuing it. I would take him off it totally, though, not just switch to every other day. A temporary return of Cushing's symptoms is not going to cause him that much harm, and from what you're describing, he is already urinating very irregularly anyway. If this is a drug-related side effect, I believe you'd want to have a trial period during which the trilo is totally out of his system in order to accurately judge whether or not it is indeed the cause.

Unfortunately, given the fact that a lot of his issues are neurological, another ominous possibility is that the pituitary tumor that is causing his Cushing's has enlarged and is now exerting pressure on other areas of the brain. When this happens, the tumor is referred to as a "macroadenoma." For more information about pituitary macroadenomas, take a look at this link:

http://www.k9cushings.com/forum/showthread.php?t=229

Before jumping to this conclusion, though, I'd definitely want to experiment with taking him totally off the trilostane for at least a week in order to see whether or not he improves. I am really sorry about his prostate tumor, but I am afraid I can't offer any feedback about that. Does your vet think there is any possibility that the tumor could have spread cells to other areas of Homer's body? If so, that might also account for his overall health decline. However, since you say he improved markedly while off the trilo in March, that is definitely the first thing I'd be looking at as the possible source of the problem.

Marianne

[Squirt's Mom]

Hi Marissa,

You said you started giving the Trilo at night - is the ACTH performed at night? If not, the ACTH is not valid. It must be performed 4-6 hours after taking the Trilo so I am a bit concerned that the testing isn't be given at the right time.

With the prostrate tumor, Homer is going to have elevated cortisol but not due to Cushing's. The stress of the tumor will cause elevations all on it's on, which is also going to give very confusing information via the ACTH since the test cannot determine the cause of the excess cortisol, only the presence of it. So there is now a question in my mind whether the Cushing's diagnosis is correct or if his tests returned false-positives because of the tumor. This is what happened with my Squirt - she had a tumor on her spleen that caused false-positives. When the tumor was removed, the cortisol returned to normal. Was the prostrate problem present when he was initially tested for Cushing's?

So I have some questions - the timing of the dosing and ACTHs, and the initial diagnosis.

Hugs,
Leslie and the gang

[molly muffin]

Hi Marissa, I'm so sorry that Homer is having these problems, but I have to agree on a couple things. If the Trilostane is given only at night, the ACTH unless done 4 hours later is invalid. If Homer has a tumor, then all testing to diagnosis cushings can't be trusted either, due to the tumor nautrally causing the bodies cortisol to rise.
I'd get rid of the vetoryl all together like the others suggested. There are a couple things that can cause what you are saying are Homers current symptoms, one is an overdose of Trislostane (vetoryl), the other is if the dog doesn't and didn't have cushings but another reason for the cortisol to rise. There are others but that are the two main ones that I'd be thinking in your case.

So, stop it and see what you want to do about the tumor. If it is cutting off by putting pressure on the urethra, then no amount of vetoryl will help that. :(

Stop and reevaluate the situation is what I'd do.

hugs, hang in there,
Sharlene and Molly Muffin

[labblab]

That is great that Leslie caught that info about giving Homer the trilo at night because I totally missed it. And she's absolutely right -- if his ACTH tests have not been given until the next morning, his test results will be much higher than had he been tested in the recommended 4-6 hour post-dosing window. So he may indeed be overdosing on the drug.

Secondly, it occurs to me that your vet will want to make sure that the manufacturer thinks it is OK to give trilostane in the presence of a known prostate tumor. Due to it's hormonal activity, it may be worsening the prostate condition. Or, in the reverse, it may be helpful (since it has been used to treat advanced human breast cancer). I just don't know the answer to that, but the folks at Dechra (maker of brandname Vetoryl) should. Here's how you and/or your vet can contact their Kansas office to ask:

http://www.dechra-us.com/Default.aspx?ID=365

Marianne

[Pinskies]

Hello everyone,

Thank you so much for your tips and advice.

I didn't think about giving the trilo at night and it messing up the ACTH test results. When Homer had his last ACTH test, it was when he missed two trilo doses due to my ordering issues with the meds - so on the day of his test, I gave him the trilo in the morning (5:30 a.m.) and his test was around 11 a.m. Although I'm not sure how valid that test was given the fact he missed two doses the days before. We will switch it to the morning again from now on.

I also didn't think about the tumor messing with the cortisol levels and throwing the test results off. I can check with the vet about this.

For now, I may drop the trilo to every other day and see what that does. I'm kind of scared to stop it cold turkey, at least until I check with the vet about all of these other variables.

[molly muffin]

Always variables eh. :) It's the life of a cushing family I think.
If the problems are very persistent in the evening, you can look at splitting the dose, but this isn't something you can split yourself. You'd need the dosage already in pill form, so that you could give half in the morning and 1/2 about 12 hours later before bed.
I didn't even think about what Marianne thought of, but she is right that cortisol can affect hormones so it could actually not be good for a tumor. Definitely check with the vet about that.
Be aware that every other day can cause spikes and drops. Drops on the day you give it and spikes upwards on the day you don't. Very hard on the body.

Hugs,
Sharlene and Molly Muffin

[goldengirl88]

Hello;
Welcome to the forum. I don't have a lot of time right now but wanted to tell you my Tipper has been experiencing a lot of mucus in her eyes. Also she has drainage or mucus going on in her throat. Please read my thread about it. I am totally convinced it is something caused by the Cushings narrowing the nasal passages. There is some connection there and when the IMS sees Tipper I am going to get to the bottom of it. The eyes, nose ,and throat all go to the same opening, and are related in that way, so I feel it is something directly caused by the Cushings. Maybe it does something to their sinuses and causes this mucus. Almost all these dogs snore also so there is somthing to this that I need to the IMS put the puzzle pieces together. Bless You and your baby.
Patti