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View Full Version : Mini Poodle with Cushing's (PDH) and Chronic Kidney Failure



joannayeo
03-26-2013, 05:17 AM
Hi everyone,

I'm so glad I found this support group for cushing dog owners. Everyone seems so helpful (: I've been reading up a lot on this forum and various other sites I can find on the internet with regards to care and treatment for cushing dogs. Here's our story:

My 10.5 year old miniature poodle (male, still intact) got diagnosed with pituitary-dependent cushing's and chronic kidney failure (previous vet says it's around stage 3. Current senior vet says it's quite mild, probably early stage 3?) about 2+ weeks ago. But both vets are pretty sure it's cushings. We've done LDDS, ACTH, blood & urine test and even an ultrasound scan.

Unlike normal cushings dogs that have an enormous appetite, he is not so keen on food :/ He's naturally picky too. Hills K/d diet and royal canin's renal diet are not to his liking. We simply cant get him to eat them after MANY tries. We've decided to get a homemade recipe from BalanceIT. He responds to that quite a bit except for the rice and canine K supplement. I guess the taste is not really to his liking :( So, to add carbs and add calories, we used cabbage (steamed w/o salt), sweet potato, potato, raw honey, pears and apples. -> these are foods that we manage to get him eating and are relatively low in phosphorous.

He tried trilostane (vetoryl) 10mg, once a day for 5 days last week but got taken off after he started losing appetite since day 3/4 and vomited on e 5th night. Blood test showed his kidneys worsen and he's also having a bit of problems with his liver. Vet told us to put him on iv fluids for a week or so before starting on trilostane 10mg again. He lost 0.7kg already and is 6.5kg now.

I'm afraid that the same might happen again so I decided to switch vet to get another opinion.The current one is more senior and has got quite a bit of experience with Cushing's dogs. He advises us bring him home and get him in a better shape (I.e eat more, increase weight) before deciding on what to do next. He is doing well now with eating (: He said one possibility would be to start trilostane at an even lower dose (break e pill. He knows that by right the pill shouldnt be broken but I think his lab can fix that for us). In desperation,I've even bought cushex drops (from Petalive, native remedies) online and am waiting for the shipment to arrive.

I ran into an owner of a cushing dog at the vet's who has tried cushex for 1.5 months. Her dog, a 9 year old papillon is reacting well to cushex and won't be needing to start on trilostane. I'm very tempted to consider using cushex to avoid the complications that we experienced with his kidneys on the first try :( We don't have lysodren in Singapore and will have to ship it in if we decide to use it.

Any suggestions for treatment, diet, how to increase his water consumption (im giving him more fruits [apples & pears] and veg [cabbage] to increase his water intake) and the use of cushex drops? Sorry for the super long post. I'm really worried about my dog and hope that you guys can help me out. I'm praying alot for him to get better too. Thank you so much in advance! (:

Other problems:
1. A bit of liver problems - Vet gave us hepavite
2. 3 lumps on his body (current vet suspects it's abscess). Size range from ~2cm to 4 cm in diameter
3. Frequent bruisings on body that comes and goes (takes a while though). I'm not sure why they are gone.
4. Hind leg weakness. He's got a bit of problems getting up from the floor (perhaps our granite and parquet flooring is a bit too slippery for him?). He could lay on the floor for hours if im not at home to pick him up. He gets aggressive when my mom or dad tries to carry him up. When he starts to cry/ bark, we know that he needs to poop or pee. Since then, we've bought quite a few rugs for him to walk/ rest on. It gives him better grip and he's able to walk and stand better on them. I'm also keeping him in my room where I have covered the floors with these rugs, mats and mattress. If he's goes out of my room, he'll start walking ALOT and end up slipping and fallling. He gets a bit aggressive when we try to help him up :( Now he's spending more time resting in bed.
5. Drinking less water (since 2 days ago). Could it due to inactivity thus less need for water? I'm trying to increase his water intake by giving him fruits (apples and pears. sometimes asian pears). I guess water content in cabbages might help to supplement too?
6. Panting quite a but in his sleep. Not too heavily though.

Medications he is on now;
1. Hepavite- once a day
2. Curam antibiotics- 1.33ml, twice a day
3. Phospate binder - half tab, once a day
4. Ranitidine- 1ml, twice daily. But we're giving him once daily since vet says it's optional

Diet:
1. Cabbage- he loves and eats quite a lot of this
2.Roasted chicken breast meat. Portions according to BalanceIT's recipe
3. White rice- he eats very little of this
3. Sweet potato
4. Raw honey- 3/4 to 1.5 teaspoons a day
5. Occasional- pears, apples

Trish
03-26-2013, 07:08 AM
Hi Joanna

Welcome and glad you found us! Singapore is a lovely part of the world :) I am no expert on cushings, the ones that are will be sound asleep at the moment!! But they will be around tomorrow to help answer your questions. But I will see what I can do to get you started!

Firstly, I am glad you have found a new vet for your poodle boy, what's his name (your poodle, not the vet :D)?

I am wondering what tests your first vet did to diagnose the cushings, the members here will be wanting to know what these results are, including his liver and renal tests. If you could post the numbers of any abnormal tests and also include your laboratory reference ranges it would be really helpful.

Your boy does not have some of the more usual symptoms we see with cushing pups such as excessive drinking, eating and urinating so it would be worthwhile reviewing how the vet came to this diagnosis as cushings can often mimic other diseases. It is best to rule out all other potential problems first before treating the cushings if he has it. Luckily cushings is not a fast moving disease so you do have time to do this and not rush into treatment. One of the aims of treating cushings is to get control of the symptoms and if your boy is not having too many typical cushings symptoms it can be hard to tell if the treatment is working.

We also have a few people dealing with kidney problems just now so post his urine results too please. Has he had an ultrasound? It would be useful to look at his other organs like liver and kidneys as they are both issues for your boy at this stage. Also it would be helpful to see his blood count results to see if there are any clues there as to cause of his bruising.

The general consensus on the forum is that unfortunately natural therapies do not work for cushings, the aim of the medications is to lower the cortisol and for the most part only trilostane of lysodren can do this and most of the other "treatments" only lighten your wallet but do not help your dog!

What is your vet doing about the x3 abscess? Are they open? Pus? Is he on antibiotics, abscesses usually need to be drained if present. Or are they lipomas which are fatty lumps that do not tend to cause many problems.

His reaction to the trilostane could be an indication that he had too much of the drug and his cortisol dropped to low. I hope your vet did an actch test to check this out properly. When this happens it is called an addisonian crisis and they do need to be monitored carefully, IV fluids, usually treat with prednisone and check their electrolytes. This can be fatal if not treated properly and it is a good idea to have prednisone at home for just such an emergency. If you have results from his stay in hospital please post them. It is a good idea to always ask for a copy of results when he has tests done and keep them in a folder for future reference so you can see any trends.

I agree with the 2nd vet to keep him off drugs and get him as stable as possible and complete any further investigations and absolutely confirm a cushings diagnosis (the experts on this forum can help you with that) then decide if your boys symptoms are bad enough to warrant further treatment.

I wonder if he is in pain when he slips and someone tries to help him and he gets aggressive, especially if that behaviour is out of character for him. Has this been checked, maybe he has some arthritis??

I hope this helps and rest assured the angels that help everyone here will be on tomorrow to offer their advice on how to manage your baby.

Trish :)

joannayeo
03-26-2013, 07:33 AM
Hi Trish,

Thanks so much for your reply! I'm writing in from Singapore so it's day time here for us. His name's Yeogurt (we spelled it this way to include our last name. haha.) Both vets are pretty sure it's cushings after doing LDDS, ACTH and even an ultrasound scan. They've confirmed it's pituitary dependent. And yup, they did another ACTH test too and other blood test to check his kidneys after the bad reaction from trilostane ( loss of appetite, weak and tired. ). He's on curam antibiotics. I suppose that is for the lumps..

He does have most of the symptoms of cushings: losing hair, pot belly, increase urination and drinking. Just that his appetite isnt too good (he's always been a picky eater). Vet says it's probably due to his kidney problem. It's only until 2 days ago that he's starting to drink less. We'll be taking him to see the vet tomorrow for more checkup.

I'll wait for more people to come on later in the day. (Also hoping that there may be some successful cases on cushex!) Looking forward to hear from the rest (:

- Joanna

labblab
03-26-2013, 08:51 AM
Hi Joanna!

Welcome to you and Yeogurt :). I am sorry that I have only a few minutes free to post right now. But I do want to tell you that the manufacturer of brandname Vetoryl specifically warns against using the drug in dogs who suffer from significant kidney (or liver) impairment:


Do not use VETORYL Capsules in animals with primary hepatic disease or renal insufficiency.

Depending upon the extent of Yeogurt's kidney dysfunction, it may not be safe to use trilostane in any dose. The manufacturer (Dechra) can clarify the basis for the warning, but I suspect it may relate to the drug not being metabolized/excreted properly which, in turn, could lead to an unsafe buildup of the drug in the body. Dechra maintains on-staff vets who are happy to respond to questions of this nature. If you take a look at this thread, you will see a number of links that offer you Dechra's published product information as well as contact phone/email listings for both their U.K. and U.S. offices.

http://www.k9cushings.com/forum/showthread.php?t=185

Offhand, I don't know whether or not Lysodren carries the same warning re: kidney and/or liver impairment. But I wanted to go ahead and let you know about the issue with trilostane.

Marianne

Squirt's Mom
03-26-2013, 10:04 AM
I shudder every time someone says they are going to use Cushex Drops or Supraglan. Cushex claims to treat both Cushing's AND Addison's which are polar opposite conditions. :rolleyes: Several of us here have done a bit of research on the product and questioning of the maker, and are not impressed with it in the least. However, I wasn't sure how the ingredients would effect kidney or liver disease so I went to check and found that the ingredients have changed - once again. So I have written to find out *exactly* what is in it now and will pass that info on when, if, I get it.

One of our admins wrote the makers asking for ANY scientific support, peer reviews, anything that would legitimize their products and there is none. They admit there is nothing more than the claims posted on their website to support the validity of the claims. With all that Yeogurt is already dealing with, this is something I would not give him.

Just my 2 cents worth. ;)

Hugs,
Leslie and the gang

molly muffin
03-26-2013, 09:56 PM
Just building on what Marianne said, your vet can contact Dechra also and find out for sure if vetroyl can or can't be given, since in Singapore they don't have lysodren.
The main thing is to get the kidney situation under control. That is the most dire I think. You can add water to food if you need to get more liquid into him. Also you can make your own chicken broth (nothing store bought) and no additives, and see if that encourages him to drink more. Some of the others might be able to address diet also.
A couple of our dogs are currently going through kidney problems and working on getting it right. Jasper's thread is here. http://www.k9cushings.com/forum/showthread.php?p=98242#post98242 Jasper has been on lysodren, went to low and is now experiencing kidney problems. Tina has discussed what she is doing diet wise currently. Jasper too has issues with some foods.
Hope this helps a bit. Feel free to ask anything, but I think I'd currently be trying to take care of the kidneys.
Oh your vet might be talking about using a compounding pharmacy to get a lower dose of trilostane, like 5mgs.

Sharlene and Molly Muffin