Tobisan's Mommy
04-09-2013, 11:38 AM
Hi folks,
I was hoping I could get some feedback from folks with more experience with Cushings as my husband and I are feeling a little overwhelmed with information and ideas. -please forgive the long explanation!
Our Tobisan is a rescued Shiba Inu - we adopted him just over 3 years ago and there was a whole lot of controversy at the time about exactly how old he was - so we're not really certain how old he is now. (he was a surrender with no info) -his age was estimated at the time to be anywhere from 4y/o to 8y/o depending on who you spoke to - based on our observations of him we guessed 6y/o at the time, which would make him about 9y/o now.
For as long as he's been with us he's been a low energy dog - sleeps a lot, doesn't play much with traditional dog toys but will sit and chew on a bone for a nice long time, or work to figure out one of those hidden treat puzzles until he's found every treat.
He had a number of health issues when he first joined our family, that sort of came up one at a time -first we realized that he was a very picky eater -refusing to eat a number of different food choices for more then a few bites, and was a bit under weight - which lead to us discovering that when his stomach was empty he would vomit bile, which lead to him refusing to eat- creating a viscous cycle. So we worked simultaneously on trying to find food he would eat well and getting him on stomach meds. (omeprazole worked best for him and that's what he's still on)
This lead to us realizing that he had a swallowing issue. If you filled his water bowl he drank super fast and choked himself, gave him too large of a chewy type treat and he had to work for a significant period of time to get it swallowed (licking at the air to work at swallowing) - and during allergy season it got profoundly worse to the point that he'd gag while trying to swallow and heaving up mucus. After discussions with our regular vet and a visit to a specialist he was diagnosed with some damage to his throat (probably from the repeated bile regurgitation) and he was placed on half a benedryl tablet twice a day and we where advised to control the amount of water in his bowl at any given time as well as to make sure that he got small pieces of chewy treats that where more manageable. The combination of these things has gotten us to a point where he does occasionally have to lick at the air a little to get something down, but we haven't had any gagging or mucus regurgitation in two years. The specialist also attributed his snoring to this throat damage.
Then we addressed his low energy levels with his regular vet. On the blood panel his thyroid levels came back borderline low, so they put him on 0.3 mg of Tyroxine and his levels came back up to the normal range - his energy levels haven't really changed, but we've maintained the dose and test periodically.
We where aware that he had a mildly luxating patella in his right hind leg - and then one night in November 2011 he went to jump onto the bed like he did every night, and on takeoff tore both cruciate ligaments in his left hind knee. We did surgery- with absolutely 100% perfect results (thanks in part to the fact that he's not a super active dog I guess!) and started him on Dasuquin for the initial problem knee. He walks with no limp at all now.
However - the fur came back over the incision first, and came back increadibly slowly over the rest of the area that was shaved for surgery - never returning to his belly or his left hind buttock. We had spoken to our vet about this and he recommended adding flaxseed oil to his diet to try and stimulate the fur growth. We had some mild success - but his belly is still bare.
Then 3 months ago we noticed that he had some fur loss in odd patterns on his snout, exposing black skin underneath - we thought he was rubbing at it and discussed with our vet whether it might be an allergic issue - taking him off food with any grains in it and watching whether he rubbed excessively at his snout. We saw no change at all to this area of alopecia. Our vet then sent us to a Canine Dermatologist.
The Canine Dermatologist noticed some small amount of thinning in his fur on his sides as well as a papery texture to the exposed skin on his belly and suspected Cushings- recommending testing. We did a CBC/chemistry/T4/FT4. His AST(SGOT) came back low at 13, his Alk Phosphatase came back high at 390, and his Lipase came back high at 969 - everything else tested normal. We also did a Urinalysis which showed no issues.
He recommended that we do an 8 hour low dose Dex - which we then did. His Cortisol tested at 5.1 initially, then at 4 hours it tested at 4.4 and at 8 hours at 5.0.
Our vet is suggesting that we now start Lysodren treatment, and if it doesn't give us good results then we look to do an Ultrasound. Based on the experiences those of you who have dealt with, or are dealing with this - does that seem to be a reasonable way to proceed?
Thank you,
~M
I was hoping I could get some feedback from folks with more experience with Cushings as my husband and I are feeling a little overwhelmed with information and ideas. -please forgive the long explanation!
Our Tobisan is a rescued Shiba Inu - we adopted him just over 3 years ago and there was a whole lot of controversy at the time about exactly how old he was - so we're not really certain how old he is now. (he was a surrender with no info) -his age was estimated at the time to be anywhere from 4y/o to 8y/o depending on who you spoke to - based on our observations of him we guessed 6y/o at the time, which would make him about 9y/o now.
For as long as he's been with us he's been a low energy dog - sleeps a lot, doesn't play much with traditional dog toys but will sit and chew on a bone for a nice long time, or work to figure out one of those hidden treat puzzles until he's found every treat.
He had a number of health issues when he first joined our family, that sort of came up one at a time -first we realized that he was a very picky eater -refusing to eat a number of different food choices for more then a few bites, and was a bit under weight - which lead to us discovering that when his stomach was empty he would vomit bile, which lead to him refusing to eat- creating a viscous cycle. So we worked simultaneously on trying to find food he would eat well and getting him on stomach meds. (omeprazole worked best for him and that's what he's still on)
This lead to us realizing that he had a swallowing issue. If you filled his water bowl he drank super fast and choked himself, gave him too large of a chewy type treat and he had to work for a significant period of time to get it swallowed (licking at the air to work at swallowing) - and during allergy season it got profoundly worse to the point that he'd gag while trying to swallow and heaving up mucus. After discussions with our regular vet and a visit to a specialist he was diagnosed with some damage to his throat (probably from the repeated bile regurgitation) and he was placed on half a benedryl tablet twice a day and we where advised to control the amount of water in his bowl at any given time as well as to make sure that he got small pieces of chewy treats that where more manageable. The combination of these things has gotten us to a point where he does occasionally have to lick at the air a little to get something down, but we haven't had any gagging or mucus regurgitation in two years. The specialist also attributed his snoring to this throat damage.
Then we addressed his low energy levels with his regular vet. On the blood panel his thyroid levels came back borderline low, so they put him on 0.3 mg of Tyroxine and his levels came back up to the normal range - his energy levels haven't really changed, but we've maintained the dose and test periodically.
We where aware that he had a mildly luxating patella in his right hind leg - and then one night in November 2011 he went to jump onto the bed like he did every night, and on takeoff tore both cruciate ligaments in his left hind knee. We did surgery- with absolutely 100% perfect results (thanks in part to the fact that he's not a super active dog I guess!) and started him on Dasuquin for the initial problem knee. He walks with no limp at all now.
However - the fur came back over the incision first, and came back increadibly slowly over the rest of the area that was shaved for surgery - never returning to his belly or his left hind buttock. We had spoken to our vet about this and he recommended adding flaxseed oil to his diet to try and stimulate the fur growth. We had some mild success - but his belly is still bare.
Then 3 months ago we noticed that he had some fur loss in odd patterns on his snout, exposing black skin underneath - we thought he was rubbing at it and discussed with our vet whether it might be an allergic issue - taking him off food with any grains in it and watching whether he rubbed excessively at his snout. We saw no change at all to this area of alopecia. Our vet then sent us to a Canine Dermatologist.
The Canine Dermatologist noticed some small amount of thinning in his fur on his sides as well as a papery texture to the exposed skin on his belly and suspected Cushings- recommending testing. We did a CBC/chemistry/T4/FT4. His AST(SGOT) came back low at 13, his Alk Phosphatase came back high at 390, and his Lipase came back high at 969 - everything else tested normal. We also did a Urinalysis which showed no issues.
He recommended that we do an 8 hour low dose Dex - which we then did. His Cortisol tested at 5.1 initially, then at 4 hours it tested at 4.4 and at 8 hours at 5.0.
Our vet is suggesting that we now start Lysodren treatment, and if it doesn't give us good results then we look to do an Ultrasound. Based on the experiences those of you who have dealt with, or are dealing with this - does that seem to be a reasonable way to proceed?
Thank you,
~M