Finnegan - 8 y/o Soft Coated Wheaten Terrier -

[JFBMaine]

Hello, I just found this forum and need some help. My Soft Coated Wheaten Terrier, eight year old Finnegan is believed to have Cushing. I had him at the vets last week for his annual check up and I told the vet that he drinks an enormous amount of water, does not want to go for walks and sleeps all day. She did a blood test and the part of the test for the liver came back in the high 800 range and the norm I was told is around 260. She said we should wait and do another blood test next month to see how it looks. I called another vet in Houston ( a friend) and he said he believed that Finnegan has Cushings. Finnegan has had small seizures years ago, he is constantly hungry, and pants constantly. He has always been a little on the heavy side, was the largest in his litter, so he does have a bit of a stomach anyway even though he did enjoy his many walks and playing with his buddies...before the last few weeks. Thank you for any help you can give me. He is my best friend...I was there when he was born and he has been with me every day of his life. Felice

[Squirt's Mom]

Hi Felice,

Welcome to you and Finnegan! :)

It's not usually this slow around here but being a holiday, folks aren't around as much today.

First, it's going to be ok...even if it is Cushing's, it's going to be ok. Not perfect, but ok. You have already taken a couple of great steps on Finnegan's behalf by calling your friend and by joining our family. There is an enormous amount of knowledge and experience here plus we are great hand holders. :) I understand how attached you feel to him. I've had my Squirt since she was 5 wks old; she is my soul dog, my heart dog. When she was first diagnosed, I totally lost it! I came here a complete basket-case! :eek: But these wonderful folks gently led me along until I could breath again and start to absorb a tiny bit about Cushing's. The more I have learned, the more comfortable I am dealing with her issues and I'm sure the same will holds true for you.

You are at the very beginning of the diagnostic phase. First, Cushing's would be very difficult to diagnose based on liver values alone. Several things can cause those values to elevate. It is an indicator, tho. Since Cushing's is a slow progressing condition, take your time and rule out all other possibilities including diabetes, thyroid problems, and liver disease. If everything comes back negative, then turn your attention to Cushing's.

Is Finnegan on any other meds, supplements, or herbs at the moment? If so, what for? Other than the seizures and recent suspicions, does he have any other health issues? The more you can tell us about him the more meaningful feedback we can provide. Also, if you could post the actual lab results along with all the gobbledygook following the numbers, that would help also.

If you don't have copies of his test results, your vet should be glad to provide them. It is a good idea to keep a file at home just in case you have to see a different vet for any reason. Several of us also keep journals of our babies daily activies - meds, pee and poop history, intake of water and food, moods, sleep patterns, any odd or different behaviors, etc. That way you don't have to try to remember when he upchucked that weird white stringy thing. :eek::p Vets often find these journals helpful as well.

I am so glad you found us and hope to learn more about you and Finnegan soon.

Hugs,
Leslie and the girls

PS. I have some links for you. Also be sure to check out the Resources section for some great material on Cushing's as well as other conditions.

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

Thyroid info:
http://www.thyroid-info.com/articles/dog-hypo.htm

Canine Hyperadrenocorticism, Diabetes Mellitus, or Both?
http://www.vet.uga.edu/vpp/clerk/Zwicker/

diabetes info
http://k9diabetes.com/forum

Cushing's info:
PowerPoint Presentation
http://talkoftheinternet.com/etvma1/hac-3-13-07.ppt

Long Beach Animal Hospital*
http://www.lbah.com/canine/cushings.htm

Drs. Foster and Smith*
http://www.peteducation.com/article.cfm?c=2+2097&aid=416

Newman Veterinary*
http://www.newmanveterinary.com/CushingDiag.html

Cushing’s signs and pics*
http://www.newmanveterinary.com/CushSignFrame.html

BMD Health Library*
http://www.bestbeau.ca/bmd_health_links_4.htm
(scroll down to see Endocrine Diseases)

Mar Vista Animal Medical Center*
http://www.marvistavet.com/html/cushing_s_disease.html

Vetstream*
http://www.vetstreamcanis.com/ACI/February08/VMD2/FactSheet052.asp

[frijole]

Felice,

Looks like Leslie covered alot with you so I'll just say welcome and confirm that with treatment your dog can lead a wonderful life. My schnauzer is over 15 and has been treated for 3 yrs with lysodren. You are wise to learn all you can about the disease as you are Finnegan's voice.

Welcome and all the best,
Kim

[MiniSchnauzerMom]

Felice,

Just stopped by to add my welcome to you and your baby Finnegan. You've come to the right place for information and support. There are lots of caring people here and we're here to help.

Give Finnegan some extra pets from me! Will be watching for your update.

Louise

[forscooter]

Hi Felice,

Wanted to add my welcome! I know Leslie covered this with you but wanted to underline the point about also checking/ruling out other diseases/conditions. When I was reading your post, I also thought about the possibility of diabetes. Endocrine disorders can be a bit to tease apart and also, it can be not that uncommon to have more than one. So, if you post any tests that are done along with results, everyone here will be helping you along.

When Scooter got diagnosed, one of the first things we checked was his urine. Did the vet happen to run any urine tests as a part of the check-up? Cushing's dogs, as well as those with diabetes, will often have dilute urine. Just thinking that may be a start for now if you know and have the results of that...

Leslie gave you lots of great information to read through....it can all be a bit overwhelming at first so I usually tell people to read but not to worry about learning it all at once...it's a process. And please do ask lots of questions bc that helps the learning too....

Welcome again!
Beth, Bailey and always Scooter

[gpgscott]

Hello Felice and Finnegan,

You have been covered up with advice.

You are wise to seek information, and thanks for joining here.

Now, to go ahead and figure it out.

Please let us know. I know we can help you sort it out.

Scott

[JFBMaine]

Hello to everyone, I am a photographer and just returned from a session, sorry for the delay in returning the thread. I am so confused about all of this. The vet I have here in Maine wants to wait until June to run another blood test on Finnegan, the same one to see if the liver thing is higher. I don't have the result however will call the vet tomorrow to get that information. THe name of the test he had , on the bill, is Chem 12/Lytes/CBC. In January he was not feeling well and I took him in and they ran this same test and it was about 40 points higher than it should be and this time it had tripled! The vet in Houston said that with the increased drinking, no interest in going for a walk, he no longer wants to sleep with me, he now sleeps on the wood floor not on his bed or rug, hungry all the time, that he thought it was Cushings. AM I making a mistake by waiting until next month for another blood test? Thank you for your e mails and support! Felice

[gpgscott]

Felice,

All that you are reporting concerning behavior points toward Cushing's.

My advice concerning diagnosis is a bit different from the norm.

I suggest first a UC:CR, this is a urine test, you collect the sample first thing in the morning and take it in. The result is not conclusive for Cushing's but is it conclusive as a rule out.

If the UC:CR is in the Cushing's range then I would ask for an ACTH sent to UTK (university of Tennessee@Knoxville) for a full adrenal panel. This will tell you about cortisol and five other hormones, all of which can cause Cushing's symptoms.

There are many issues which can cause elevated liver enzymes but you have significant symptoms also.

Finnegan is young and in good health it seems, so the sooner you know the better.

Thanks again for joining, I know there is a treatment for your pup whether it is Cushing's or something different.

Scott

[JFBMaine]

Hi Scott, how do I collect a sample of his urine? THis may be a stupid question, I am sorry. Thanks, Felice

[frijole]

Felice,

The good news is that there is not normally a rush to treat cushings so you have time to "get it right". It appears that you simply had a blood panel done which indicated high liver enzymes. That's how most of us started out. However, there are other issues that cause liver enzymes to be high and that mimic cushings including hypothyroidism, diabetes to name a few.

The symptoms you mentioned are all common cushings signs. Most vets do specific testing for cushings. I'll give you a link at the end of this to our resource section and that will help get you started. Don't let it all scare you. If it is cushings you can treat Finnegan and expect a normal happy life. Our role is to simply help you get up to speed since you are your dog's voice. ;)

Glad you found us. Tell us all you can and ask questions.

Kim

http://www.k9cushings.com/forum/forumdisplay.php?f=10

[gpgscott]

Hi Scott, how do I collect a sample of his urine? THis may be a stupid question, I am sorry. Thanks, Felice

Oh!, there are stories about this:D

You do not need a large sample and there are many devices used, large spoons...etc...

It is important that it be seen by the Dr. as soon as possible after collection. My Dr. insists on 30 minutes.

Scott

[StarDeb55]

Felice, I would also like to welcome you & Finnegan! You have already received great advice, so I won't repeat it. The one thing I will tell you is that part of making the Cush diagnosis is the presence of pretty strong symptoms, including abnormal labwork. When it comes to the labwork, more than likely the values you are talking about are the alkaline phosphatase, & ALT, both of which are liver enzymes. The great majority of Cushpups do have a certain degree of liver damage, because the liver is having to process the excess production of cortisol by the adrenal glands, The other symptoms including the voracious appetite, pot-belly & drinking huge amounts of water are common, too. Does Finnegan have any issues with skin or coat, muscle wasting, especially in the back end? You rely on the presence of symptoms, & a subsequent decrease in those symptoms, when you begin treatment with either of the 2 common meds, lysodren or trilostane. If I were in your shoes based on the description you have given us of Finnegan 's symptoms, I would begin the diagnostic testing needed for Cushing's. The first & easiest step is a urine creatinine:cortisol ratio (UCCR) which you can collect at home. It should be the first morning pee prior to eating, & you only need about a tablespoon. This is a good first step because if it comes back negative, you ARE NOT dealing with Cushing's. Positive simply means that Cushing's is a possiblity, further testing required.

Debbie

Looks like Scott & I were posting at the same time about the UCCR, so sorry for any duplication.

[JFBMaine]

Thank you! I will call my vet tomorrow, however she doesn't seem really interested in running any more test and has more of a wait and see attitude, which I don't feel comfortable with at this time. I will collect Finnegan's urine and deliver it to them for the tests that you are recommending. I will post the results as soon as I get them. Thanks again. Wonderful people on this site!!! As soon as I figure out how to upload photographs of Finnegan I will do that. Felice

[Rusty's Mom]

Welcome to this site. As you can see, you will receive a wealth of info and opinions here!!

My first thought when I read that your vet doesn't want to be proactive now and since this has been going on since the first of the year, is to consider taking your Finnegan to another more proactive vet or an internal medicine vet/specialist.

Not all people want to treat their dogs proactively. However, for those of us who do, we need to find a vet who matches our desires.

I'll be thinking of you and Finnegan - gotta love that name!!

MJ

[JFBMaine]

Hi, when I first was told that Finnegan may have Cushings I did a little cruising on the internet and found something offered that is suppose to be natural, Cushex Drops by PetAlive. Is anyone familiar with this product? THanks, Felice

[frijole]

Felice,

We have a member who actually contacted them to get scientific results and if I recall they either did not reply or replied but did not provide supporting information. There are lots of "miracle cures" on the internet and I fear this is just another one. It has been around for a while but I have never read of a success story. If you are going to do the urine test you should do it before making any changes including supplements. At this point you don't have a cushings diagnosis so I would get the urine test done and take it from there.

I'm moving this question to your thread so all information is in one place. It becomes like a diary and will make it easier for you up the road. Plus it helps us keep stories straight. :p

Kim

[lulusmom]

Hi Felice,

I am the member that wrote to PetAlive, as well as other companies claiming to have natural remedies that are effective in treating cushing's. None of these companies have done any testing to prove their claims. PetAlive ignored my very direct question about testing and provided a list of wonderful things their natural remedy would do for my dogs. They also mentioned that it is safe to use with conventional treatment. Well duh, the point of my email to them was to ask them to provide supporting documentation that their product's efficacy would allow a pet owner to avoid conventional treatment. It is pretty disturbing that these people get away with such blatant fraudulent advertising.

Pet owners with cushdogs, especially those new to the disease, are overwhelmed and very vulnerable which makes them huge targets for these unscrupulous companies. I would suggest that any member that is contemplating treating with anything other than conventional treatment, to do their own research and ask questions of any company that claims to have an effective treatment for cushing's. It is only effective if clinical trials have been done to prove its effiicacy by way of acth stimulation tests, low dose dexamethasone suppression test, urine cortisol:creatinine ratio, etc.

Glynda

[jrepac]

I would not panic about the high liver values, but certainly would get the urine test done first. The high Alk Phos values are not life threatening, merely indicative that something is causing the liver to work overtime. Many things can raise the liver enzymes up, not just Cushings. I've been dealing with high liver enzymes for some time now, and my terrier is doing quite well with her cushings treatment.

Re: Cushex, the drops have several ingredients that are supposed to address certain symptoms of Cushings...you can read up on them pretty easily at various sites that discuss homeopathic remedies/treatments. However, it is doubtful that the drops would lower cortisol. Having used them, I did not find them harmful, but I think their efficacy is limited at best.

There are also supplements like Denamarin (and similar remedies), that you can give for liver support, if needed. These are endorsed by vets and many pet owners. But, get the basic tests done first.

Jeff

[JFBMaine]

Update on Finnegan's journey with Cushings. He is scheduled to have a LDDST( :confused:...not sure what that is) test a week from today. The vet told me that this will confirm that he does have Cushings, both the vets I have spoken with believe he most likely has it, and she said we can start treatment once we get the results. Thank you again to everyone who has e mailed me with answers, comments, views, information, links, and support! Felice

[Roxee's Dad]

Hi Felice,
I have not posted to you before this as you have recvd so much good advice. I am a bit concerned that the vet it using only the LDDS test to determine a cushings diagnosis. An LDDS test can create a false positive in dogs with non-adrenal illness.

Here is a link for more information on the LDDS and other testing:

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2007&Category=&PID=18195&O=Generic

I am also a little concerned that the vet will start treatment based on that test alone. There should at least be an ACTH to find out where Finnegan's baseline is at so you and the vet can have a number to compare it to during his treatment monitoring.

If you are using any of the two proven methods of treatment, Lyso or Trilo, you want to be absolutely sure that Finnegan has a correct diagnosis.

Belly rubs to Finnegan:)

[frijole]

FELICE,

The reason everyone suggested starting out with the urine test is because it is next to peanuts cost wise to the LDDS test. (a couple hundred bucks average) This way if it is ruled out you save money and look at alternatives.

I also agree with John - you need more than the ldds. You might want to read in our Reference Thread on testing and diagnosing before going in. OR ask us questions. It will save you time and money more than likely.

The best,
Kim

[forscooter]

Just chiming in here....we also started with the UCCR...then the ACTH...then the LDDS. Do you know if they also ruled out any diabetes or other adrenal illness? This should be done bc of the reasons mentioned above. Please don't rely just on the LDDS alone. It is a great test to use IF the other scenarios (any other adrenal illnesses) have been ruled out....along with other tests. There is no 100% foolproof test unfortunately for Cushing's....

Hang in there, Beth and the crew

[JFBMaine]

John, thank you for this information. I have made a copy of the information from the link you have given me and I will go over it with my vet. I am really nervous about making the right or wrong decision with Finnegan's treatment. Gee, I was less nervous when I was dealing with my own illness ( I'm fine now) years ago!!!

[JFBMaine]

Hi Kim and Beth, we have ruled out diabetes. I asked for the urine test and she said that the results would not give us the information that we need. She said because of his symptoms that it sounds as if he does have Cushings. Thanks for any more thoughts on this. Felice

[gpgscott]

Felice,

This is just my opinion. I think in most cases you can skip the LDDS, it is costly and stressful for the pup, the pup has to be at the clinic all day or you have to drag him back and forth either way the stress of the situation can affect the outcome of the test making it inconclusive. I would ask for the full adrenal panel from UTK (university of Tennessee @ Knoxville) and if that came back indicating elevations of cortisol only then I would want an ultrasound. If this test came back with elevations of hormones other than or including cortisol this information would be important to the selection of a treatment. It is possible your Dr. is not aware of this extended panel.

Is the Dr. being open and discussing the process throughly with you?

Scott

[JFBMaine]

HI Scott, this is a new vet from me because the vet I have had for years has retired and sold his practice. No, we have not really discussed it other than I just called her today asking to have more test.
When I met with her last week she said we should wait a month to take the CBC blood test again to see if Finnegan's results are still rising. She told me at that point that she thought Cushings might be a possibility. I called another vet, a friend out of state, and he said from the symptoms that I was giving him he thought Finnegan had Cushings. So after looking on line, it certainly looks like Cushings. So that is why I called the vet today for more tests. She said the urine test would tell us nothing. SHe already ruled out diabetes. His symptoms are excessive drinking the last few weeks, for about a year always hungry, off and on for the last year lethargic and that has increased this last couple of weeks, sleeping all the time, panting, sleeps on the coolest area he can find ( not on his bed or mine) legs seems stiff sometimes when he walks. I took him to the vets in January because he just didn't seem to feel well however the vet didn't find anything. She did that same blood test Chem12/Lytes/CBC and the liver part was somewhat elevated and last week it was really high. Hope this is not too much information. Thanks so very much to all of you! Felice

[JFBMaine]

P.S.- Finnegan does not have a pot belly or hair loss.

[Roxee's Dad]

Hi Felice,

We know this is alot to take in and it certainly does sound like all the cushings symptoms. Just take a deep breath, read and educate yourself as we all had to do. We are here to help you through our own experiences.

Scott mentioned the UTK adrenal panel, this would be the gold standard. In hindsight I wish I had done it. Now, I am considering it but I will have to stop 4 months worth of treatment to go thru a washout period. There are various treatment as there are various cushings. PDH, ADH and Atypical. All have pretty much the same symptoms. A pup can have raised cortisol and raised intermediate hormones at the same time. If the intermediate hormones are also high, Trilo may raise them even more, causing further complications. In this case Lyso may be the best choice. As you can see, this can get a bit complicated.

Does your new vet have any experience with Cushings? If not, ask her if she would be willing to discuss this with you and work together as a team. Some vets don't:( I have fired a few vets in my time. My current vet is good about discussing symptoms, treatments and possibilities. You may as well find out up front. Otherwise I would be looking for another vet with experience.

As has been said, we are here to help in anyway we can, experiences, advice, opinions and handholding. Feel free to ask any questions or just express your thoughts, sometimes it helps knowing there are others of us in the same situation and sharing the same feelings of being totally lost. I have and still depend on my cush family here to get me thru and continue to help me understand what is going on with my Roxee.

More Belly rubs to Finnegan:)

[JFBMaine]

Yes, it is overwhelming and on top of it, I am a photographer and entering the busiest, most stressful time of the year for me. I am self employed and have to stay focused because Finnegan and I rely on this income to get us through the year. I will call the vet and ask her to meet with me before we start any test so that I know where she stands and will present the information that I have received here. Thanks again.

[Squirt's Mom]

Hi Felice,

Here are some links to help you and your vet with the UTK panel.

Atypical Cushing’s*
http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=485128&sk=&date=&pageID=1

http://www.vetcontact.com/en/art.php?a=132&t=

UT Panel
http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php

http://www.vet.utk.edu/diagnostic/en...logy/index.php


Also one about the urine test we spoke of, the UC:CR -

urine cortisol:creatinine ratio*
http://veterinarymedicine.dvm360.com...tegoryId=45679


I understand that you are swamped trying to make a living but please take the time up front to learn all you can, get the correct testing (multiple) done and diagnosis arrived at FIRST, then start treatment as needed. The time spent now will save you more time and more money down the road. Take this opportunity to learn from us; John isn't the only one to regret some things and several have had to stop and start all over due to haste, lack of understanding, or vets unqualified to treat this condition in the beginning phases. Take your time.

Hope things are good for you both today!
Hugs,
Leslie and the girls

[JFBMaine]

Thanks again to all of you. I will call my vet and make an appt with her to discuss that I want the UTK done first. Will let you know how all goes and if she is not open to this I will look for another vet. Great support!

[Harley PoMMom]

Hi Felice,

My Harley was dx with cushings in March 2009 with a LDDS Test by his old vet. Harley's old vet wanted to treat him with Trilostane, at the urging of the people of this forum, I had the UTK panel done on Harley before treating him with the Trilostane.

The UTK panel results showed Harley has elevated estradiol, which means he is an Atypical cushing pup.

With these results (UTK) Harley's treatment is Melatonin and pressed flax hulls with lignans.

I don't know what would of happened to Harley if I had not found this forum with all these kind, knowledgable and wonderful people here.

I wish you the best with Finnegan.

Lori and Harley

[JFBMaine]

Lori & Harley, thank you. I am so very grateful to everyone who has e mailed me. I sound like an emotional idiot on most of my e mails...which I guess I am right now. I have called the vet's office to leave a message and sent an e mail to them. I am not having the LDDST test on Finnegan and want the UTK. If she is willing to work with me I will send her the links for the UTK and if not we will move onto someone else. Finnegan and I are doing a little French Canadian gig right now to celebrate that we found all of you!! Love Felice & Finnegan

[StarDeb55]

Felice, John has given you dead on information about the LDDS. It's imperative that you confirm any positive LDDS with a 2nd test such as an ACTH, abdominal ultrasound, or the high dose dex. This is what makes Cushing's so frustrating to diagnose as there is no single test that is 100% sensitive or specific.

I'm in total agreement with what Scott has suggested about skipping the LDDS. My Harley was diagnose a year ago with Pit Cushing's + Atypical, based simply on the results of his UTK full adrenal panel & an abdominal ultrasound. At the time, I asked the IMS that we were seeing if she needed anything else to confirm the diagnosis besides the UTK & ultrasound, mentioning the LDDS, her response was, "Nope, just the 2." She said that she doesn't really even use the LDDS any more to make a Cushing's diagnosis because of the risk of false positives.

Debbie

[Harley PoMMom]

Felice,

I probably should have wrote this in my previous post to you, but the LDDS test was not the only test done on Harley to confirm his cushings.

I also had an ultrasound and endogenous ACTH done on Harley.

Harley's case is a little puzzling so I won't go into the details bc I don't want to confuse you more.

All I wanted to stress is that these lovely people really know their cushings and will guide you in the right direction.

Take care, Harley and Lori

[Roxee's Dad]

Hi Felice,


I sound like an emotional idiot on most of my e mails...which I guess I am right now

Your officially one of us now:eek::D:eek::D:eek:

[Wylie's Mom]

Hi Felice & a belated Welcome,

I don't have much to add... just stuff to support what others have said. My GP vet sent me straight to an IMS vet (Internal Medicine Specialist) for an ultrasound after seeing my Wylie's clinical signs and UC:CR & ACTH stim test results. She, too, doesn't bother with the LDDS. In hindsight, if I or my GP vet had know about the UTK panel, I would have done that instead of the ACTH stim test. Five months after starting treatment with Lysodren, I had his estradiol levels tested through UTK and found that they were high, I was relieved that I happened to choose Lysodren, as Trilostane would probably have increased the levels even more. I think you are on the right track going for the UTK full adrenal panel... the ultrasound was also a great thing to do in Wylie's case, but let's first wait for UTK results.

Also, you said that diabetes was ruled out, what about hypothyroidism? Cushpups tend to test boarderline low for this.

-Susy

[gpgscott]

Also, you said that diabetes was ruled out, what about hypothyroidism? Cushpups tend to test boarderline low for this.

-Susy

And this is a very good point, it seems that Moria was hypothyroid for a while and it was not until she began exhibiting laryngeal issues that she was diagnosed.

Hypothyroid can cause all sorts of issues, I would ask to be tested for it. It is not costly to treat and can make a large difference.

Scott

[JFBMaine]

Thank you to everyone ! I am going to cuddle with my boy right now. Love to all of you. Felice

[ChristyA]

Hi Felice,
I agree with Scott. I wish I had known to go that route when Dexter was diagnosed. My vet didn't even mention UTK and he didn't mention an ultrasound. As a matter of fact he didn't follow protocol at all. It wasn't until I went to an Internal Medicine Specialist that we had an ultrasound and were able to get Dexter stabilized on his lysodren.

I think you have a good plan in talking to the vet before anything goes further. You really need to be sure she knows what she is doing and how much experience she has in dealing with Cushing's, this will save you time and money. Let us know how the meeting goes, I am curious to hear what she says.

Christy

[JFBMaine]

Below is the e mail that I have received from my vet, Please give me your thoughts on what I should start with in tests. The good news is that she is open to discussing options and willing to listening. Thanks to all of you she thinks I know what I am doing ;) I don't think I even want to consider the LDDST because Finnegan is a very sensitive and nervous boy and it would be a difficult day for him even if I didn't keep him there for the day and brought him back & forth. And it sounds as if I may get a false reading because of the stress he would display. Plus it sounds as if the UTK panel is more of what we need for results.
SHould I go for the thyroid test first, or switch to the specialist?

Hi, Felice,

You've certainly done your homework! Good job! :) 3 of the 4 links on the second e-mail you sent were out-of-date, but I found the information regarding the UTK adrenal panel through the Veterinary Information Network, so all is well.

We have a lot of options on how to proceed with diagnostics for Cushing's Disease for Finnegan (who, as we discussed on the phone, is exhibiting classic signs of Cushing's). According to my research on VIN, most veterinarians perform the LDDST first, and proceed to the UTK panel if the LDDST results do not offer firm support for a diagnosis of Cushing's. That being said, since part of the UTK panel is an ACTH simulation test (an alternative preliminary Cushings diagnostic test), there is no reason why we couldn't just skip the LDDST and do the panel instead.

Price is a big reason why most vets do the LDDST first and only go on to the UTK panel if necessary - an LDDST is relatively inexpensive and easy to run (it costs about $85 dollars, I think - I don't have the clinic computer handy to check on that). A UTK panel is much, much more expensive - the panel itself costs over $200 to run. The Cortrosyn needed to run the ACTH stim test part of the panel is also quite expensive.

So here's a summary of the different things we can do:

- We could start with the LDDST as scheduled on Wednesday. If the results indicate that Finnegan has Cushing's Disease, we do not need to test further. We would start treatment and monitor him from there. However, if the results are wishy-washy, we would go on to the UTK panel next.

- We can skip the LDDST and run the UTK panel immediately, which, in theory, should give us a definitive yes/no on Cushing's.

- Given the complexities of any hormone-related disease, you always have the option of having us refer you to a specialist - Dr. Gail Mason at Bath-Brunswick Veterinary Associates is the nearest person with endocrinology expertise. She could assess Finnegan and advise you on how best to proceed. She recently diagnosed a sex hormone imbalance in another dog we sent to her for consultation - she is quite good.

The fact that Finnegan has a history of epileptic seizures makes me a bit concerned that this could be pituitary dependent Cushing's - in that case, the disease is caused by a tumor of the pituitary gland, which could also be putting pressure on his brain. However, the fact that he has gone many months now without any seizures is reassuring: if Finnegan had a pituitary tumor big enough to be causing seizures, the incidence of seizures should be getting worse over time, not better. The option for referral to a veterinary neurologist in Scarborough exists if he starts having seizures again at any point.

Another thought I had: regardless of how we proceed in looking for Cushing's, it would also be prudent to run a complete thyroid panel on Finnegan. Sometimes hypothyroidism can cause symptoms in dogs that mimic Cushing's (though usually not the elevation in the AlkP). We send the profile to Michigan State University, which provides us with a lot more useful information than just a T4 level. The only downside is that it takes up to 14 business days to get results. I would recommend running it anyway.

In summary, my personal recommendation for Finnegan would be to do the LDDST and thyroid panel first, and move on to the UTK adrenal panel if we don't get a diagnosis from either of those tests - but I'm flexible; we'll do whatever you feel most comfortable doing.

Sorry for the long and complicated e-mail answer! These cases are never simple. I am out of the office for the rest of the week, but feel free to contact me at this e-mail address (removed) if you have any questions, or would like to discuss it further - I'll be online frequently. Dr. Collins, who saw Finnegan most recently, is in the office all day on Friday if you'd like to speak with her. We'll keep Finnegan's Wednesday morning appointment for now - we'll almost certainly be drawing some blood for something. :)

Take care,
--Dr. Anne

[ChristyA]

Hi Felice,
If Finneganwere my pup I would definately go with the UTK panel. I noticed in her email she claims she would start treatment if the LDDST came back positive, that's not good. For one she would need to run an ACTH to see where Finnegan's cortisol level is as a starting point, and depending on the results you may want to have an ultrasound done if there is a need to determine if the Cushing's is adrenal or pituitary.

She talked about a cost savings by doing the LDDST. You don't want to cut corners on the diagnosis. It can be expensive, but - if this isn't diagnosed correctly and without a doubt - Finnegan's well being will be at stake. If you give a dog Cushing's meds without it being Cushing's it will be life threatening.

I hope you do the UTK panel. Which your vet said will already include the ACTH and you definately need the ACTH done also.

If it is Cushing's I would request your vet work with the specialist she recommended. The specialist we went to was actually less expensive than our regular vet.

We went through 3 regular vets until the specialist got Dexter regulated. I wasted a lot of time and money with vets that weren't really sure which tests needed to be done and when. I won't ever do that again.

How is Finnegan doing? I hope he is holding up ok. Wheaten's are so pretty. We were looking on petfinder to adopt one last fall. We didn't find any in our area. We now have a flat-coat retreiver who is 2 and a little Boxer (maybe mix) that is a demon at 4 months.

Christy

[frijole]

Felice,

I am sure others that have had the UTK panel done will jump in with additional comments but here is my 2 cents...

First, what a nice note. While your vet might not have a lot of experience she is at least willing to do research and read which is wonderful.

My experience is that the LDDS test is the same or MORE than the UTK panel. The UTK Panel price is on the website and my memory is that it is $135 or $155. Make sure she sends the results directly to THEM and not to their regular lab. Otherwise that lab would mark up the price and send them off to UTK. I paid $128 for the LDDS 3 yrs ago but I have seen it as high as $250 so it depends on the vets' office! ;)

I think that the reason why most vets do the ldds test first is because that it used to be the golden rule. Atypical cushings was often overlooked and undiscovered as a result. It has been our experience here that more and more vets are learning about the UTK panel and using it. It is not new - it is simply that alot of vets are not as knowledgable about cushings and testing. They are after all vets - not specialists so it is hard to know everything about everything.

I do agree that having the thyroid tested is worthwhile. Not only could your dog only have hypothyroidism - alot of dogs, including mine, have BOTH cushings and hypothyroidism. The good news is that you give them a pill and it's $8 a bottle for in my case 2 mos. supply. Yeah!

You have come a long ways in a short time. Finnegan will be just fine - keep up the great work!

Kim

[labblab]

Hi Felice,

I have not had the chance to welcome you prior to this, but I am so glad that you have joined our group! And thanks for posting your vet's email. On your behalf, I appreciate the detail with which she has written about your options and her related thoughts.

I am certainly not a vet :o, but after reading what your vet has written, here are a few thoughts of mine. I do agree that the thyroid testing would be a good idea, and am glad that she is recommending the Michigan State panel. Thyroid issues and Cushing's issues can indeed mimic one other, and can also be intertwined. Thyroid levels can be abnormally depressed AS A RESULT of Cushing's, or they can be an independent problem. And the Michigan State panel will be able to shed much more light on that. So I think the thyroid testing is a good idea, regardless of anything else. It will add more information to the mix.

Secondly, I would prefer having the UTK adrenal panel run prior to the LDDS (for all the reasons you have already been given). However, if the UTK panel comes out negative -- and if the thyroid panel indicates that any identified thyroid issues are secondary to another illness and are not the primary cause of Finnegan's problems -- then I would advance to a LDDS and/or ultrasound. This is because one flaw to the ACTH stim test is that it does a poor job of identifying the adrenal form of Cushing's. Adrenal Cushing's is much less common than the pituitary form of the disease, but will more reliably produce a "positive" result via the LDDS or abdominal ultrasound.

My one additional thought relates to the fact that epilepsy has been thrown into the mix. This being the case, you may very well want to pursue the consultation with the specialist, either before or after some additional testing. This is because there are potential drug interactions between epilepsy medications and those used to treat Cushing's. If Finnegan does have Cushing's, I think you would benefit from the expertise of a specialist when it comes to selecting the appropriate treatment for Finnegan. So you may want to go ahead and enlist the specialist's help with the diagnostics, as well.

Marianne

[JFBMaine]

Christy, I am going to go with the UTK panal even though it is expensive. And from what I have been told on this site ,by many of you, is that my vet should not be starting treatment for Cushings from the results of a LDDST test. So I am staying away from that test.
I am not familiar with the flat-coat retreiver, I love boxers...they are so darn cute. Thanks for your information and support. Felice

[frijole]

Christy, I am going to go with the UTK panal even though it is expensive. And from what I have been told on this site ,by many of you, is that my vet should not be starting treatment for Cushings from the results of a LDDST test. So I am staying away from that test.
I am not familiar with the flat-coat retreiver, I love boxers...they are so darn cute. Thanks for your information and support. Felice

Felice

I just want to make sure you know that there is nothing wrong at all with the LDDS test. In fact it has been the best known standard for a long time - its just that cushings is hard to diagnose and almost always more than one test is required - We are suggesting the ORDER you start in - to save time and money. Again, we are not vets but simply people that read about a whole lot of dogs' testing experiences so we learn from that.

Hope this helps
Kim

[Roxee's Dad]

Hi Felice,
Sounds like you and Finnegan have a nice vet that is open to discussions :) As we have said we are not vets but give you our thoughts based on the many experiences we have all gone through.

I'm sure more experienced and knowledgeble members may chime in with there idea's and suggestions. But the statement that the LDDS test will give her a positive diagnosis is not correct. As has been said and written by many vets, the LDDS can give a false positive and if used, should be used in conjuction with another test such as the ACTH and to be really sure it's a Pit tumor causing the cushings, should be verified with an UltraSound (high resolution)

If it were me and I had another chance to do it over, I would go for the thyroid testing and the UTK adrenal panel followed by the ultra sound.

Belly rubs to your handsome boy.

PS: BTW, you do know what you are doing, look how much you have learned since you joined and started researching in the resources section.

[JFBMaine]

Hi Kim, I am sure that my vet would get some good information from the LDDST test however the process makes me stressed because I know what it would do to Finnegan and he is not feeling well as it is. From everything that I have read and the information that you folks have given me I think we would get more information at this point with the UTK panel. I do have a question because I am a little ( okay alot) confused; will the UTK panel tell us if it is adrenal or pituitary or will we have to do the ultrasound?

[JFBMaine]

Okay, I think John has answered my question. Looks as if even after the results from the UTK panel we would have to do the ultrasound to see if it is adrenal or pituitary. Thanks!

[JFBMaine]

John, thanks for the compliment saying that I know what I am doing....but NO! However, with all the links that you folks have provided, the experiences that you have had w/ your own pets, and all your knowledge shared with me, I can sit here at my computer e mailing my vet sounding as if I know what I am talking about. But I must admit I do feel better about going forward. THanks so much to all of you again, and again. I am not getting support from my friends. They think I am over reacting and should just wait to see what happens with Finnegan. They think so what if he drinks water all the time, wants to sleep all day and is hungry all the time. But I know this guy is not feeling well and has not for a while.

[labblab]

My one additional thought relates to the fact that epilepsy has been thrown into the mix. This being the case, you may very well want to pursue the consultation with the specialist, either before or after some additional testing. This is because there are potential drug interactions between epilepsy medications and those used to treat Cushing's. If Finnegan does have Cushing's, I think you would benefit from the expertise of a specialist when it comes to selecting the appropriate treatment for Finnegan. So you may want to go ahead and enlist the specialist's help with the diagnostics, as well.

Marianne
Felice, I know I am quoting myself here from my earlier reply to you :p, but I really am curious to know more about Finnegan's epilepsy history. Can you tell us about that? Because even though the epilepsy may be unrelated to whether or not he has Cushing's, I do think that may have an effect on future treatment plans.

Marianne

[JFBMaine]

Hi Maryanne, FInnegan has have maybe three or four ( to my knowledge, he may of had some when I was not present- he spends time with friends who have three Wheaten Terriers when I am working over a weekend ) in the last 5 years. The last one maybe two years ago. What has happened is that he gets disoriented, his eyes roll back, and he passes out for a half a minute or so ( which feels like an hour or so ) The vet said that we would only do something for these if he had them on a regular basis.

[JFBMaine]

Marianne, he does not take medications for anything. He didn't even when he had the seizures. Thanks.

[JFBMaine]

This is the most recent e mail from my vet. She is being very open.
Hi, Felice,

I didn't realize you're in Portland - that actually gives you a couple of good options. My first choice would be to see Dr. Wagner, the internal medicine specialist at the Maine Veterinary Referral Center in Scarborough (http://www.maineveterinaryreferralcenter.com/). They are _highly_ recommended - I've had nothing but good feedback from people we've referred there. (The other good thing about Maine Vet Ref is that is where the neurologist is as well if Finnegan's seizures recur.) Your other choice would still be Dr. Mason, who splits her time between BBVA and Portland Veterinary Specialists on outer Congress Street.

Re: LDDST and stress - you're right, cortisol is a natural stress hormone, so elevations can occur if a dog is stressed during the test. However, the test looks at relative cortisol levels as well as absolute values, so even a stressed dog with a higher than normal baseline cortisol can still be expected to have evidence of suppression (or not). However, it is true that we occasionally get conflicting results back - usually false negatives, but false positives are certainly possible. And you're right, the next step would be the ACTH stimulation test anyway.

So - let's plan on the UTK adrenal panel (I would still recommend the thyroid panel as well) for Wednesday. I'll ask Nancy to figure out the price of that and then I'll get back to you with the answer. I also need to look up whether the blood draws are 1 hour apart or 2, I can't quite remember. We'll worry about whether the Cushing's is pituitary dependent or adrenal dependent later. There's a chance that it may not matter; the newest drug on the market for the treatment of Cushing's (trilostane) is labeled for both.

If you would prefer to go with the referral first, just let me know. I'd recommend the Maine Vet Ref Center and Dr. Wagner in that case. I will admit that there is a distinct advantage to pursuing the referral, that being that Dr. Wagner sees far more cases of endocrine disease than I do, and would be better versed than I on the best treatment options for Finnegan if he does test positive for Cushing's Disease. The referral option is one to seriously consider, and I would be happy to set that up if you would like.

I look forward to hearing back from you tomorrow.

Take care,
--Dr. Anne

[labblab]

I didn't realize you're in Portland - that actually gives you a couple of good options. My first choice would be to see Dr. Wagner, the internal medicine specialist at the Maine Veterinary Referral Center in Scarborough (http://www.maineveterinaryreferralcenter.com/). They are _highly_ recommended - I've had nothing but good feedback from people we've referred there. (The other good thing about Maine Vet Ref is that is where the neurologist is as well if Finnegan's seizures recur.)...

If you would prefer to go with the referral first, just let me know. I'd recommend the Maine Vet Ref Center and Dr. Wagner in that case. I will admit that there is a distinct advantage to pursuing the referral, that being that Dr. Wagner sees far more cases of endocrine disease than I do, and would be better versed than I on the best treatment options for Finnegan if he does test positive for Cushing's Disease. The referral option is one to seriously consider, and I would be happy to set that up if you would like.

--Dr. Anne
Felice, I think I'd go with the referral to Dr. Wagner, especially given Dr. Anne's endorsement. She really has summarized it all in a nutshell, and good for her for doing so! :)

Marianne

[ChristyA]

I agree with Marianne, I would go for the specialist.

Christy

[gpgscott]

Hi Felice,

You have covered a lot of ground today.

Let me wrap up what I have seen here.

The thyroid is a seperate issue and is an important one, I think that needs to be pursued regardless of what course you decide on for Cushing's.

I think you have a good Dr. who is not aware of the profound effects of the intermediate hormones. I think if you go forward with the UTK panel she will be very happy with the information she receives as a result and I think Fin will get a more concise treatment as a result.

The LDDS in my opinion is really only useful to differentiate between pituitary and adrenal forms of Cushing's and given the wildcard of stress is not that reliable.

The cost for the UTK panel is $135.00 charge by UTK, and then the charges by your Dr. for ACTH stim injection, two blood draws, preparation of the samples and shipping. It should be in the range of $300.00. It can and should be submitted directly to UTK, submitting to a third party lab only results in extra cost, as much as $200.00 extra according to one member here.

Scott

edited to add

Just saw the part about Trilo in your Drs. post. I think it is way premature to be considering treatment and depending on the outcome of the UTK panel if you have it, Trilo may not be indicated.

[Wylie's Mom]

Felice,

I have to say, (even though I disagree with the LDDS) I really like your GP vet - she's open, upfront and honest:).

Another thing about the UTK panel (not that you need anymore convincing), you're kinda killing two birds with one stone - regular Cushing's and Atypical - Finnegan may have one or the other, both, or neither!

BTW-Wylie had the Mich. State U thyroid panel also;).

-Susy

[JFBMaine]

HI, update on Finnegan. My vet has encouraged me to go w/ the specialist so I have made an appointment , Tuesday June 9th, and will ask for the Thyroid test and the UTK panel. Thanks so much for the information and forms to directly send the panel test directly to the university ( that is a big savings! )
I wish the appointment was sooner. Finnegan continues to drink enough water for a couple of elephants, spends the day sleeping however is first at the door when I am going for a ride in the car. So a few weeks will be fine and I feel because of everyone on this site that I have made the best decision. Even my vet told me that she wished everyone cared for their pets the way I do. I wanted to tell her she should join this site because here everyone does!

[gpgscott]

Very best to you and Fin, Felice.

It will be hard to wait but just remember that Cushing's progresses slowly and if that is his issue you want to make sure you are giving him the most appropriate treatment.

Please contine to post during this period with any questions or comments you have.

Scott

[Wylie's Mom]

Remember to get copies of all the test results and post them here. (I think both tests are about a 2 week wait.)

-Susy

[Roxee's Dad]

Hi Felice,

So happy that you are finding your way thru this.


They think I am over reacting and should just wait to see what happens with Finnegan. They think so what if he drinks water all the time, wants to sleep all day and is hungry all the time.

I'm not proud of this as I did not find my cush family here for quite a while. I let Roxee go when she was first dx'd. She was in great shape, loved to swim in the pool, chase and retrieve her favorite ball, do backflips when she chased the frisbee. So what if she drank alot of water and would eat until her belly wanted to burst. Well after over 2 years later, due to the muscle wasting, she could hardly stand or walk, I would have to hold her upright to pee and poop and I contemplated the end. It was Christmas and I just happened to google cushings again and found Zoe's Story. I read and read before I even knew I was reading in a forum that I didn't know existed. I went through everything you are going through. My friends and mentors here gave me hope and walked me thru the process and although Roxee will probably never regain the strength she had previously, she is doing much better. I still consider finding Zoe's Story on this forum as mine and Roxee's Christmas miracle. My Foxy Roxee is alive today because of it. Every day adds up to a week which add up to a month and so on... And I treasure every moment. She is a fighter and just won't give up, so how can I?

So keep on doing what you are doing. AND do keep us up to date on how Finnegan is doing. Just curious, does he have a nickname? Maybe Finnie? He still reminds me of my 14 year old baby boy Mickey.

[JFBMaine]

Hi to all, yes, thanks I will get copies of all tests and post them. And a good suggestion to keep a file. So waiting for the appointment and the tests to return will make it a month...that is hard to take however I agree that it is the best road. I call him Mr. Finn or Finnie and my grandson calls him Finny, FIn, Fin. Finn was not big on kids however is just now putting up with Milo. I will upload photos taken today...one of Finn trying to sneak by him and another I caught of them just standing together. Thanks! I'll have to upload a photo or Finn and me....you know how they say couples who have been together for a long time start to look alike....well it has happened to Finn and me. :DFelice

[JFBMaine]

Hello everyone, I will not have anything to post until Finnegan's doctor's appt on June 9th. I worry that this site won't be here because people often mention that they couldn't find this site and the other one was gone...and so on. I really don't know what I would do without this site! How does this work just incase!:o Don't want to be paranoid however without you folks, I really would be lost at this point!! Felice

[ChristyA]

Hi Felice,
I don't think this site will close down. I can give you my email address but I will be out of town until June 14th and I don't believe I'll have internet access.

Just in case for some reason this site does go down you can go to K9diabetes. com

The owner of that site let us start a community there when the old site went down.

I'm hoping the best for Finnegan. I really think you are making very good choices for him.

Christy

[Squirt's Mom]

Hi Felice,

Honey, you would be amazed at the efforts being made to ensure that K9cushing's.com remains and grows for years and years to come. What happened at our old site is tragic and many of us are still licking wounds, BUT what happened there, won't happen here, that I can just about promise on my life. So put your fears of losing K9cushings.com out of your mind.

From a practical point of view, anything that is important be sure to make a hard copy of - printed, removable storage, etc. I just learned a hard lesson about that when I had to restore my system! :eek: Of course, not everyone is the techno idiot that I am! :rolleyes:

Hugs,
Leslie and the girls

[JFBMaine]

Hi Leslie, thanks....I'll be able to sleep tonight. This is such a great group of people and information. Yes, I have been making many copies and Finnegan's file is growing and growing! Felice

[JFBMaine]

Hi Christy, just saw your reply. Thanks so much! I feel better knowing that this site seems secure. Felice

[gpgscott]

I worry that this site won't be here because people often mention that they couldn't find this site and the other one was gone...and so on.

Hi Felice,

Unfortunately you came to us in a period of flux.

I can't comment on the former site and why we can no longer access it, we just don't know.

I do know about this one, and I can tell you that it is not going down and there will be someone here when you need them.

The site is new and there may be some issues as we grow with changes, but that will not affect your your ability to communicate with others on this forum.

I know the waiting is hard;)

Scott

[forscooter]

Felice,

The waiting is the pits but don't worry, you have lots of people waiting right here by your side! And knowing the people that are here now and in charge, you can make a safe and complete bet that you will not be left out cold!

Hang in there! Beth, Bailey and always Scooter

[JFBMaine]

Hi, I have become a K9Cushings junkie....checking this site on a regular basis. It this common for a cush pup? Finnegan does not appear these last few days to be drinking as much water as he had been. He continues to sleep all day and not interested in going for walks just a stroll in the yard ( small yard). He has always LOVED his car rides...has his LL Bean bed, blanket, and water bowl in the back. He still enjoys his rides however I have noticed that it seems to tire him out and he sits in the back seat with his head hanging.....panting. Thanks for your thoughts on this. Felice

[gpgscott]

Hi Felice,

One of the reasons Cushing's is so difficult to diagnose is the broad range and severity of symptoms. Keep a log of what you notice, time of day, whether the symptoms are related to a meal, excersice etc... The more you can tell the IMS the better.

Scott

[JFBMaine]

Scott, thank you, I will start a journal on him today. Felice

[Squirt's Mom]

Hi Felice,

Another addict! :D I've been addicted for over a year now and have no intentions of being 'cured'! :p

You may remember my Squirt is Atypical as well as PDH but not on Lyso or Trilo, just melatonin and lignans. You description of Finnegan while riding could have been Squirt not long ago. Until she started feeling bad, she would get so excited every time she saw my bags 'cuz she knew we were going somewhere and she loved to travel. She loved to ride, to watch everything go by, hang her head out the window and feel the wind in her hair, bark at anyone and anything that got to close or seemed to be headed our way, visiting folks, meeting new folks...she loved it all. She was my travel buddy for nearly 10 years. Then the day came when she saw my bag and went to hide. :(

About a month ago, I went to see my family. When I came downstairs with my bags and Squirt saw them, she started bouncing and wagging her tail like she used to! I was thrilled and packed her travel bag, too. :D For the first time in a long time, she WANTED to go and really enjoyed the trip. She has gone with me once again at her desire and has made several little car rides in town with me, too.

I know how sad it is when they stop enjoying the things they used to, but keep the faith. Once he starts treatment and his hormones are regulated, your little man will start coming out once again.

Hang in there!
Hugs,
Leslie and the girls

[JFBMaine]

Hi Leslie & girls, I need to learn more about the different types of Cushings, although I know Finn does not have the medication related one because he takes nothing. Your little Squirt sounds like so much fun and a character!! I'm happy that she is back to herself and traveling with you again! Finnegan has traveled back and forth from Maine to Texas several times and loved it! He is the perfect "car dog". When I lived in the country, I would leave my car door open because he would love to jump in for a little nap. ANd if I didn't have anywhere to go I would still take a spin around the block because he wanted to go for a ride. He just looks exhausted after a half hour in the car even though he has his bed in there. Thanks for sharing your Squirt story. I don't know if there is a "better" type of Cushings however atypical sounds as if it can be treated "more natural". THanks, Felice

[Squirt's Mom]

Hi Felice,

In real simple terms, there are four types of Cushing's (hyperadrenocorticism) - Iatrogenic, pituitary dependent (PDH), adrenal dependent (ADH), and Atypical. Iatrogenic is the one caused by external sources, IE steroid meds and is treated by slowly stopping the steroids. PDH is when there is a tumor on the pituitary gland and ADH is when the tumor is on one or both of the adrenal glands, both causing the release of excess cortisol.

PDH has been treated only with meds such as Lysodren, Trilostane, Ketochonazole and Anipryl in the US until recently. Our precious LucyGoo is the first patient in the US to have the tumor surgically removed, which is something that has been done in The Netherlands for some time now. So, thanks to Lucy and Gina, this option may soon be viable for pups in the US, too.

ADH can be treated medically or if the pup is a candidate, the tumor(s) can be removed. Adrenalectomys have been performed here for quite some time and one of our members, Ken and Shiloh, have a real success story in that arena.

Atypical is a form of Cushing's in which intermediate and/or sex hormones are elevated without the presence of elevated cortisol. These other hormones cause the same signs and discomfort as do PDH and ADH and can cause some of the same damage over the long term. With Atypical, a tumor may or may not be present. This form is treated with melatonin and lignans, either in the purified capsule form, flax seed oil (FSO) w/lignans, or crushed flax hulls.

My Squirt has been diagnosed with both PDH and Atypical so she is considered to have "true" Cushing's since her cortisol was also elevated along with the other hormones. But, her cortisol has come down, so we are not looking at starting the Lyso just yet. As an Atypical pup, Trilo is not an option for her.

When you get the UTK panel back, you should have the answers you are looking for and directions on how to get started on treatment. Plus we will be here to help you, as well.

Hugs,
Leslie and the girls

[JFBMaine]

Leslie, this is very helpful. Thank you! So how will we determine if the tumors are benign or not? I would think that makes a huge difference from the get go. I had a run in with cancer myself and wish I had found an amazing group of people like this ! This situation with Finnegan is more difficult for me than when I was ill! Thanks again. Felice

[Roxee's Dad]

Now there's that beautiful, sorry, handsome avatar:D:D:D

[JFBMaine]

Hey John...it worked ! Well, well, well. Thanks, Felice & Finn

[Harley PoMMom]

Hi Felice,


I have become a K9Cushings junkie LOL Me too!

Love your avatar of Finnegan, he is one handsome fellow :D

Lori and Harley

[JFBMaine]

Thanks for the compliments re: my looker here sitting next to me. The photo was right after his haircut. I'm a photographer and I can't take him on portrait sessions because he wants my attention all the time so where ever I point my camera that is where goes. He'll go and sit next to a family that I am photographing. I had one couple who insisted that he stay in their photo and they used it as their Christmas card..it was pretty funny. He now has to stay in the car...not everyone wants a "stand in" dog in their family portrait. Felice

[JFBMaine]

Finnegan has his appointment with an internist tomorrow morning at 9 AM eastern time. I don't know if I will sleep tonight....I will post how it goes when I return.

[Roxee's Dad]

Keeping fingers and 16 paws crossed that all goes well.

[JFBMaine]

Thanks to all the paws and fingers....we'll take em'.

[frijole]

Good luck. Hope the specialist is wonderful. Check in and let us know how it goes. Kim

[JFBMaine]

Okay, stressed, poorer and really no more information. Dropped him off at 9 am at the internist's office for an ultrasound and they didn't do it until 4 oclock. He had been panting so much all day that he had air bubbles and it was hard for them to get a clear reading. SHe said his adrenal glands look normal in size ( however again it was hard to get a clear picture). She did see several small nogales in his liver. She did a urine test and we'll get part of the results tomorrow and the other part in three days. She wants to do an ACTH test ( $286) however does not feel as if we need the UTK panel ( she quoted me $500 even if it is sent directly to University of TN) She and I went around and around about the UTK panel because I kept saying it is what I want and she feels as if it is not needed and that CUshings dogs ( quoted a vet by the name of Friedman?) are over treated. SO I am off to work and don't know what the heck to do. I would appreciate your thoughts. Thank you so very much. My head hurts and my poor baby is totally stressed from spending the day there. We both need a drink!!! Felice

[Wylie's Mom]

Hi Felice,

I'm sorry about your appointment today... do you know why it was hard for them to get a clear reading? because they don't have a high resolution machine? or he wasn't fasted? or there were internal things in the way? I'm suprised about her reluctance to do the UTK panel... I had high hopes with this IMS (your GP vet recommended her and I like your GP vet;)). BTW- I'm guessing it's probably Dr. Feldman she was talking about, but I couldn't tell you if she quoted him in the correct context. It looks like you put up a fight, but I'm guessing you ended up doing the ACTH stim. If not, maybe you can have your GP give you an estimate for the UTK panel. If you did do the ACTH stim, I would just wait and see for now. I would discuss what happened today with your GP vet.

-Susy

[gpgscott]

Sorry for the stress. Everyone has every right to charge what they want but $500.00 is outrageous, the only difference between it and a cortisol only in actual cost is about $100.00 which is the upcharge for the five additional hormones from UTK. All of the other expenses are identical with the possible exception of a difference in shipping cost.

I also do not know how to take the overtreated comment, that is the same thing my first Dr. told me when he was trying to talk me out of further diagnostics over two years ago.

Based on your post it sounds like this Dr. is discounting the possibility of Atypical Cushing's as the only way to really determine is the full panel.

It is not uncommon to see small lesions on the liver, these are generally not serious.

I am sorry that it did not go better and hope your GP can help you sort it all out, I hate to see you spend lots of money and get no where.

Scott

[Roxee's Dad]

Hi Felice,

So sorry that you had a bad experience with the IMS


Dropped him off at 9 am at the internist's office for an ultrasound and they didn't do it until 4 oclock. He had been panting so much all day that he had air bubbles and it was hard for them to get a clear reading.

I asked why my pup needs to be dropped off so early and picked up so late. They explained that they felt most owners may let their pup eat when they should be fasted.
I always take Roxee in for her ACTH stim, take her back in the car and we go for a ride and then I bring her back for her post draw. After her post draw, we go together and have lunch in the park. Did the same with her ultrasound, when I drilled the receptionist, she finally told me the Ultrasound specialist would be there between noon and 4:00pm and they agreed to let me bring Roxee in at noon and I didn't hand her over until the US specialist arrived. So now they know I won't leave my pup at the vet's for any unneccessary amount of time. Rozee is going in for a dental on Weds. When I scheduled it they know me well enough and said that I could bring her in at 11:30, they'll do the dental at 12:00 and I should be able to take her home at 1:00.
Just my opinion, but I would ask my vet to do the blood draw for the UTK panel before I went any further. This way, when you get the test results and the recommeded treatment from the UTK's Dr Oliver (if it is cushings), you will know what the diagnosis is and should feel assured that you had the best testing performed. It will save you time and money in the long run.

Regarding the statement of overtreated. Our Roxee went untreated and she is paying the price, muscle atrophy,(all of a sudden I realized she can barely walk or stand up to pee without falling over) blindness..... So based on my experience I do not agree with her statement.

PS: More belly rubs to Finny.

[ventilate]

Hi;
I want to say as well, I am disappointed at your IMS attitude about Cushings, the Uof T panel and about Cush dogs being overtreated. the over treatment statement I do not understand. When we take our dogs to the IMS it is because they have a condition that needs tobe treated. Like John said not treating the dogs can leave them in pain and unable to walk. We are there because we want to prevent that, and treating the Cushings is the only way to do it.
Enjoy the drink, both of you:) and good luck, hope your GP can help get things straightened out.
Hugs from me and mine
Sharon, HRH Nike and Kenai

[StarDeb55]

Felice, several of us have learned that all IMS vets are not created equal, & I am one of them. My former IMS has treated my 1st boy, Barkley, for his last 2 years for his Cushing's, & did a great job with him. I was quite impressed, so when Harley was diagnosed by my GP a year ago, through the UTK panel, I told him that I wanted Harley to see the same IMS to confirm the diagnosis, & get him started on treatment. To make a long story short, the way she handles her practice had changed quite drastically in 2 years, & not for the better. I had 2 very serious disagreements with how she managed Harley's care, & after the 2nd disagreement, I basically fired her, & moved Harley back to my GP. You are obviously not happy with what happened today, so I would talk to your GP. I would ask if they would have a problem managing Finn's care, using the IMS for consultations as needed. This is what I did with my GP, & this plan has worked well for us.

Debbie

[forscooter]

Oh Felice, I am so sorry you had such an awful day! Bailey gets completely stressed at the vet's, and they always let me take him, leave with him, and bring him back too. I think what the IMS suggested is ridiculous between the fee and the over-treated statement! That's like saying diabetes or hypothyroidism or any other endocrine disorder is over-treated! How can it possibly be over-treated?

If your GP vet will do the full panel with you, I'd go with that.

Please try and relax and you can always think about this tomorrow. I think you and Finnegan should just spend some quality relaxation time...you've both been through enough for one day!!!

Hugs, Beth, Bailey and always Scoobie

[JFBMaine]

Hello everyone, thank you for your input - all VERY helpful. Please excuse me, I'm tired just returned from work, and the mind is not clear. The IMS said because Finnegan had been so stressed all day and panting the it created air bubbles and that prevented her from getting a clear reading of the size of the adrenal glands. I feel as if I didn't get my $$$ worth because had they done the ultrasound first thing in the morning when he was scheduled he would not of had the air bubbles. I may ask for a repeat of that test...am I off base there?
My GP and IMS went to school together....so they know each other. No, I did not have the ACTH stim done today. I decided to take Finn home because he had not eaten all day and he was so stressed ( as I was too) and felt as if he had enough for one day. His little furless belly needed some rubs. The weird thing is that the IMS after feeling his chest said he felt like an Atypical cushing dog. I am not sure but I get the feeling that she would also start treatment with just an ACTH test. I don't understand the high cost of the UTK. The ACTH is $286 so I guess for another $214 I will get the full enchiliada. It will be a battle because she feels strongly that it is not necessary. I will stand my ground...and as far as the $$$, well I have been saying that I need to drop weight so here is my chance....no more Whole Foods for me!
The IMS will call me tomorrow with the urine results and I'll give you the scoop. Thanks again so much for all your support and good night.

[Roxee's Dad]

Hi Felice,
I found this statement very interesting.


The weird thing is that the IMS after feeling his chest said he felt like an Atypical cushing dog

I'm just thinking of all the money we could all save if our vets or IMS's had this ability. Ok, yeah, I'm being a Smalt Alec:p Sorry.

Good that you didn't do the ACTH while Finny was stressed. Get a good nights sleep.

[AlisonandMia]

I think the thing is that Cushing's is very likely both undertreated and overtreated when you look at the dog population as a whole.

I remember Natalie (K9Diabetes) saying to me once that she gets the impression that half time here we are trying to reassure people that the treatment their dogs needs is both safe and effective if done correctly and encouraging them to go forward with the diagnosis/treatment their dog desperately needs and the other half of the time saying "No! Please stop! Your dog may not even have Cushing's" when a dog has been inadequately diagnosed but the vet wants to launch into treatment immediately.

Not wanting to really embark on a proper diagnosis and treatment of a dog which could well need treatment is not really going to balance the problem of "overtreatment" that does occur at times. What is happening across a population isn't always relevant to any one individual case. It's like denying an individual woman a c-section that is clearly indicated because "there are too many c-sections done these days" (which is probably true). My sister-in-law had that experience with near-disastrous results!

The other thing is that "Internal Medicine" is a pretty large area and some IMS's just may not be that "interested" in the Cushing's corner of things especially as there are areas of controversy that pop up from time to time which some may find off-putting too. I remember reading that humans with Cushing's (much rarer disease in humans) can find it extremely hard to find an endocrinologist who is interested in and knowledgeable about the disease. Most human endocrinologists are dealing primarily with diabetes and not much else, apparently.

Alison

[JFBMaine]

Hello my dear friends, I spoke with the IMS just now and Finnegan's urine has no protein, no obvious infections, and concentration is okay. I asked to have the ultra sound redone and she agreed to that and will not recharge me, and she will do the UTK for me on Monday also. THe UTK is $325 and another part of the blood work ( sorry I didn't get what it was...I thought she said infection...which doesn't make sense of course) is $156. I told her that I needed to know if it was Atypical or not because if it was atypical I wanted to treat him with Flax and melatonin. She said she didn't think that worked however I want to go down that road first, if he is Atypical and she said that she would support that decision. So, I think I can stop drinking now, for a while, until we go in Monday anyway. Thanks to everyone for all the help and support. Felice & Finnegan

[Wylie's Mom]

So, I think I can stop drinking now, for a while, until we go in Monday anyway.

LOL

Good job on the no-charge ultrasound redo - that's only fair! I don't understand the extra $156 on the UTK panel (my vet had quoted me about $300 for the panel). I'm glad that she is being more supportive;).

-Susy

[Squirt's Mom]

So, I think I can stop drinking now, for a while, until we go in Monday anyway.

LMAO!!! You might want to hide that bottle real well, Felice. Beth or Louise one will be needing it for one of their concoctions, I'm sure! :p

I applaud you for standing up for what you felt was in Finnegan's best interest and getting the job done! YEAH!!!

What you heard as "infection" was probably "injection" meaning the stim agent they used. I just dropped nearly $500 today for the UTK panel, blood work and urinalysis. Then nearly had a stroke over spending $105 at Target for things we need. :eek: But didn't blink an eye at the vet's office. :rolleyes:

This is Squirt's second UTK panel after being on melatonin and lignans since last Aug. so in about 2 weeks I should know if it is helping her or not. Atypical is something not alot of vets have experience in so they may not be aware of any pups this approach has helped but I think we could change their mind here. ;)

Keep up the good work and do keep an eye out for Beth and Louise!

Hugs,
Leslie and the girls

just kidding about Beth and Louise...they are very nice and more than willing to share! :D:p:D

[Roxee's Dad]

Hi Felice,
Very happy that your IMS is working with you to solve Finny's problem.

Regarding Louise, I believe she has been banned from the blender, so no concoctions from her. Not to sure about Beth and the blender though:p

More belly rubs to Finny's bare belly:)

[Squirt's Mom]

Hi Felice,

About that statement your vet made about Atypical and the way the chest felt....does Finn have fat pads behind his front legs? Kinda on the sides? Squirt does and she's been diagnosed as Atypical so I was wondering if that is a "sign" of Atypical? I have never heard of that connection before either - chest and Atypical - so I was just wondering out loud. Did you vet explain why he said that? It would be interesting to know what his thinking was there.

Hugs,
Leslie and the girls

[gpgscott]

Hi Felice,

You are being persistant and that is good.

I am confused about the IMS not being familiar with Atypical. Huge red flags.

I can tell you, if a dog has elevations of hormones other than cortisol, particularly estradiol, the lignans/melatonin treatment does work. I can also tell you that dogs with mild elevations of cortisol respond favorably to this treatment.

There is a nice reference in our resources area that is peer reviewed material.

I want to go back to the cost just to give you a reference.

ACTH:

Two blood draws, one or two hours apart depending on the stim agent used. One hour apart for cortrosyn or synacthen depot, and two hours apart for acthar gel.

Cost of cortrosyn for Moria @60lbs $60.00 US. as of 06/08

Additional costs;

two blood draws
spin down samples to plasma
label
freeze
ship
above x 2.

UTK charge for full panel $125.00

I think you are being overcharged for the labs. I also continue to be concerned about the comment about 'overtreating' and and the same time the Dr. is recommending a diagnositic which only gives part of the picture (ACTH)

As I have already mentioned the lab charges are up to the clinic and they vary, unfortunately there appears to be little competition in your region. I do think this is negotiable depending on your view and persistance.

Just giving you my experience.

Scott

[StarDeb55]

UTK has posted on their website that the full panel charges will increase from $135 to $140, effective 7/1/09.

Debbie

[JFBMaine]

Good morning all. Alison, I think that's an excellent point about the inadequate diagnose of dogs.
Leslie, ah yes, I am sure now that is was " injection" - thank you! I very much look forward to hearing how Squirt is doing on the melatonin and ligians. Is Squirt also on vitamins? In re: to fat pads. He has a large fatty tumor ( once removed and has grown back) in his "arm pit" if he had an arm....so I guess it would be a "leg pit".
And Beth & Louise...come on over I would love to create some "concoctions" with you ! However the liquor cabinet has to be restocked at this point. :D

[JFBMaine]

Hi everyone, just returned from Finnegan's second IMS appt. She said the adrenal glands look normal size ( on the high end of normal), his urine tests all came back normal. So does this narrow us down to Atypical or Pituitary cushings? Costs for UTK UTenn $270, Fedex $55, injection/cortrosyn $156.
Sorry John, I forgot to ask her about the chest comment. The IMS didn't know the turn around time for results from UTenn however if I remember correctly you folks told me two weeks. Felice & Finnegan

[Squirt's Mom]

Hi Felice,

It sounds from the description as if the adrenals are what is called bilaterally enlarged, meaning both glands are about the same size tho larger than normal. This is what is typically seen with PDH. In ADH, one gland will be much larger than the other, with one sometimes withered. I'm not sure if Atypical can cause the adrenals to swell a bit a well as well, but it would be logical IMHO. :o Keep in mind it is possible for a pup to have more than one form of Cushing's...fun, huh? :p

The UTK panel is the next step for Finnegan I would take. This will let you know if the cortisol is elevated as well as know about the other five hormones involved in Cushing's. It does take about 2 weeks for the results to get back. How they work at UTK is this - every Mon. they empty out their freezer and work on those samples for that week. The next Mon. it starts all over again. So you want to try to get the sample sent off on Mon. - Wed., or Thurs at the latest, as the sample will be overnited. That way Finn's sample should be in the next weeks work at the lab.

You are doing a wonderful job for Finnegan and I know he is grateful to you.

Hugs,
Leslie and the girls

[JFBMaine]

Hi Leslie, sorry, I did not make it clear that I did have the UTK blood drawn today and it will be in the mail tonight. So will it be two weeks from today? I did not know that it is possible to have more than one cushings!! Gee weez !!!! So from the UTK test I will know the kind of cushings that he has? WIll I also learn the severity of the illness at this point?

[gpgscott]

Hi Felice,

Two weeks is about right. UTK will recieve the samples tomorrow and they will put them in their freezer. Next Monday they will begin to empty that freezer and the earliest I would look for a response would be one week from this Wed.

Looking forward to the results.

Scott

[Squirt's Mom]

Hi Felice,

Cool! :cool: Then his sample should be in Knoxville tonite and should be pulled next Mon. for analysis. Which means the results could come next week even! And, yes, it should let you know what you are dealing with. As for the level of severity, the results will tell you which hormones are out of whack and by how much based on the norms from the lab. The general health of the pup will tell if there has been any real damage from the cortisol, if it is elevated. Left to run rampant, cortisol can damage the liver, heart, kidneys, and other internal organs, as can the other hormones but I don't believe they are as quite as destructive as the cortisol. Someone will correct me if I am wrong about that. ;)

My Squirt was first dianosed as PDH then, just because I wanted to have all the bases covered, she had the UTK panel, which came back Atypical, too. Since she had elevated cortisol along with the other hormones, she is considered to have "true" Cushing's, but is being treated only with the Atypical treatments for now. Long story, but after she had a splenic tumor removed, her cortisol came down to it's lowest since diagnosis in 3/08 - back to normal range, in fact. So I am very anxious to see her results from Wed. I am hoping against hope that her elevated cortisol was the result of a non-adrenal illness - the tumor. Which means every time the phone rings, I am gonna jump out of my skin! :p My hope for Finn and you is that UTK finds he is only Atypical. :)

So you and I can just twitch ourselves crazy til we get the results on our babies. :D

Hugs,
Leslie and the girls

[JFBMaine]

Leslie, I will keep my fingers crossed for you and Squirt. It is not easy waiting for SURE!! THanks for your support and information. Hugs to you and Squirt !! And Scott, thank you too for the info. Felice & Finnegan

[Wylie's Mom]

Hi Felice,

Well, it looks like Finnegan's & Wylie's samples will be batch mates - he's having the UTK panel this Wednesday. FWIW - Wylie has fatty tumors in three of his "leg pits"... oh wait, I haven't checked recently... he might have one in all of his pits by now:rolleyes:. Since your vet is using Cortrosyn for the injection, that explains the increased cost compared to mine... my vet uses some ACTH gel, which costs about $150 less. I believe the results can be different, based on which injection is used. I feel that Cortrosyn is more accurate, but I think many vets believe the gel wouldn't be significantly different.

-Susy

[JFBMaine]

Susy, so Finnegan and Wylie will have their blood together in the same freezer ! And they both have "leg pit" tumors! Are you sure Wylie wasn't a Wheaten Terrier in a former life? Well, it will be interesting to see if we both get our results at the same time. We'll pretend to hold hands waiting for the vets to call! Felice

[JFBMaine]

I took Finnegan to the ocean yesterday and he actually ran into the water for a minute....but then wanted to leave and get into the car. He loves the beach and has always enjoyed running along the water. It really broke my heart. I took him again tonight to a different beach and he had no interest at all in it. He just got out to do his thing and wanted back in the car. I hope once we figure out which Cushings he has and starts treatment that his wonderful personality comes back. He just lays out on the wood floor all day and is only interested in going to the backyard to pee and poop and that's it. :-((

[frijole]

Hang in there. Finnegan just feels yucky is all. Give him lots of hugs and tell him all is well. Dogs are so smart - they sense how you feel. You are close, it just doesn't feel like you've made progress. Hang on and keep posting. Our shoulders are sturdy. Hugs, Kim

[Roxee's Dad]

Hi Felice,
If it was warm outside, Finny was probably not comfortable. Usually Cush pups cannot tolerate the heat to well. Probably why he is laying on the cool wood floors.

Belly rubs to finny:)

[Squirt's Mom]

Hi Felice,

I know how difficult it is to see your baby not himself. :( But hold to the faith that with treatment Finn will come back and you will be able to enjoy doing things together again. One of these days, not too far down the road, you will be here telling us what a wonderful day the two of you had at the beach. When that is hard for you to believe, know that I believe it enough for both of us.

Hang in there!
Hugs,
Leslie and the girls

[JFBMaine]

Thanks for the support. I was just so tired last night and it is hard to see him not himself at all. John, it was chilly at the beach last night. But you are correct that just a little heat seems to bother him....he is not enjoying his car rides anymore because it tends to be warmer in the car ...even if I blast the air conditioner for him. I think it was extra hard because the client I was photographing last night had a Wheaten Terrier that died a couple years ago when a tumor in his abdomen burst. Sent me down a road of terror!!! So thanks to all of you for being there to listen to my whining.

[SaxLady]

Felice,
Please don't worry about a tumor bursting. When I spoke with Katrina's intern yesterday she said that is a very rare occurance. I know how worried you are over Finnegan's health and I have included you both in my prayers.
Hugs,
Candy

[AlisonandMia]

. I think it was extra hard because the client I was photographing last night had a Wheaten Terrier that died a couple years ago when a tumor in his abdomen burst. Sent me down a road of terror!!! So thanks to all of you for being there to listen to my whining.

That is one good thing that can come of having a middle-aged/elderly dog investigated for Cushing's - the dog gets a really thorough, high resolution abdominal ultrasound done as part of the workup. Several dogs here have had other problems (unrelated or only very vaguely related to their Cushing's) come to light as a result of ultrasound and so could get appropriate, preventative treatment before something went really bad. Leslie's Squirt had a potentially very dangerous tumor on her spleen discovered on a "Cushing's" ultrasound and subsequently had surgery. If that had gone undiscovered it could very well have burst with fatal results. Others have had gallbladder issues discovered.

I do wonder if every middle-aged dog doesn't deserve at least one ultrasound at some point to just screen for any potential nasties that could be lurking within and which could be more easily and possibly more cheaply dealt with if caught early.

Alison

[StarDeb55]

Harley is one of the pups that Alison is referring to that benefitted from his Cushing's diagnostic ultrasound. We discovered that he has pre-existing gall bladder issues including a dilated common bile duct that none of his vets knew were there. This became a very important piece of information as Harley became seriously ill last September, spent 2 days at his GP vet on IV fluid, with what the GP decided was a probably gall bladder attack.

Debbie

[Wylie's Mom]

Wylie is another example of having a gall bladder issue found with the Cushing's ultrasound and had a gall bladder attack about a month after Harley.

About the UTK results... hopefully, we're more than half way through our pretend hand holding:p.

-Susy

[JFBMaine]

Hi, thanks to everyone for the encouragement. Finnegan and I are waiting ( however not patiently ) for his results from the UTK panel. We're both getting chunky from eating more and exercising less....he looks cuter than I do with the big thighs. :D I have found a holistic vet who makes house calls and will be visiting with us next Monday, which is perfect timing because we will have our results.
Susie, I guess you have not heard anything about Wylie's results either. I am going to call the internist tomorrow to see if they have heard anything. I will be sleeping with my rescue remedy next to my bed. :o

[SaxLady]

That makes three of us waiting with bated breath. Katrina's blood was sent to Dr. Oliver one week ago last Friday. Hopefully, results will be soon.
Candy

[JFBMaine]

Candy, Finnegan's blood was sent out Monday, Wylie on Wednesday, and your Katrina at the end of the week. It will be interesting to see when we each get the results. Yes, all of us holding our breaths. I will post the results as soon as I hear. I am thinking of you and Katrina...and of course Wylie and family!

[Harley PoMMom]

Hi Candy,

When Harley's full adrenal panel was done in May, it took exactly 2 weeks to get his results, his blood draws were taken on a Thrusday, sent out the next day which was a Friday. I was on pins and needles :eek: So I know how you all feel about the "waiting game" :(

Hugs to you all.
Lori

[Squirt's Mom]

Hey Candy,

Patience is not required when waiting on test results, thank goodness! :)

Squirt just had her UTK done on Wed., June 10th and they came back on Thurs., the 18th. So 8 days for us...this time! Last time it took like a month...but that was because it got lost in our vets freezer! LOL That was hilarious to me but Dr C was just embarrassed to death. She had been driving UTK, her staff, and FedEx crazy trying to find that sample! :D:p:D So, if it seems to be taking too long, ask your vet to check their freezer. :p

Squirt is another one who was saved by an ultrasound - they found a splenic tumor that could easily have cost her her life if it had ruptured. And without the U/S, we probably would not have known it was even there until it did rupture. So don't underestimate the value of the ultrasound...they are worth every penny and inconvenience you may incur.

Hang in there!
Hugs,
Leslie and the girls

[JFBMaine]

Hi, I called the internist and they received the results last night. Has a few abnormal readings however she said it's not a "slam dunk". U of Tenn is recommending the flaxseed and melatonin. IMS said they would mail the results however I am going to drive over there to get a copy so that I can post it here....so that you can tell me what it all means because she said she has not read one of these before.
When I think of my vet wanting to start Finn on Cushing drugs last month really not even knowing what we were dealing w/ at this point makes me sick. Thanks to this forum I didn't allow that to happen!

[Squirt's Mom]

Hi Candy,

Glad those results are in! :D The WAIT is over....for that part. :p So take a deep breath and relax a bit.

When you get the results, post the numbers along with the units of measurement (ng/l, mnol/L, etc) plus the reference (or normal) ranges given. That will help us be sure we are all on the same page with the values.

Don't feel too harsh toward your vet. Many don't know a thing about Atypical and several of us here have had to educate our vets on the topic, Squirt and I being one of those. This is a fairly new form of Cushing's that is just beginning to come to the forefront. But thanks to forums like this, seminars and continuing education for vets awareness is blooming. So you are in a unique position to help your vet learn about something new. If they are willing to listen and work with you, then give them a chance.

Looking forward to seeing those results!
Hugs,
Leslie and the girls

[JFBMaine]

Leslie, the internist is saying that Finn is not, at this point, being diagnosed with CUshing however he has all the symptoms. Would U or Tenn suggest melatonin and flax if they didn't think he was atypical? Thanks

[JFBMaine]

This is what the internist just sent me...I will ask for the complete UTK results.

06-17-09
CLIENT DISCHARGE INSTRUCTIONS – INTERNAL MEDICINE EVALUATION
Client: Felice Boucher
Patient: “Finnigan”, 8 years old Neutered Male Wheaten Terrier, 61.2 lbs.
Date of visits: 6-9-09, 6-15-09
Presenting Complaint: Further evaluation of suspected hyperadrenocorticism. He has had lethargy, increased appetite, panting, thirst and urination for 4-6 months. Elevated ALKP( 283) noted in 1/09 and 5/09.

Examination 6-9-09: BARH, nervous, afebrile. Integ: multiple smooth SQ masses (3-4 cm R thorax, 2-3 cm L axilla, 1 cm thoracic inlet, 1 cm lateral R popliteal region, 3-4 cm prepuce), sebaceous adenoma R shoulder. EENT: wnl. CV: HR 100, no murmur/arrhythmia, pulses s/s, mm red. RESP: panting, clear. GI/GU: sl firm, nonpainful abdomen, no obvious organomegaly, normal oral exam, normal perineal exam. LN: wnl. MS/NS: amb x 4, slightly overweight.

Temperature:101.4 0F HR:126 bpm RR: 24/min

Diagnostics:

6-9-09: Urinalysis, urine culture (catheterized sample): Specific gravity 1.029, negative protein, inactive sediment, negative bacterial culture.

Abdominal ultrasound - hyperechoic liver, 2 small (7mm diameter) hypoechoic hepatic nodules, upper limits normal size adrenal glands, normal urinary tract.
Liver - hyperechogenicity consistent with steroid or other vacuolar hepatopathy, nodules may be benign (regenerative) or malignant
Adrenal glands - normal in width and appearance, cannot rule out pituitary dependent hyperadrenocorticism; adrenal tumor less likely but not ruled out.

Blood pressure - oscillometric normal (104, 142 mmHg)

Fine needle aspirates of right popliteal mass and thoracic inlet mass – consistent with lipomas

6-15-09: ACTH stimulation test for Adrenal Panel at University of Tennessee – mildly to moderately increased pre- and post-ACTH estradiol levels; elevated baseline cortisol, normal post-ACTH cortisol.



Diagnosis: Suspect hyperadrenocorticism – due to estradiol increases



Medications:

Melatonin supplementation – 6 mg given twice daily.

Flaxseed – see information on handout.



Discharge Instructions: Finnegan’s history and initial lab results have been most consistent with a diagnosis of hyperadrenocorticism. His Adrenal Panel results indicate increased estradiol levels, which may or may not be responsible for his symptoms. The recommended treatment is with melatonin and flaxseed hulls. These products can take several weeks to be effective and often do not improve the symptoms. I will contact Dr. Oliver’s lab to discuss his results more fully and I will be in touch with any other recommendations.

We have evaluated him for other problems associated with hyperadrenocorticism (such as protein or infection in his urine and high blood pressure), and for other conditions that might cause his symptoms and blood results. His urinalysis and urine culture were normal, as was his blood pressure. His abdominal ultrasound showed 2 small nodules in his liver that are unlikely to be the source of his problems, but ideally these should be reevaluated with ultrasound in 2-3 months.

The decision to treat hyperadrenocorticism is usually based on the severity of the symptoms associated with the disease. Finnigan has fairly significant symptoms, but none that are necessarily life threatening at this point. His weakness or lethargy may progress, he may develop a urinary tract infection, or develop high blood pressure. These may in turn affect his quality of life, but how severe they may become is difficult to predict. In general he appears to be a good candidate for treatment because he does not have other significant health concerns.


Please contact me if you have any additional questions regarding my findings or recommendations.

Sincerely,

[Squirt's Mom]

Hi Candy,

Based on that comment I am wondering if Finn's cortisol is not elevated, only the other hormones are and not being familiar with them, she doesn't understand that still means she has Atypical Cushing's. Most vets are used to dealing with cush pups that have elevated cortisol which is considered to be "true" Cushing's, as Dr O calls it. Their lack of understanding, leads them to think it isn't Cushing's if the cortisol is normal. I hope this makes sense!

Once you have the results, we will be able to see what she does and maybe have better insight to what she is thinking. Lord knows, half the time I don't know what I'm thinking so trying to figure out what someone else is thinking can be dangerous for me.;)

Hang in there and this will all get sorted out for you soon!
Hugs,
Leslie and the girls

[JFBMaine]

I can't seem to copy and paste the results so will have to type them in.

Cortisol ng/ml result 80.4 Normal range 2.0-56.5 Result ( post ACTH) 110.07 Normal range 70.6-151.2

androstenedione ng/ml result 1.12/ normal range 0.05-0.36 result ( post ACTH) 1.41 Normal range 0.24-2.90

Estradiol result 77.1 / normal range 23.1 - 65.1 result ( post ACTH)85.1 Normal range 23.3-69.4

Progesterone ng/ml result 0.37 /normal range 0.03-0.17 result ( post ACTH)1.22 Normal range 0.22- 2.63

17 OH Progesterone ng/ml result 0.19 / normal range 0.08-0.22 result ( post ACTH) 0.60 Normal range 0.25-2.63

Aldosterone pg/ml result 84.0 /normal range 11-139.9 result ( post ACTH) 170.2 Normal range 72.9-398.5

Dr. Oliver checked off "indicate presence of increased adrenal activity." COnsider items 2 thru 4 on treatment option sheet attached.

[jrepac]

Boy, this is a little confusing.

Based on those #s, wouldn't Finn be diagnosed with "regular" and "atypical" Cushings? Yet, when I read the diagnosis text it sound like they are attributing the higher cortisol to the higher estradiol. Huh?

From what UTK puts on their site re: melatonin and flax, both can help suppress cortisol, as well as the other hormones involved in atypical.

Jeff

[JFBMaine]

oops I posted one thing incorrect Progesterone" the normal range should be 0.22-1.45
So from these results you are saying that Finnegan does have Cushings? Atypical for sure and maybe regular?

[jrepac]

well, the ACTH scores puzzle me a bit...high baseline but normal post test results.....so something is making the cortisol higher at the onset....the diagnosis seemed to be implying it was the estradiol.

I'm curious to see what the folks who are experienced w/Atypical think about the results....and the commentary provided.

[lulusmom]

The basal number is of little consequence and quite often this pre stim (basal) number can be greater than the reference range, due primarily to stress. When interpreting results with respect to cortisol, it is the post stimulation number that is used for purposes of diagnosing typical cushing's. In Finnegan's case, his cortisol would be interpreted as normal.

UTK considers the stimulated numbers to be more informative but I have seen them diagnose a dog as atypical with elevated baseline results. It looks to be that estradiol is probably the intermediate hormone that is causing all of Finnegan's symptoms and labwork abnormalities. Melatonin and purified lignans or pressed flaxseed hulls are probably going to be the recommended treatment regimen, with a caveat that if results are not seen in two to four months, a Lysodren maintenance dose may be added. There is a treatment recommendation sheet that is attached to the test results. Can you please get your hands on that and let us know which treatment UTK is recommending?

With the normal cortisol, you and Finnegan dodged the bullet as atypical requires much less expensive and benign treatment. Most members don't report immediate improvements so patience is truly a virtue when treating an atypical cushdog.

Glynda

[gpgscott]

Hi Felice,

The main hormone out of range is estradiol and this one is frequently controlled with melatonin/lignans but it can take a number of months to see effect.

I don't think I would place a lot of importance on the slightly high pre cortisol in view of the normal post number. Stress can cause an elevated pre cortisol number. But I do think you should retest and do the full panel again in 3 months if you are going to commence the melatonin/lignans treatment this way you can asses the cortisol again.

I hope the melatonin/lignans does the trick.

Adding, as Glynda has pointed out Dr. Oliver @UTK has advised several of us that when you know you are dealing with estrdiol only that you can monitor coarsely with liver values and also evaluted just the estradiol rather than the full panel without a stim.

Scott

[Squirt's Mom]

Hi Felice,

Can you tell me why I am calling you "Candy"? :confused::confused: geez....Please forgive a feeble old mind.... :o

I agree with Glynda and Scott - Finn is simply Atypical, not true Cushing's since the post cortisol # is within the normal range. This would be consistent with the U/S results as well - "Adrenal glands - normal in width and appearance" The prior statement that they are "upper limits normal size adrenal glands" could simply be due to the extra work they are doing producing the estradiol. In true hyperadrenocorticism (Cushing's), the adrenal will be either both enlarged (PDH) or one will be much larger than the other (ADH). PDH means a pituitary tumor is present, ADH means an adrenal tumor is present. With Atypical, a tumor may or may not be present.

As Glynda said, this is the best that could have happened other than a complete misdiagnosis ruling out any form of Cushing's.

You done good! Now to get treatment started according to the treatment sheet - and this will be a breeze compared to loading with Lyso or treating with Trilo! :D

Hugs,
Leslie and the girls

[JFBMaine]

Leslie, you can call me anything you want ! I am so very grateful for all of you and thank you a million times over for your help! It seems as far as Cushings goes, this is good news. I will start looking in the "search" area for information on Flaxseed, Melatonin, and better dog food for Finn. I have my fingers crossed for Wylie and Katrina. Felice

[Squirt's Mom]

Hi Felice,

It has been brought to my attention that my explanation of findings on the ultrasound needs some more input.

Abnormalities in the adrenal glands can be caused by things other than cortisol, elevated estradiol being one of them, as in Finn's case. Some dogs with confirmed pituitary Cushing's will have normal appearing adrenals, IE no enlargement. With adrenal Cushing's, most pups will present with one gland enlarged while the other is normal, smaller, or withered (atrophied). It is also possible for a pup to have a tumor on both adrenals which would then show as bilaterally enlarged (fairly equally enlarged).

I hope this helps you understand better what is looked for in diagnosing which type of Cushing's is present.

Hugs,
Leslie and the girls

[JFBMaine]

Hi Leslie, however if he had pituitary cushings wouldn't that show up with the UTK panel?

[gpgscott]

Felice,

The UTK panel which you have just done to be indicative of PDH or pituitary Cushing's would have had a much larger post number for the cortisol. The normal post cortisol number indicates it is most likely the elevation of estradiol which is causing Fin's symptoms.

Scott

You can get the melatonin just about anywhere, 3mg twice daily is a commonly prescribed dose. It must be standard melatonin not a rapid or extended release type product.

I use purified lignans because Moria is easy to pill, it is a standarized dose and is more effective than flaxseed oil w/lignans. I purchase the purified lignans from vitacost.com. Some of the other members have in the last few months began using a pressed flax hull which has been endorsed by UTK. I am sure they will be posting to tell you of their experience with this product and why they have chosen it.

[Roxee's Dad]

Hi Felice,
So happy you finally got a diagnosis. A much preferred one at that.

It would be great if you would post the treatment options 2 thru 4.

Keep up the good work and a gentle belly rub to Finny:)

[JFBMaine]

Hi John, thank you. Nice to hear from you...we've missed you. #2 Melatonin, #3 or Melatonin implants, #4 Flaxseed hull product w/ lignans Belly rubs will be administered as requested.

[Squirt's Mom]

Hi Felice,

Like Scott said, since the post (the last) number on the cortisol result is less than the highest number of the range given, it is considered normal and more than likely not PDH (pituitary dependent hyperadrenocorticisim) but rather the estradiol that makes Finn a cush pup - an Atypical cush pup only.

This is some really confusing stuff to get sorted out at first but maybe this will help. There are four types of Cushing's - pituitary dependent (PDH), adrenal dependent (ADH), Iatrogenic, and Atypical. PDH and ADH involve tumors on the respective glands and cause high elevations in cortisol. These are usually treated with Lysodren or Trilostane. Iatrogenic is a form that is caused by external steroids (by giving the pup meds that contain steroids) and is treated by simply slowly stopping the steroid med(s). Atypical is a form that is caused by elevations in 1-5 of the intermediate/sex hormones and is treated with melatonin and lignans. (Those are the five hormones that are listed on the UTK panel result in addition to the cortisol.) So there are a total of six hormones that can cause Cushing's.

A pup can have more than one form. It is not uncommon for a pup to be diagnosed as having PDH and being Atypical, or as having ADH and being Atypical. In these cases, the cortisol is elevated as well as at least one of the other five hormones, and in some cases all six hormones will be elevated. It is possible, but rare, for a pup to have both PDH and ADH, and even more rare to have PDH, ADH and be Atypical.

Is your head spinnin' yet? ;):p That will slow down in no time as you learn more and more. When it has settled some, remind me and I will tell you about my Squirt - who's story is quite different. :rolleyes::p But that will keep til a later time when you have your feet under you a bit better. She's a cush oddy. :D

For now, all you need to really understand is that Finn is Atypical because his cortisol is normal while the estradiol is elevated. (If I am reading the results correctly, this is the only hormone out of whack.) Estradiol is produced in the adrenals but can also be produced in other areas of the body like the gonads and skin. So the first approach is usually to treat with the melatonin and lignans for a few months. Then IF his signs are still present, or worsening, and the follow-up UTK panel still shows the estradiol is elevated, the Lysodren can be added as a maintenance. Loading is not usually recommended for Atypical pups, so that is a big relief. :D

So you and Finn are among the lucky ones in that all you are dealing with is Atypical. YIPEE!!!

Hugs,
Leslie and the girls

[Wylie's Mom]

Hi Felice,

Such great news for you and Finnegan... CONGRATULATION:D:D:D! Good job in stickin' to your guns to have the UTK panel done;) - you now have been rewarded:D.

In case you needed more detailed info on the current UTK treatment options:

http://www.vet.utk.edu/diagnostic/endocrinology/pdf/Steroid%20Profiles%20for%20Diagnosis%20of%20Atypic al%20Cushing's.pdf

I saw that you got your results and immediately called my vet:p, but was transferred to her VM :mad:.

Still waiting,
Susy

[jrepac]

very interesting & insightful stuff here....I need to hurry up and get the UTK panel done....more and more, I'm thinking I'm dealing w/Atypical cushings disease....

[StarDeb55]

Candy, the elevated estradiol can cause the exact same symptoms as Cushing's. If an elevated estradiol is the only thing that is out of range, in a way, Finn, is lucky, you won't have to be dealing with even a maintenance dose of lysodren. The problem with estradiol is that there are non-adrenal tissues that also produce estradiol including adipose (fatty) tissue among others, so estradiol can be the most difficult of all of the intermediates to bring down. If I remember correctly, Scott's Moria has only an elevated estradiol, & has been doing well on the melatonin + lignans for around 2 years. As Leslie has already indicated, please post all of the panel results as soon as you can. Also, there should be a treatment recommendation sheet from UTK that was included. Please post what the treatment recommendations are, if something else is included besides the melatonin + lignans.

Debbie

[StarDeb55]

Felice, I'm so sorry that I called you Candy, also. I should have read everything that has been posted this morning, as I just got home from work, so please excuse the other post while I catch up.

Debbie

[Harley PoMMom]

Hi Felice,

Great news for Finn and you. Harley's estradiol hormone is very elevated, this is the only one of his that is high at the post. So it looks like Finn and Harley are sharing the same problem.:(:eek::)
I believe Glynda calls this hormone the demon one. :eek::D

Hang in there, we're all here for you and Finn, and you both will do just great.

Actually, Harley is starting to get alittle more chipper these days, I noticed this Monday night, he actually wanted to play with his toys for more than just a few tosses.:D:D Sooo, maybe his treatment is starting, ever so slowly, to work.

Hugs to you and Finn.
Lori

[Harley PoMMom]

Hi Felice,

Just wondering how you and Finnegan are doing.

Hugs to both of ya.
Lori

[JFBMaine]

Hi Lori, I just returned ( gone for almost 4 days) from Bar Harbor, Maine where I photographed a very large wedding. Finn and I have a holistic vet coming today at 1 pm to get help with changing his diet....he has so many sensitivites. I am going to go over the recommendation from University of Penn with the melatonin & flaxseed hulls. What are your plans with Harley? Thanks for checking in. Felice

[Harley PoMMom]

Hi Felice,

With Harley...July 16th he will be taking the melatonin/pressed flax hulls treatment for 2 months, so he goes into the vets and gets his estradiol hormone checked ( blood drawn, sent to UTK), also I'll be getting a CBC done and another ultrasound to see if that nodule has grown on his adrenal gland.

In my last post to you I stated that I thought Harley was getting better, he is definitely getting better...he has yellow pee :) it's been since March since I seen yellow pee coming from him :D He's got that sparkle back in his eyes again, so Felice, hang in there, this treatment WORKS. It just takes some time.

Poor Finn, not only cushings but food sensitivities too, that does make it a challenge when feeding, best of luck with the holistic vet, I hope she can help you with Finn's diet.

Hugs to you and Finn.
Lori

[JFBMaine]

Hi Lori, I am anxious for your July 16th appt for Harley to get the results of his treatment. Finnegan seemed to be doing a little better when I had him on just the melatonin. SInce I have added the Flaxhulls he is acting very strange ( okay more strange than his usual strange...but just one of the things I love about him).
He doesn't even want to go out to the backyard to do his business...I have to coax him out with treats. He pees or poops and runs right back in. Last night when we returned from home he ran to his bed...this is the first time EVER that he doesn't wait for his little treat when we enter the door. If I forget he always lets me know that I forgot. I am not thrilled w/ the vet that I had before, or the internist, and the new holistic vet I have is all right however she told me she has only treated her patients with drugs and is not sure about the Melatonin and Flaxhulls. I know that this is the route I want to take for Finn. I don't know what to do...should I wait a little longer or call the vet. Thanks for any input.

[gpgscott]

Hi Felice,

The running and hiding behavior could be your absence at the shoot or your behaviour combined with the addition of the treatment. He may just think you are daft, poking these pills at him:p

It takes a bit, up to three months and with what you have related about sympt's I think you are right to see it through for a while.

Best.

Scott

[JFBMaine]

Hi Scott, he is accustomed to going every weekend in the summer to his brother's home...we both spend a lot of time there so that is nothing new. I just stick the pill in a little wet dog food so I don't think he even realizes it is in there since he gulps that down in a second.
Something is off with him....he has not moved for two days and does not want to go out to even pee. And usually at 3 oclock he is at my desk asking for his snack...nothing today. I of course will stick with this treatment, I just don't know if I should call the vet or wait and see. I guess there is nothing they can do at this point. Just needed to vent I guess because I am worried. Thanks for your input...I appreciate it. Felice

[Harley PoMMom]

Hi Felice,

As with the 4th of July holiday here there were alot of noises, fireworks, guns shooting off, neighbors yippin and hollering...and I mean for nights prior to the 4th and nights after the 4th, my other pom. Bear was so scared he did not want to go outside to go potty either. But..alas...everything has calmed down..the noises...and Bear is back to normal.

Did you have alot of noises going on there around the holiday? If so, do you think Finn might be sensitive to that?

Lori

[JFBMaine]

We did have a little noise and I think the melatonin helped him because it didn't appear to bother him. He went out the next day without a problem. It's just the last two days that he is not moving, it is after 5 oclock and he is usually begging for his dinner by 4:30. Like I mentioned above he didn't even ask for his 3 oclock snack. Trust me this guy has a built in clock when it comes to his food...even when he is ill. I am only posting this to see if anyone else has had side effects or noticed anything when there dogs were placed on Flaxhulls. However , if I remember it may only be Harley that has had the treatment so far, am I correct? Just asking. Thanks.

[Harley PoMMom]

Glynda's Lulu has been on it for a while now too, 9 months, didn't know that until the other day. But I believe she isn't having any problems with it.

Felice, you know Finn best, if you think something is off with him then I would call the vet, especially if Finn is not eating, is Finn drinking?

Lori

[jrepac]

I doubt the flaxhulls would be causing his lethargy....suggest you visit vet if he doesn't improve

[JFBMaine]

He did get up to eat and went right back to his bed. I will call the vet.
Thanks, Felice

[Wylie's Mom]

Hi Felice,

Is he at least drinking? I wouldn't think it's the melatonin or flaxhulls either, but just want to make sure you are using regular melatonin (not the extended release one) and how much of the hulls are you giving him per day? How much does Finnegan weigh? My IMS had said that she had dog that got extremely lethargic on melatonin and had suggested that I gradually increase Wylie's dosage to the 6mg BID.

My first thought about not going outside would be the fireworks also, but the not eating is another story:confused:.

-Susy

[gpgscott]

Felice,

I think it is more likely the melatonin than the flax. Melatonin is a mild sedative.

You are right to be observant and it can never hurt to involve the treating Dr.

Please let us know.

Scott

[Squirt's Mom]

Hi Felice,

Squirt has been on the hulls for a little over a week now and there have been no changes in her behavior since adding them.

You are wise to call the vet just to be safe. Each pup is different so Finn may not have the same experiences the others do with the Atypical treatments tho I am inclined to think it is something unrelated to the Cushing's.

Please let us know what the vet says!

Hugs,
Leslie and the girls

[Tamarah]

Felice -

How are you an Finn doing this morning? Is he eating any better?

Crash has been on flax hulls for about a month now and hasn't had any adverse effects since switching from FSO.

This is probably way off, but you had mentioned Finn has food sensitivities could it be that he might be allergic to the hulls? Again, probably way off, but the possibility popped into my head so I thought I'd raise the question. Did you get to talk with the vet yesterday? Let us know how you and Finn are doing?

Sending you and Finn a couple of smiles this mornng. :):)

Tammy, Crash, & Darby

[JFBMaine]

Good morning everyone, thank you for your concern. Finnegan's appetite has not changed, he is still eating fine and drinking. The only difference is that he is not doing is usual asking for his snack exactly at 3 pm and his dinner at 5 ( he starts asking for it at 4:30 everyday). Maybe that is a good thing that he is not as food oriented?? Just so very different. A couple days after I started the melatonin he seemed to be doing better and for the first time the fireworks did not bother him. THe last several days he has stayed in his bed all day ( not moving at all) and not even wanting to go out to pee or poop. I have to bribe him, trick him, or drag him out. I may have made too many changes to his diet too quickly...starting to change his food, adding the hulls, and adding the melatonin. I like our new vet , who makes home visits, however have not made contact because I know that she is going to suggest we start him on cushings drugs ( can't remember which one she uses). She said that she would support my trying the melatonin and flaxhull however admitted she had never heard of that treatment and would do some research ( which I thought was good, plus she was going to call the U of Penn).
This morning I gave Finn his old food, no hull and just his melatonin. I will slowly begin in a day or so on adding the hull, but will start with a smaller dose. The melatonin is not the time released that I give him.
I have been giving him a pill in the morning and one in the evening ( 12 hours apart) and a dose of 3mg each time. Thank you for all your input, suggestions, questions, and support. Felice and Finn

[Harley PoMMom]

Hi Felice,

I think starting the hulls at a lower dose and then slowly going up is a great plan plus switching him back to his old food. I do believe you are on to something that all of this was just too much for his sensitive tummy.

Hopefully "others," I believe as John lovingly calls them, will chime in with their opinions as well.

Keep the faith Felice, you are doing a wonderful job.

Hugs from your friends in PA.
Lori

[JFBMaine]

Hi Everyone, Finn is about the same. However, I did want to share with you something I saw on the Today SHow yesterday. They had a pc on dogs and summer heat. One of the things they mentioned to do when your dog is overheated is to take a cloth, run it under really cold water and rub it on your dogs tummy and paws. I have done this several times yesterday and today for Finn and he LOVES it. It really does cool him down...he just jumped up on my bed which he hasn't done in a long time! May be the Flaxhulls and Melatonin kicking in too! Felice & Finn

[Wylie's Mom]

That would work so quickly on our pups that were shaved for ultrasounds!!:p

My neighbor had told me about the tummy & paws, but you just reminded me... I always keep the house cold, but on walks outside on a hot day, I sometimes get worried when he wants to keep walking. I can never tell if he will want to go to on a long walk, so I need to always bring a little squirt bottle filled with cool/iced water just in case;).

-Susy

[Harley PoMMom]

That's a neat idea, Felice, I'll have to try that on Harley when we're outside playing. Like Susy, I keep my house cold... 69 degrees, I have to wear a sweatshirt inside, but my dogs are happy.

Here's hoping the hulls and the melatonin are working too.

Keep us posted...please. :D

Hugs from your PA. friends
Lori and Harley

[lulusmom]

Like Susy, I keep my house cold... 69 degrees, I have to wear a sweatshirt inside, but my dogs are happy.

Lori, can I move in with you pretty please? I am sure that Gil would understand that it would only be temporary....three or four months is not that long really. :D I would love to keep my house at 69 degrees but I'm afraid I'd have to take a second on the place to pay the electricity bills. If not for fans directed at my face at all times, I would have melted a month ago and that just wouldn't be right because it was the wicked witch that turned into a puddle. :D

Glynda the Good Witch

[Harley PoMMom]

Lori, can I move in with you pretty please? I am sure that Gil would understand that it would only be temporary....three or four months is not that long really. :D I would love to keep my house at 69 degrees but I'm afraid I'd have to take a second on the place to pay the electricity bills. If not for fans directed at my face at all times, I would have melted a month ago and that just wouldn't be right because it was the wicked witch that turned into a puddle. :D

Glynda the Good Witch

Come on over, the more the merrier! :D:D:D You know my electric bill is not that expensive right now, runs me an average of $120. 00 a month in the summer and $50.00 in the winter....but in the year 2011 the cap is coming off for the electric companies and watch out :eek::eek::eek: And Glynda, you are way too much of an angel to melt like a wicked witch, and besides we need you here, you can not go off and melt.:eek::D

Hugs to you.
Lori

[JFBMaine]

Well, we live in Maine so we only have a few hot days...no air conditioner needed. I keep a fan on the floor running at all times for Finnegan. He didn't get it at first, however he does now and he sits right in front of it. Tomorrow he gets his hair cut so that should help too. I am looking forward to Harley getting his results back on his blood test. Fingers and paws crossed! Did you see on the Today Show this morning the guy from Florida who saved his Wheaten Terrier from an alligator's mouth! The guy lost two fingers and he said that he would do it again, that his dog was more like his daughter than a dog! That's love. Gee, I have two ex husbands that wouldn't have done that much for me! Felice & Finn

[Harley PoMMom]

Hi Felice,

So good to hear from you and the Finn. Sometimes I wish I lived in a colder climate...but in Maine you have all that SNOW in the winter.

Leslie posted a link about the gator and the guy...the pup was sooo cute.

Still waiting for Harley's results, thanks for keeping all fingers and paws crossed...I think we will need them. He's still doing great.

How's Finnegan doing, are you giving him his full dose of hulls? I know you're really busy right now but...if you can find the time we sure would like to see the Finn sporting his new hair cut...hint pictures.:D

Hugs to you and Finnegan.
Lori and Harley

[JFBMaine]

Hi Felice,

So good to hear from you and the Finn. Sometimes I wish I lived in a colder climate...but in Maine you have all that SNOW in the winter.

Leslie posted a link about the gator and the guy...the pup was sooo cute.

Still waiting for Harley's results, thanks for keeping all fingers and paws crossed...I think we will need them. He's still doing great.

How's Finnegan doing, are you giving him his full dose of hulls? I know you're really busy right now but...if you can find the time we sure would like to see the Finn sporting his new hair cut...hint pictures.:D

Hugs to you and Finnegan.
Lori and Harley



Hello everyone, I just wanted to update you on Finnegan's progress. It took a little while for his Flax Hull and Melatonin to kick in ( it didn't help that I misunderstood the amount that I should be giving him however Lori and Harley helped me with figuring out that at 58 pounds he should be taking 6 mg in the morning and 6mg in the evening) Finn is now chasing squirrels at full speed ...although he did pull his little leg muscle last week and hobbled around for the next couple of days. He has stopped the constant panting, and drinking of water, he still is hungry all the time but I think he is just following my lead on that one. He does sleep most of the time but is always up for a car ride, and walk in the park. In May when we first found this forum, he was not walking at all, drinking water non stop, panting all the time and trying to find a closet or dark corner to curl up in. He now sleeps on my bed stretched across even when I climb in to claim my corner. I just want again to thank all of you over and over for your help. I had a very difficult time with finding a vet that would listen to the fact that I did not want to start treating Finnegan with drugs until I knew what kind of Cushings he had...no one, at that point, would do the full blood panel work for me. I think I have found a vet that will work with us now. And a special hug to Harley and Lori for their continued love and support, and tracking me down!! Love, Felice & Finnegan who is ready now for his morning walk.

[Roxee's Dad]

Hi Felice,
Really good to hear from you and get an update. Great news on Finny. :D So glad you are seeing good results now. :) Hope his leg heals up quickly.

[Harley PoMMom]

Hi Felice,

So glad to see your post :D I just want you to know how proud you should be of yourself for standing up for Finnegan in regards of his health, you are doing a wonderful job, having to find a vet who will work with you is no easy task but you did it and YOU got Finnegan properly diagnosed and now he is on his way to feeling so much better...Great job Felice. I am so happy for you and Finn, also very happy to hear he's chasing squirrels, but oh no :eek::eek: pulled a muscle, poor guy...time to rest a bit.

Give Finn some belly rubs for me and keep us updated...please.:D

Love and hugs.
Lori

[Squirt's Mom]

Hi Felice,

How wonderful to hear that Finn is doing so well! And it's all because of his great mom who has been such a powerful advocate for him. I am so proud of you and hope you are of yourself!

I hope his pulled muscle gets better real soon so he can romp and carry on full tilt! You must be so happy to see such a change in your baby boy.

Please keep in touch! And keep up the good work!
Hugs,
Leslie and the girls

[JFBMaine]

Thank you for all your kind words and good wishes however without this forum and those of you who put up with me and all my questions, over and over again! I give this forum and the people on it 100 credit for my boy doing as well as he is right now. So again...THANK YOU!! and a zillion hugs and kisses!

[JFBMaine]

Just wanted to drop in and say "hi" to everyone and give you an update on Finnegan. He is doing fairly well. He enjoys the winters here in Maine and does much better in the cold weather for sure, when it warms up he does not enjoy rides in the car or long walks. I have continued with the Melatonin and Flaxhulls and that greatly improved his symptoms. He has many more fatty lumps now and also small wart type things popping up on his body. I have been cooking for him over the last 6 months ( meat, brn rice, veggies, Brewers Yeast, Garlic, ) and he enjoys it however he still has a very big appetite and would eat anything. He does sleep a lot but as long as it is cool outside he is the first at the door to go for a car ride and a short walk in the park to admire the squirrels. Hope all is well with everyone and their beautiful "furbabies". Love, Felice and Finnegan

[MiniSchnauzerMom]

Hi Felice,

Thanks for your update on Finnegan and glad to hear the melatonin and flax hulls have greatly improved his symptoms.

I was a bit concerned when I saw that garlic is part of Finnegan's home cooked diet. Below are a couple of links to the ASPCA Poison Control Center and some information for your consideration.


http://www.aspca.org/pet-care/poison-control/people-foods.html


People Foods to Avoid Feeding Your Pets
Onions, Garlic, Chives

These vegetables and herbs can cause gastrointestinal irritation and could lead to red blood cell damage. Although cats are more susceptible, dogs are also at risk if a large enough amount is consumed. Toxicity is normally diagnosed through history, clinical signs and microscopic confirmation of Heinz bodies. An occasional low dose, such as what might be found in pet foods or treats, likely will not cause a problem, but we recommend that you do NOT give your pets large quantities of these foods.


http://www.aspca.org/pet-care/poison-control/plants/garlic.html

Garlic
Additional Common Names: Stinking Rose, Rustic Treacle, Comphor of the Poor, Nectar of the Gods, Serpet Garlic, Rocambole

Scientific Name: Allium sativum

Family: Liliaceae

Toxicity: Toxic to Cats, Toxic to Dogs, Toxic to Horses

Toxic Principles: N-propyl disulfide

Clinical Signs: Vomiting, breakdown of red blood cells (hemolytic anemia, Heinz body anemia), blood in urine, weakness, high heart rate, panting

Keep admiring those squirrels Finnegan!!

Louise

[Roxee's Dad]

Hi Felice,
So good to hear from you:D and I am so happy that Finney is doing well. At least living in Maine the summers are short :) We already hit 80 degrees this week but I'm not complaining.

[Harley PoMMom]

Hi Felice,

It really is good to see your post! I am so happy to hear that Finnegan is doing well.

I also wanted to Congratulate you on winning Maine's 2010 Photographer of the Year Award. Outstanding job!!

Love and hugs,
Lori

[Roxee's Dad]

I also wanted to Congratulate you on winning Maine's 2010 Photographer of the Year Award. Outstanding job!!

What???? How did I miss that? Congrats! :D:D:D:D Very nice. :)

[JFBMaine]

Louise, thank you for the info on the garlic, it is a product for dogs and cats Brewers Yeast & Garlic...I will look to see if I can find it without the garlic!
Thanks to Lori & John on the congrats for being named "Photographer of the Year 2010"...fun for sure since I was up against all those young hot shot photographers :-) The ol'gal still has it ! I wanted to mention that I noticed with Finnegan that he does best if his schedule is the same...when I have to work and he goes to stay( a day or two ) with our friends who have three Wheaten Terriers ( he has known them all his life and the only place he has gone when I am away) anyway when he comes back it takes him several days to get back to himself...he comes back exhausted because he waits by the front door for me most of the time he is there. He likes his little routine. I will have to browse the new posts to see how everyone is doing. Felice