Recently diagnosed...gathering info-Mi-12 y/o miniature schnauzer

[schnauzerluv]

Mi was recently diagnosed with Cushings so I'm trying to learn what I can. She is a 12 year old miniature schnauzer and is showing the following symptoms:

Panting
Tremors- may not be triggered or can be triggered... like a light bulb cooling off and making a popping sound.....
Does have a pot belly look
Weakness in back legs

Vet did the pre and post blood test...waited an hour after admin
and test came back positive...

Feeling really dumb about all of this right now...

Also, is there a certain dog food that would be better for her since she tested positive...Currently on a turkey and potato dog food...

[Simba's Mom]

Hello and welcome to you and Mi, so glad you found us here...we are a family of cush pups and Moms and Dads....there are lots of stories to read with so much information....and we give lots of encouragement too..so settle in, we are here for you!

[Harley PoMMom]

Hi and welcome to you and Mi,

The symptoms usually associated with Cushing's are excessive drinking/urination, ravenous appetite, hair/skin problems, and a pot-bellied appearance, does Mi display any of these?

Cushing's is a slow progressing disease so one does have the time to get a confirmed diagnosis for their furbaby. A Cushing savvy vet will not initiate any treatment without strong symptoms and a proper diagnosis. Since other non-adrenal illnesses, such as diabetes and thyroid problems, share some of the same symptoms of Cushing's it can be one the most difficult diseases to get a confirmed diagnosis for, plus not one test is 100% accurate at diagnosing Cushing's. A vet knowledgeable about Cushing's will perform multiple tests to validate a diagnosis of Cushing's.

Cushing’s is a treatable disease. Delivery of competent and humane medical care by a skilled GP and/or specialist experienced in the diagnosis and management of Cushing’s has a significant impact on patient survival and well-being. With proper medical management, close monitoring and owner observation, most Cushingoid pets can live to their full life expectancy, with complete or partial resolution of clinical signs, and good quality of life!

Could you post the results of all tests that were done on Mi along with the reference ranges? Is Mi taking any other herbs/supplements/medicines? How much does she weigh?

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

Love and hugs,
Lori

[Trixie]

I have a mini schnauzer too!! She turned 9 yesterday and recently diagnosed with Cushings. She had an elevated liver level in a routine blood test which began our story with this.
We didn't test for Cushings until she had very noticeable symptoms. With Trixie it was drinking/urinating..so much more than normal.. ravenous appetite (harder to detect) and a bit of the pot belly and some panting.
She has been on a low dose of the medication Trilostane for 3 weeks now and we're just starting to notice a subtle decrease of her symptoms.
Everyone here is very helpful and knowledgeable about this disease. They will give you good advice about what might be going on with your Mi. I'm still pretty new with this too but it would be great if you can give everyone all your info--test numbers etc..so they can better guide you through.
Barbara

[frijole]

Hi and welcome from me as well. One thing that caught my eye was that you said:

Tremors- may not be triggered or can be triggered... like a light bulb cooling off and making a popping sound.....

Can you expand on that? What do you mean by making sound? I am curious. Be as specific as you can. Thanks Kim

[schnauzerluv]

In some cases, she starts her tremors without any triggering just begins to shake....in other cases, I have lights over my kitchen sink and when I turn them off and they begin to cool, they may make a little popping sound and it sets her off and she starts her shakes...she might just be relating the sound to a weather storm event as she's storm sensitive....but when she does get the tremors (and even without any triggering of a sound), they can be pretty bad and she seems to be very scared....

Hope that helps...Kim

This may not be related at all to her Cushings....She does have alot of anxiety when going to the vet.....can that throw off her normal readings?

[Harley PoMMom]

She does have alot of anxiety when going to the vet.....can that throw off her normal readings?

Stress, anxiety, pain, and any non-adrenal illness can create false positive results from any tests for Cushing's.

When you get a chance we would really be interested in seeing all test results....Thanks!

Love and hugs, Lori

[Squirt's Mom]

Hi and welcome,

Based on the info you have given so far, I see nothing that says Cushing's. Cush pups drink and drink and drink and pee and pee and pee. Their urine is typically clear - no color or very, very little color. They lose their house training, they spend much of their time at the water bowl and act as if they are literally starving 24/7 - not hungry, starving. They seek out cool places and do not tolerate heat well at all. Their back legs get weak, lose muscle mass, and they can't take much exercise, or jump on the furniture, or climb steps. They lose hair especially in the back end area - a "rat tail" is common. They start to look very old with their heads taking on a skull-like appearance and the belly potted. They are often restless at night and withdraw during the daytime. Frequent infections are common. While the pot belly and nervousness could maybe be attributed to elevated cortisol they could also be signs of 100's of other things that have no relation to Cushing's. So take a deep breath and relax - if, IF, this is Cushing's it may have been caught very early. Regardless, there is rarely reason to rush the diagnostics OR rush into treatment. Cushing's is a very slowly progressing condition taking years to cause real damage. ;)

The signs are very important because we watch the signs to see how well the treatment is working. Without signs it can be hard to know what is going on and a cushing's savvy vet will not start treatment in the face of no signs. Here is a list of the most common signs of Cushing's from Kate Connick's site -

The most common symptoms include:
• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures


Many of the above signs are shared with other conditions like hypothyroidism, diabetes, liver or kidney disease and other. Because Cushing's is so very difficult to diagnose, it is always best to have several tests - as many as you can afford. The one your baby has had so far sounds like the ACTH. At the very least I would strongly recommend an abdominal ultrasound asking them to make sure they get a good visual of both adrenal glands. To give you an idea of how tricky this disease can be - my Squirt tested positive on five cushing's test but it turned out she had a tumor on her spleen that was causing the cortisol to be elevated and once the tumor was removed, her cortisol returned to normal and remained in normal range for nearly four years. Cortisol is the body's natural response to any stress, internal or external, so it is critical to rule out as many other possibilities as possible before arriving at a diagnosis of Cushing's. A pup who has "white coat syndrome" - a fear of vet clinics - can test positive even tho they do not have Cushing's simply because they are so stressed. So there are many factors to consider and it is very wise to take ones time before starting treatment. ;)

As for diet, as long as what she is eating now is working well for her, I wouldn't change a thing right now. If it turns out on down the road that she needs a different feed, then we can talk about it but right now finding out what is going on with your baby is more important and you don't want any changes that can cloud the picture. So unless she is having problems with the current feed, I would put that on the back burner for now.

I'm glad you found us and look forward to seeing the test results and getting to know the both of you better. Never hesitate to ask questions - we will help in any way we can.

Hugs,
Leslie and the gang

[frijole]

In some cases, she starts her tremors without any triggering just begins to shake....in other cases, I have lights over my kitchen sink and when I turn them off and they begin to cool, they may make a little popping sound and it sets her off and she starts her shakes...she might just be relating the sound to a weather storm event as she's storm sensitive....but when she does get the tremors (and even without any triggering of a sound), they can be pretty bad and she seems to be very scared....

Hope that helps...Kim

This may not be related at all to her Cushings....She does have alot of anxiety when going to the vet.....can that throw off her normal readings?

I am linking you to a video of my Annie who had tremors that were intermittent. She shook all over, her skin turned hot and pink and sometimes her breathing also became very fast. I took this early on (she lived for another 2 yrs). The shakes got much worse so this is early on. The night I took this video I woke up because the bed was shaking. Doesn't look that severe on the video but you can see what I'm talking about. Check it out and see if this is what you are referring to:

http://www.youtube.com/watch?v=PLNTmf9AbJ4

Annie was misdiagnosed as having cushings. She had many many false positives on two types of cushing's tests. Ended up she had a pheochromocytoma tumor on her adrenal gland. We went to a teaching university to have the ultrasound. They are very rare but thought it was worth sharing my story in case that is what you are dealing with.

Kim

[molly muffin]

Hello and welcome.

My dog has high anxiety levels associated with any loud noises or if she thinks there is a storm, and early in the morning sometimes before her first walk. For instance yesterday she went into high anxiety and started shaking and all the things she does when she is terrified and that was because she heard the hose going, as my husband was washing off the back patio. No lie, you would have thought we were in the worst thunderstorm ever the way she acted. We did some calming down thing where I rubbed her, took her outside to see what was going on etc. I'm not sure if a light bulb popping off would scare her or not, but if cortsiol levels is higher for any reason, then she might be (and I think mine might be doing this too) is dump some reserve cortisol from the adrenal gland, in response to a light fight or flight type of response. I am thinking this might cause the tremors.

It would be very helpful to know what regular blood work tests looked like and any urinalysis, along with the actual ACTH numbers. We see a lot of tests here so it is quite helpful in comparing yours to others.
First thing is that diabetes, thyroid, kidney, liver issues need to be ruled out. For instance is the glucose high or low, electrolytes high or low (this too can cause tremors), T4, Bun, Createnine, etc.

Again, welcome
Sharlene and Molly Muffin

[schnauzerluv]

Kim, so glad you provided the link to the video as your Annie tremors looks alot like what Mi is doing...I took a video of her this morning during one of her episodes and I'm hoping I can upload it....but you're right, sometimes the video doesn't truly reflect how bad it is...

Still waiting for a call back from the vet...

Thanks

[frijole]

Glad that it helped - I kind of wondered when you mentioned it.

Do me a favor and read Leslie's post where she describes cushing's symptoms and let us know what if any your dog has. You mentioned panting but obviously not all dogs that pant alot have cushings :) What tests if any have you had done so far?

I don't know where you live or if there are specialists in your area but if you want to save a whole lot of time and money - if your dog doesn't have traditional cushings symptoms (inhales food as in does not ever chew and spends all day in search of food even when full AND intense water consumption as in BUCKETS not just 'alot'. ) then I would invest in a full blood panel (if you haven't already) which would give you some indications as to what is going on AND I would invest in an abdominal ultrasound. You need to make sure its on a high resolution machine (not typically found at a local vet office) and that's why I mentioned a specialist - they typically have better equipment and should take better film (shots of all the organs) and are better at reading the film to diagnose.

I went to a specialist in Omaha and they only read one adrenal gland and so despite the $500 I didn't learn a thing... I went to Kansas State University and they took their time and found the tumor on the adrenal gland. I wasted a whole lot of time. Had we discovered it sooner my girl might have been a surgery candidate.. but as you can see in her photos she quit eating and lost weight due to the pheo. It just took us a year to figure it out and oh the time and money I wasted. But I did prove how stubborn a German mom who loves her dog can be. :)

Kim

PS I repeat my dog had false positives on like 5 tests for cushings. Crazy

[Budsters Mom]

Hello and welcome from me too! :)

You have come to the right place! There is a huge arsenal of K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better.

So again welcome to you and Mi,
Hugs,
Kathy and Buddy:cool:

[schnauzerluv]

Vet visit scheduled for Friday...getting bloodwork done and will get numbers on previous ACTH test...talked with vet last night and what I understood was pretest 8.28 and post was 24 which was taken 1 hr after getting injection....he said definite Cushing.

[frijole]

I can understand why your vet said that. The acth test does point to cushings. That said the first number on the test (8.28) is high just like my dog's was. She had FOUR of these tests that said cushings even though she didn't have it. All I am saying is keep a very very close eye on her when you start dosing and if you see lethargy, loss of ability to walk, lack of appetite/thirst please stop giving the drug. These tumors are rare but I am just sharing what happened to me to be precautionary. Kim

[schnauzerluv]

Thanks Kim, I appreciate your shared words of wisdom and will be watching close...Will I need to keep up with her water intake as I have two schnauzers and wondered if I needed to make some adjustments for that...

[frijole]

I had schnauzers when I loaded Haley and I measured TOTAL water intake - got a big plastic bowl and put tape on it so every day I knew how much to fill it. :) I then measured what was left at the end of the day (after 24 hrs) I assumed any change in intake was from the cush dog. Make sure you do it before loading so you know what the starting point it. Kim

[Squirt's Mom]

Here is a link to a spreadsheet one of our members made for us so we can track water intake -

http://www.k9cushings.com/forum/showthread.php?t=3583

[schnauzerluv]

Thanks for the link to the worksheet! Mi is getting 30 mg daily and I'm splitting it into morning and night....First dosage was this morning. She's 24 lbs so according to insert that dosage is good for 10 to <22 lbs so guess we are going slightly below at first which I'm good with...Had bloodwork done friday also so will post that when I get results....

Hopeful this is going to help Mi feel better and have less stress...Still learning and I'm amazed at the wealth of knowledge and willingness to help "we newbies" get through this...

Also would like to wish all a Happy Mother's Day! Was blessed to have a wonderful Mother and miss her so much...She also loved her animals and treated them better than she treated her children I think.....

[schnauzerluv]

Mi refused food this am so I did not give her the vetoryl this morning...She nosed around in her food but would not eat. Offered it early this am and again after an outside walk thinking that might help....

She's supposed to have another dosage in pm so will try again...watching her today for any other unusual signs.....

[Budsters Mom]

It sounds like her Vetroyl dosage is a little too high. if I understand correctly. You are giving her 30 mg. divided into 2 dosages. The current recommendation for starting Vetroyl is 1 mg. per pound. That means that Mi should probably start at 24 mg. a day or less. It is better to start low, then work up if needed. That gives their body time to adjust to the Vetroyl. Unfortunately, brand name Vetroyl does not come in 12 mg. dosages. You can either ask you vet about compounded Trilostane, or maybe starting on the 10 mg. Vetroyl instead? Just a thought.I hope Mi is feeling better soon.

Hugs,
Kathy and Buddy:cool:

[Budsters Mom]

If she is not eating, an ACTH test is needed to determine her levels. You don't want her to get too low.I wouldn't give her any more Vetroyl as long as she refuses food. I don't know as much as others, so I'm sure you will be hearing more about this.

Hugs,
Kathy and Buddy:cool:

[Harley PoMMom]

I'm a bit confused with Mi's Vetoryl dosage; is she getting 15 mg twice a day or is it 30 mg twice a day?

It could be that Mi is going through cortisol withdrawal syndrome in which not giving the Vetoryl should perk her back up. If she shows any other adverse signs such as diarrhea or vomiting then an ACTH stim test should be done to see where her cortisol is.

Hoping Mi is feeling better soon, please do keep us posted.

Love and hugs, Lori

[schnauzerluv]

15mg twice a day for a total of 30/day....she seemed to be able to rest better and I was encouraged...but then she refused to eat this morning...so, not sure.

Have put a call into vet to see what he thinks...Wonder if the 10mg might be a better idea...

No loose stools or any other signs...she still has tremors but that seemed a little better at first after beginning her treatment...also, she has seemed to be at a more restful state....but today, she has stuck right with me....room to room..wherever I go...of course throw in the fact that my husband is doing some carpentry work in our kitchen which may explain some of her uneasiness today....

went for another walk and she's energetic and loves to explore so I don't think she's having any issues there...

[doxiesrock912]

Best to start low. I just went through this with Daisy. She was listless and refused to eat. I stopped the Trilostane altogether for a few days and then started at 1/4 less twice a day at her IMS recommendation. We did not need to use prednisone.

So far, so good.

Not eating is a key indicator that her cortisol is too low.

[Budsters Mom]

What part of the body do Mi's tremors affect? Is it her whole body or just her head? Buddy has had head tremors. I still haven't figured them out. They have stopped for now. Kim suggested taking a video of Buddy's tremors when they occur to show the vet. I did that on two occasions. It was a great idea. You might want to try that.

Hugs,
Kathy and Buddy:cool:

[molly muffin]

Hi, what did your vet say? Did she eventually eat anything today?

Sharlene and Molly Muffin

[schnauzerluv]

She did finally eat this afternoon thank goodness! We are going to hold off and start in the morning with a lower dose if appetite is good in am...

[schnauzerluv]

Kathy...Thanks for the input on the video suggestion...I do have video of Mi and her tremors and tried to upload today to youtube...but it was going to take 5 hours to upload....Wanted to share the link just in case someone else has had the same issue. Mi's tremors are pretty much all of her body.....she acts like she knows in advance that she's fixing to have them because she always comes to where I am looks at me as if to say "do something"....She'll tremble for awhile, then pant and then relax...Now, the vet visit is full blown stress......shaking and panting constantly the whole time we're there. Not sure if there is something that is triggering the tremors at home...a sound that I don't notice maybe sometimes might cause them...then some sounds I do know will get her started.....

Anyone else have anything close to the same as Mi?

BTW, Mi's name is really Mia...husband named her (?) but over time has shortened to Mi.....I'm NiNi to my granddaughter (18 mos old) and Mi is Mimi so we have a MiMi and a NiNi in the same household...no wonder Mi is having issues... :)

[frijole]

My first video was like 15 min long and I learned that same lesson. ;) Please take a shorter version as it shouldn't take long to figure out what is going on. Did I ask if she feels hot after the trembling episodes?

Re the trilostane - when was your last acth test and what were the results? Glad she ate! If she hesitates tomorrow it could be that the cortisol is too low. Withholding the drug lets her body rejuvenate and create cortisol which makes her feel better.

Fingers crossed. Kim

[molly muffin]

Yay so glad she had something to eat today. Mimi and NiNi, that is too cute. :)

Molly does the trembling if we get in the car. It's weird she'll run to the car to get into it but then once we're inside the trembling starts, same with storms, she trembles something awful, but those are fear trembling, so maybe not the same kind as what Mi is having, unless something is scaring her. Molly heard the water hose the other day, decided we were having a storm and trembled like crazy. I had to take her outside and show her it was just the hose really loud against the concrete. So, maybe there is a sound or smell or something she associates with something bad? no idea really.

Sharlene and Molly Muffin

[schnauzerluv]

I don't think I've noticed her feeling hot after the episodes but I'll take note next time......

The last acth test was prior to her beginning treatment...her treatment began on 5/10th...

Results of the test were:

8.28 pre
22.90 post ..1 hr


Should be getting bloodwork results tomorrow from visit on 5/10th also...

[Trixie]

I hope Mi is doing okay and getting back to her regular appetite. We had no side effects starting on a low dose (6mg 2x a day) for Trixie who is 14-15 pounds. She is now on 7mg 2 x and still no side effects. (knocking wood here) It took awhile before I saw any change in her symptoms. Even now symptom decrease is very gradual, but I think low and slow is the way to go. The prescription needs to be compounded at a pet pharmacy. I didn't even know this was done for pets until we had this diagnosis!
Love the NiNi and MiMi story! I think both names your granddaughter uses for you and Mi are super cute!! :p
Barbara

[schnauzerluv]

We've started again this morning with 10 mg vetoryl and see how Mi does. She was taking 15 mg two times a day and showed some signs of loss of appetite a few days afterward. So....we are back to eating decently now and going to start again and see how she does...

Another question unrelated to Mi and I don't want to be breaking any rules, but I have another miniature schnauzer pet 12.5 lb, 5 months old that must have a gotten a couple of flea bites and he is miserable. Can I give him some Benadryl and if so, how much? I've read 1 mg per pound of weight but wanted to check with anyone on the forum that has had the same issue....

Thanks!:)

[molly muffin]

Yes you can give Benadryl. I'd go with the under 30lbs, 10mg dosage.
It does make them sleepy usually too. So you might want to adjust if you think it's making them too sleepy. Several members use it, for allergies, etc on here, and I'm sure some of them will be stopping by to offer tips.

Sharlene and Molly Muffin

[schnauzerluv]

Kim,
I stopped Mimi's medication as I'm not convinced she has cushings....She really never had the classic symptoms such as always being hungry and thirsty.. The tremors were the main issues I have been concerned with....She has always had issues with going to the vet so I was concerned that she had a false positive diagnosis....You had asked about whether she feels hot after the trembling episodes and I do notice that her body temp does feel elevated with the tremors... Was there a reason you asked that? Thanks, Bertha

[molly muffin]

Let us know how she does off the medication. :) Hopefully that will be an end of the tremors and not eating.
It is hard to know for certain what to do when there are no classic symptoms to treat. Which of course is why many vets don't treat unless symptoms are present.

Sharlene and Molly Muffin

[frijole]

Kim,
I stopped Mimi's medication as I'm not convinced she has cushings....She really never had the classic symptoms such as always being hungry and thirsty.. The tremors were the main issues I have been concerned with....She has always had issues with going to the vet so I was concerned that she had a false positive diagnosis....You had asked about whether she feels hot after the trembling episodes and I do notice that her body temp does feel elevated with the tremors... Was there a reason you asked that? Thanks, Bertha

Bertha I asked about that because my Annie was feverish after the trembling episodes to the point where she was very hot, sometimes drenched with sweat and her skin was bright red. I now know it was the adrenal tumor called a pheochromocytoma. Her body was producing cortisol to fight it and that is why she had the false positives on the cushing's tests. If this sounds like it could be what your baby is going through I strongly encourage you to have an ultrasound done or review film if it was already done to see if perhaps there is a 'pheo' that could be causing your dog to tremble.

IT could be something totally different but obviously something is causing it - could be pain of some sort. Sending love, Kim