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Stimpy
05-09-2013, 12:22 AM
Hi all,

I'm new here and sad to say my little guy (11 pounds, neutered) was just diagnosed.. but I'm glad to find this forum, really seems like a friendly group of people here.

Here's Stimpy's story:

Stimpy began showing some incontinence, ravenous hunger, an ever-growing pot belly and grunting/hyperventilating when picked up. Then some unusual flat (not raised) scabs on his legs and raised blemishes on his back. Easily visible being hairless.

The vet took a couple urine samples indicating normal kidney function. Since the above symptoms suggested Cushings, they did some blood tests which seemed to ruled it out. Vet recommended changing from Orijen kibble to a lower protein (uncertain of the belly), so I switched to California Natural. I told them it seemed more like gas/bloat rather than a weight issue.

Hyperventilating now more frequent, now even when just laying down/relaxed. Tends to lay flat with belly stretched across floor, appears to be uncomfortable like he's always just had a big meal. A raised scab at the tip of Stimpy's tail began to work its way up the shaft and become raw. I have another dog who took notice of this and aside from his obsession with licking Stimpy's back the last several weeks, he then began licking his tail as well.

More blood tests, xrays and an ultrasound: 2x enlarged liver. Slightly elevated blood pressure of "200". Vet wasn't overly concerned given nervous dog + added stress being at vet. Requested dexamethasone suppression test. I'm wondering why this tests wasn't done in the first place ($$$).

Tail becoming more raw; caught the other dog starting to CHEW on Stimpy's tail, causing it to bleed. Stimpy didn't seem to notice. Got supplies/ointment from vet to try and heal it, until one morning when it was left unwrapped to breathe and the other dog took to another good chew, this time almost gnawing it OFF. Very disturbed, I scheduled the amputation as suggested by the vet.

Suppression test results came back indicating Cushings (endocrinology below). Vet docked Stimpy's tail and did dental work while under anesthesia (scale/polish and extract 6 infected/loose teeth). Claimed with Cushings, infection can spread due to low immune system and is best removed along with the tail.

All drama aside, it's been 24hrs and Stimpy is recovering well -- acts like nothing happened! He's on Clavaseptin antibiotics and 10mg Tramadol for pain (although doesn't seem to need it/make a difference).

Needless to say, this has been a costly diagnosis (not to mention the other dog having his own issues). Premium holistic food all their lives makes me wonder how they'd be now had they been on a cheaper brand.

Ok that's about it in a nutshell. I'd be happy to hear any comments, good or bad regarding any of this. Unfortunately, I'm going away for 6 days so I can't start treating this until I return. Both dogs are staying at a very nice home-based doggy daycare so I've informed the lady and she is experienced dealing with these sorts of things. Despite that, it still makes me more nervous than anything and I hope it's smooth sailing during this time.

I've seen requests on the forum for test results, so here are Stimpy's:

Cortisol (0hr): 220 (0-280 nmol/L)
Cortisol (4hr Dex): 146
Cortisol (8hr Dex): 254

"Poor suppression noted at 4 and 9 hour. Consistent with Cushings (possible adrenal based) as long as history and blood work correspond. Check imaging or HDDS to differentiate pituitary vs adrenal."

Thanks in advance!

Harley PoMMom
05-09-2013, 12:37 AM
Hi and welcome to you and Stimpy,

So sorry for the reasons that brought you here but glad you found us.

Was the enlarged liver the only finding noted on the ultrasound? nothing about the adrenals or any other organ?

What Cushing's medication is the vet wanting to treat Stimpy with? What dosage is rx'd? Is Stimpy on any other herbs/supplements/medicines? Does Stimpy have diluted urine? Could you ask the vet exactly which "blood test" was performed that ruled out a Cushing's diagnosis? Gosh I am sorry for all these additional questions but the more information we know about your boy the better our feedback can be, ok?

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

Love and hugs, Lori

Budsters Mom
05-09-2013, 12:40 AM
Hello and welcome from me too! :)

You have come to the right place! There is a large group 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 Stimpy,
Hugs,
Kathy and Buddy:cool:

Trixie
05-09-2013, 12:43 AM
Welcome to the board. Sorry to hear about what you've gone through with Stimpy recently! I am pretty new here myself, so not great on advising about the test numbers, but you will have others responding who can help and give advice and suggestions.
It sounds like Stimpy is recovering really well after only a day.
I think starting treatment after you return is okay..I don't believe you have to rush into treating and waiting a week or so should not be a problem. Is Stimpy also drinking a lot more than usual?
There will be others responding who are more knowledgeable than I am. They will probably ask you to post any other numbers you have from the bloodwork.
Sounds like your dog care arrangement will work out fine for both your dogs while you're away but I can understand your apprehension. It's so hard not to worry about all this. Hope everything stays uneventful while you're away.
Barbara

Stimpy
05-09-2013, 12:55 AM
Wow, that was fast! Already feeling confident you guys will guide me in the right direction here as I feel my vet may have been able to take a more direct route.

Thanks so much for the warm welcome from both of you! Here are the answers to your questions:

Lori>
-enlarged liver was the only finding from the ultrasound
-vet is suggesting Trilostane (dosage not mentioned), but ~$50/mth plus the following:
-*ACTH supplies @ $58 + response test @ $114 + collection fee @ $32 + exam @ $43
-he's not on any other meds/herbals but does take 1.25cc Ascenta brand K9 Omega 3 liquid w/kibble in AM
-diluted urine: this test had to be done twice but I'm pretty sure it all came back "ok"

Good question about the blood test that seemed to rule it out, I'll find out.

Barbara>
-he doesn't drink more than usual but then he's not begun treatment yet either. He does go pee the moment he gets outside though. This was one of the reasons I had them do a urinary test.

Thanks again for your support!

* I saw this link in another thread on extending the cost of ACTH tests, will see what the vet says about that as well: http://endocrinevet.blogspot.ca/2011/03/how-to-extend-your-supply-of-cortrosyn.html (http://endocrinevet.blogspot.ca/2011/03/how-to-extend-your-supply-of-cortrosyn.html)

Trixie
05-09-2013, 01:13 AM
My dog recently started on Trilostane. If and when you begin to treat, Stimpy's dosage will be a very important thing to consider. Suggested dose to start is one mg per pound, but again..I am new to this too and others here will be a better judge after they see your test results and bloodwork.
Drinking a lot of water and in turn doing a lot of peeing is a common symptom of Cushings. It lessens after treatment begins..(hopefully).
It is all crazy expensive..no one here will argue that point!! :eek:
Barbara

Simba's Mom
05-09-2013, 02:23 AM
Welcome to you and Stimpy, so glad you found this site, it's the best, get ready for lots of info and encouragement too....hang in there, we are here for you and Stimpy....

Harley PoMMom
05-09-2013, 04:30 AM
Stimpy sure is a cutie pie!! The usual symptoms associated with Cushing's disease are an ravenous appetite, excessive drinking/urination, pot-bellied appearance, and hair/skin issues. Most dog's with Cushing's do have diluted urine because they drink buckets of water, the excess cortisol causes the kidneys to work harder (peeing) thus the dog has to drink loads of water to keep up with the kidneys. And since strong obvious symptoms are a huge part of making a Cushing's diagnosis I'm a bit skeptical of Stimpy's.

Has the vet determined what those scabs on his legs and raised blemishes on his back are? If not, has the vet said anything about doing a skin scraping or punch biopsy or even a referral to a dermatologist?

Cushing's is one of the most difficult diseases to get a confirmed diagnosis for and it is often misdiagnosed too. Other non-adrenal illnesses share some of the same symptoms as Cushing's such as diabetes and thyroid problems, have these two been ruled out?

Here are some links from our Resource Thread which have a wealth of information about Cushing's and Trilostane/Vetoryl:
Links to Cushings Websites (especially helpful for new members!) (http://www.k9cushings.com/forum/showthread.php?t=180) and Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

Love and hugs, Lori

goldengirl88
05-09-2013, 09:46 AM
Welcome to you and Stimpy. His avitar is so cute! This is the best possible place to be to help your dog. These people are wonderful, compassionate, and very knowledgeable about Cushings. They will always guide you and support you. Good Luck to you and your baby. God Bless You Both
Patti

Boriss McCall
05-09-2013, 11:41 AM
Hi Welcome to the group,
Stimpy is adorable. Love the pic!! so sorry to hear about his problems. Glad you were able to do some thing about his poor little tail.
Hopefully you will have all the answers you need soon.

molly muffin
05-12-2013, 07:55 PM
Hi and welcome to the forum. Sorry to hear about stimpy's poor tail.
So they didn't mention the adrenal glands being enlarged on the US? That is something that is often seen in combination with an enlarged liver with cushings, as it is the adrenal glands that actually cause the liver to enlarge by producing too much cortisol. I would think this is something they would be looking at specifically since the lab report said possibly adrenal based. So I'd ask about that too.

It's a good start, just a few follow ups needed to make sure that they are on the right track. ;)

Sharlene and Molly Muffin