Lark the Husky with Iatrogenic Cushings

[CaroleLark]

Hello to everyone and thank you for all the information you share here. I am hoping to find information on Iatrogenic Cushing's caused by Temaril-P.

My mother passed away last week and now I am caring for her dog. When I saw her, pot belly, hair falling out in chunks, constant, very fast panting, incessant hunger and thirst and very weak back legs, we took her to her vet. She had been prescribed 20 mg (4 5mg pills a day) of Temaril-P for a chronic asthma-like cough and congestion. She had been taking one-two pills a day for years and it wasn't controlling the symptoms. It did make her puffy and lethargic. So in February, the doctor upped her dose and though I strongly object to long-tem steroid use, said it would be no problem.

A neighbor took her to the vet this last Friday as I dealing with arrangements because she has bloody mucous leaking from her nostril. That's the first question, the vet did not know why she had this and just prescribed anti-biotics which have done nothing, in fact it has gotten worse. Has anyone experienced this and could it be because of Cushing's related elevated blood pressure?

The vet saw her and said he would charge $1200 to test her for Cushing's but never once mentioned weaning her off the Temaril-P. She seems to have all the classic symptoms so I don't know why this wasn't suggested. It is a large clinic and different doctors see her every time.

So I have begun weaning her off the medicine, and the panting has gone down and the thirst is less. I am worried about her though because she has no appetite and will only eat one egg and a little roasted turkey and for a dog that weighs almost 70 lbs that doesn't seem like enough to keep her strength up. I have tried to tempt her with all manner of food that she liked before but she turns her head away. She does urinate, but defecation is very occasional liquid diarrhea. To my knowledge she never had a constant urination problem.

She does go for walks (very slowly) and feels better in the mornings. But we live upstairs so I bought a special lifting aid and we help her because her legs, especially her back ones are so weak.

Just looking to see if anyone has any experience with this. She seems so utterly miserable it is heartbreaking. I want to make sure I am doing the right things for her. I have called the vet numerous times to get their advice and no one gets back to me, but to be honest, if the doctor couldn't see that she was on long-term steroids to cause this, I don't know that I trust him.

If anyone has gone through this or knows about it, how long does it take to see improvement? Could it be that the drugs have given her permanent Cushing's or damaged organs such as her liver? Is there something we can do to make her feel more comfortable or get her to eat?

Any help would be greatly appreciated. She is such a sweet, beautiful dog and I hate to see her suffer so. Thank you.

[Harley PoMMom]

Hi and welcome!

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

Any type of medication that has a steroid in it and is used over a period of time can cause a dog to have Cushing like symptoms known as Iatrogenic Cushing's, and the vet should of known this.

With Iatrogenic Cushing's one has to slowly taper the use of the steroid and this could take months. Testing for Cushing's at this time would be useless.

My non-cush pup, Bear, has a collapsed trachea which made him cough a lot. His vet rx'd terbutaline and hydrocodone to be given twice a day, these medications have really helped.

The nose bleeds most definitely could be from high blood pressure and this should be checked ASAP.

As far as the appetite goes, usually a dog will follow their nose and the smellier the food the more inclined they are to eat...Tripe, Parmesan cheese, sardines, tuna and the water, baby food (without onions) are some things that come to mind.

As far as the vet goes I would not go back and would look for an IMS (Internal Medicine Specialists), IMS' are much more knowledgeable and experienced than your average GP vet.

Has any recent blood work been done, and if so could you post anything that is marked abnormal...Thanks!

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]

Hello and welcome!:)
I am so sorry that you lost your mother recently. Lark is extremely lucky to have such a caring family member step in to care for her.
You have come to the right place! There are many 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. Others will be popping in shortly to welcome you also.
So again welcome to you and Lark,

Hugs,
Kathy and Buddy:cool:

[SoggyDoggy]

Hi and a big welcome from me too. I am so sorry to hear of the loss of your Mother, Lark is very lucky that you are there for her and that you are so proactive in her care.

With regards to her interest in food and her demeanour, if she has been with your mother a long time, she is possibly grieving over her loss. it is a big change for us to go through, but animals do feel that too and she is probably feeling that grief as well. That can manifest in lack of interest in the world and in food in both us and our pups.

As Lori said, I would be finding another vet, preferably an IMS (Internal Medicine Specialist) that you can consult with and develop a rapport with. While a big vet practice is good in that you can always get an appointment easily, it means that you see a lot of different vets, and they don't grow to know Lark or her history. That can sometimes result in the brush off experience without further investigation, and in my opinion, any discharge of blood should be investigated, particularly if there are other known health issues. Sometimes a smaller practice that you can build a good rapport and case history with is of higher benefit and often then, if an emergency situation pops up, they will squeeze you in anyway. It sounds a bit like your current vet practice is more interested in treating the practice owner's wallet than the animals. :eek:

I also wonder if they ever investigated the cause of the congestion and cough? Could it be as Lori suggested the collapsing trachea? Does Lark cough more if you rub her throat, after eating or drinking, or exercise? It's something to think about and if so, there are non steroidal treatments to consider once you manage to wean her off her current meds. Of course, again as Lori said, you must go very slowly to give her body time to adjust.

If you do decide to go with another practice or even better an IMS, make sure to ask the current group for a copy of Lark's full case history, including any test results that have been performed along the way, vaccination and medication history's etc. it will give your new vets an idea of where to start and a chance to review what has and hasn't been done in the past. I wish you the best of luck with her, she is very lucky to have you, and again, condolences on the loss of your mother.

Take care.

[molly muffin]

Hello and welcome from me too and condolences on the passing of your mom. That is a hard thing for humans and dogs to go through. :(
I second the finding a different vet who has a better idea of what they might dealing with, someone like an IMS definitely.
The others have given you some very good advice on the weaning off steroid. I know it is hard when they have been on them for years. I'd get the blood pressure checked. Is Lark nervous going to the vet? That can make it hard to get a good reading on the BP. Usually they take it several times at different intervals to get a correct reading.

That is a bit to get you started with, but the bloody nasal discharge doesn't sound good and needs to be sorted out as soon as possible.

Hang in there!
Sharlene and Molly Muffin

[mytil]

Hi and welcome from me as well.

I am sorry your Mom has passed, my deepest condolences. Lark is one lucky pup to have you.

The low appetite and loose stools could also be contributed to being taken off the Temaril too quickly for the adrenal glands to start responding properly which can be just as bad as long term use of steroids.

I would immediately find another vet or even an Internal Medicine Specialist (IMS) as a consult on how to proceed. IMO I think the current vet is in over his/her head.

Keep us posted
Terry

[Trish]

Gosh you have had a hard time of life lately, so sorry to hear of your Mom's passing but I bet she is resting easy knowing you are taking care of her Lark. My condolences on your loss.

The others have asked a few questions and they will all be most helpful when you get a chance to post Lark's latest results. I really just want to reiterate how important it is to go slow when weaning Prednisone and it sounds like Lark has been on it a long long time so I think it would be best to do that under the supervision of an IMS as it can be tricky and she will need monitoring.

I hope you get some answers soon from vets as to how to proceed towards getting Lark feeling better, I agree with Naomi, this must be a big change for her to with your Mom's passing and she is probably feeling poorly. Big hugs for both of you :)

[CaroleLark]

Thank you to everyone for your kind welcome and condolences. I have never experienced so much kindness and help on a board before and Lark and I do really appreciate it!

I will DEFINITELY seek an IMS vet in my area to see what we can do. I have been reading as much as I can about how to taper down the medicine and it is very tricky, people saying weaning themselves off the last 2.5 mg is actually the hardest. So we will take it slowly for sure, though I would love to get that nasty stuff out of her system.

I am shocked and will be telling everyone I know, that when you put yourself or your pets on steroids it must be tapered off. I had no idea! And I have been taking her to her vet appointments for over a year! There were times when my mother (who had cancer) would be rushed to the hospital and stay for a week and a kind neighbor would feed her. At that time, giving her her medicine was spotty at best. No vet ever told me she could have died :eek:

She is making a little progress every day. Last night and this morning, she walked down the stairs and up the stairs without any assistance! It was a huge victory and we all celebrated. It wasn't graceful by any means and her back legs really struggled but she did it!

Still no appetite, just an egg. Lots of water. The hard, distended belly looks like it may be softening, but that could be wishful thinking :) She finally defecated today after two days, and it was very soft stools but I was getting worried about that.

I have always thought the source of the cough was allergy-related. It is a wheezing and a hacking that sounds asthmatic. I have always tried to clean up her diet, but my mother, more especially when she became ill, spoiled her to death with inappropriate treats. We had 24 hour nursing care at her home and the nurses went into overdrive with the bad stuff. So her cough got worse and her Temaril-P dosage went up. I am really going to do my best to get her on a grain-free, mostly raw diet. We had excellent success with it for my cat who was tearing himself up with scratching, and thousands of vet bills later and the only answer: you got it, put him on steroids. I refused and instead started him on a rabbit diet and then added in foods to see which ones he reacted to. It was chicken! And chicken is in everything! So we read labels and he is doing great. I hope the same for Lark.

I unfortunately don't have any blood tests at this time. I will get a hold of those for the IMS. She has been tested for EVERYTHING including lung cancer, you name it as the source of the cough. And yes, those vets made a fortune on us.

I will let you know if there is any more progress and will continue to read whatever information I can. Thank you all!!!!!!!!!!

[CaroleLark]

In case anyone would like to see, here is a link to a photo of our beautiful Lark!

http://www.thesnugbug.com/LarkImage.jpg

[Harley PoMMom]

Oh Lark is absolutely gorgeous!!! Such a sweet face!!!

Here are some links that I hope are helpful: Finding an Internal Medicine Specialist Vet (ACVIM) (N. America and other countries) (http://www.k9cushings.com/forum/showthread.php?t=182) and Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10)

Love and hugs, Lori

[mytil]

Oh your Lark is stunning!!!! Thank you for posting this photo. Glad we could all help out. :)

Please keep us posted.
Terry

[molly muffin]

Oh Lark is a darlin. What a beauty. You might find that many of the issues clear up once you can get rid of the steroids. I know exactly how it is. No one told me about steroids being a problem either and my Golden was on them for years too. Terrible stuff. It can be a life saver in some instances, but you do need to be aware of the potential problems of long term usage, how to wean them off, etc.
The diet change sounds like a good option, narrow it down and find out what it is that is bothering Lark.
I don't think that you'll really know what is going on and If there are problems and what they are till after the steriods are sufficiently out of Larks system. No cushing test would get an accurate result with the steriods in the system. As they are pretty expensive, ACTH, LDDS that isn't something you'd want to do until at Least 30 days of no steroid use.
I'm so glad you found us. We're just one big family where, with people in and out all the time, all hours of the day (since we have members all over the world) and we have happy days and sad days, but whatever it is, we all go through it together.
Hugs,
Sharlene and Molly Muffin

[Budsters Mom]

Wow! Lark is one of the most beautiful dogs that I've ever seen!:)
Thank you for sharing her photo with all of us! I hope you find a wonderful IMS to care for your sweet girl. You're an angel to step in and take over her care. She is very lucky to have you pulling for her.

Hugs,
Kathy and Buddy:cool:

[SoggyDoggy]

Wow! Lark is a real beauty and again so lucky that you are there to step in for her. I think that over time when you manage to wean her off the steroids and sort those allergies that she will bounce back and conquer those stairs! It's interesting that you found chicken as the allergy source for your cat, my two dogs are also allergic/intollerant to it and the more people I speak to that test it out with their pets find they too have an issue. Makes you wonder why it is so frequently used in pet foods doesn't it?

In the meantime, I hope you too are doing ok. Take care of yourself as well.

[doxiesrock912]

Lark is gorgeous!

Steroids are bad news long term. My father was just completely weaned off of prednisone after being on it for more than a year due to complications from radiation/chemo for lung cancer.

Once the steroids are completely stopped, you'll be amazed at Lark's improvement:)

[CaroleLark]

Thanks so much! I will definitely go through this link to find one. I was sharing this information with a neighbor who is also having problems with her vet. It is helping so much.

[Simba's Mom]

Hello and welcome, your Lark is beautiful, she's lucky to have you..sorry about loosing your Mom, lots of changes for you....take care we are here for you...

[CaroleLark]

Wow! Lark is a real beauty and again so lucky that you are there to step in for her. I think that over time when you manage to wean her off the steroids and sort those allergies that she will bounce back and conquer those stairs! It's interesting that you found chicken as the allergy source for your cat, my two dogs are also allergic/intollerant to it and the more people I speak to that test it out with their pets find they too have an issue. Makes you wonder why it is so frequently used in pet foods doesn't it?

Yes, we were very surprised because the original vet prescribed poultry only as the diet to start with. Finding this out has saved our cat so much suffering. I do wish vets knew more about the power of changing the diet before giving these powerful drugs. There are just too many side effects.

And thanks to everyone for the compliments on our beautiful girl. She is sadly not looking her gorgeous self right now as that picture was taken a year ago. But she still gets a lot of attention whenever I take her out and has one of the sweetest dispositions I've ever seen in a dog.

I'm so happy to have found this forum and all the wonderful care and support. I will definitely keep you posted and will probably have more questions. She ate a little solid food today and was cheerful on her walks. It's up and down, so we're supporting her and celebrating all her victories. Just hoping to make her as comfortable and healthy as possible for her final years as she is such a lovable dog.

[Squirt's Mom]

Makes you wonder why it is so frequently used in pet foods doesn't it?

I was taking part in a conversation about this recently and the general consensus seems to be that the reason we are seeing more and more dogs allergic to chicken is precisely because it is and has been used in dog feeds for years and years and years regardless of the brand or stated flavor on the front of the package. Many feeds that claim to be duck or beef or lamb also contain chicken in some form or the other such as meal or fat along with the duck/beef/lamb/etc. So our pup's systems have been bombarded with chicken almost from day one. This is why nutritionist like to try a novel protein, a meat source the pup has never had, when allergies seem to be rearing their heads. Rabbit is an excellent choice for this and I am excited to see you knew to try this and recognized what you saw with the change. Way to go, Mom!

[CaroleLark]

I was taking part in a conversation about this recently and the general consensus seems to be that the reason we are seeing more and more dogs allergic to chicken is precisely because it is and has been used in dog feeds for years and years and years regardless of the brand or stated flavor on the front of the package. Many feeds that claim to be duck or beef or lamb also contain chicken in some form or the other such as meal or fat along with the duck/beef/lamb/etc. So our pup's systems have been bombarded with chicken almost from day one. This is why nutritionist like to try a novel protein, a meat source the pup has never had, when allergies seem to be rearing their heads. Rabbit is an excellent choice for this and I am excited to see you knew to try this and recognized what you saw with the change. Way to go, Mom!

I love that your dog is named Squirt. It just cracked me up when I saw the picture. He/she must be so much fun.

I agree that chicken is in everything! Once you start reading labels it's a big eye opener. And while I do have trouble switching my cats over to a purely raw diet, I'm hoping Lark will be a little better. I think the other problem is chickens are raised now in the most appalling conditions, with drugs and antibiotics and growth hormones and now GMO feed. That goes straight into their livers which is then put in pet food. I don't eat commercial meat or eggs for that very reason, so I'm sure it can't be good for my pets either. We have had no problem with duck though, don't know how that is different.

I am very hopeful for what people are saying about coming off the steroids and improvements. I looked at her today and she is a lot less puffy and her pot belly is definitely shrinking. Everyone here who has to deal with this terrible condition for their beloved pets I so feel for. It's so sad to see how uncomfortable they are. A well-meaning neighbor suggested that instead of dealing with the hassle and bills of taking care of her I should put her down. Well that is something I would never do. So I told Lark that when she is feeling better and her coat improves, we're going to go down for a visit and show off!

[CaroleLark]

I must also add to anyone considering feeding rabbit, that it is only short term because rabbit is very low in fat. Which may sound good, but fats are very necessary for fat-soluble vitamins. Native Americans used to refer to 'rabbit sickness' because if you couldn't find any big game and only ate rabbit for a while, you would start wasting. Just a note.

[SoggyDoggy]

A well-meaning neighbor suggested that instead of dealing with the hassle and bills of taking care of her I should put her down. Well that is something I would never do. So I told Lark that when she is feeling better and her coat improves, we're going to go down for a visit and show off!

:eek::eek::eek::eek::eek::eek::eek::eek::eek::eek: :eek::eek::eek::eek::eek::eek::eek::eek::eek::eek: :eek::eek::eek::eek::eek::eek:

I'd say not only show off but add a big fat "Told you so!"

Oh My Days! Some people just don't get it! :confused::confused::confused::confused:

As for the comment about rabbit, thanks for that. It makes sense now why we down under can't feed our dogs Kangaroo for too long either, same deal with very low fats. It's used for elimination diets a fair bit, but I could never do that with my boys. They tend to get it at least once a week or fortnight, they love it. :D They've never had rabbit though (they try to charge $25-$30 per kilo for it here!)

Great news that you are seeing some improvements in Lark too, give her time and she will be a stunner once more. Take care.

[CaroleLark]

I was a little taken aback that someone thought killing an animal was a good option. :confused: But I guess some people don't really see pets as that important.

And that is interesting about the kangaroo. I wouldn't have guessed it was low fat, but then I guess it makes sense because high-fat animals are usually slow.

I can't wait to show everyone the new and improved Lark! Plus my husband, who is being a great sport about the whole thing, really likes taking her for walks and I know once she's able to go for nice long ones, he's going to fall in love with her.

[Budsters Mom]

Yes,
Several People have told me the same thing about putting Buddy down!:mad: They don't know what the heck they're talking about!:mad: They love to offer advice but, are not supportive. I am surrounded by those types of people! I have found all the support I need in this very special family known as K9Cushing's. We are here for you too! Yes, your husband will fall in love with Lark. How can he not?:)

Love and Hugs,
Kathy and Buddy:cool:

[CaroleLark]

I'm so sorry that people are not supporting you as you work so hard to keep your furbaby healthy. People do look at you like you're crazy or have some displaced motherly love. I guess they don't understand pets are part of the family and I would do no less for my pets than any relative. Oh well, they're missing out on a lot of love. I'm glad you find support here to help you in dealing with a chronic illness such as Cushings. It's a wonderful community.

[mytil]

I surely am glad you are seeing an improvement in Lark!!! I know everyone here is pulling for your sweetie pie.

I am sorry some people just do not get it, Kathy and Carole. Believe it or not, I had a heart specialist (for my Clancy boy years ago) who told me (while treating Clancy) that his wife had an Australian Shepherd too who was in the early stages of heart problems (she was a canine heart specialist too) and her dog was only 5 - so put her down instead of treating...they come in all colors don't they. Well, we all know better - they are worth everything we are able to give them.

Keep us posted
Terry

[molly muffin]

Yay for improvement for Lark. :) As Lark gets better and better I bet your husband will have found a new constant companion for his walks. A fine showing they will make too I'm sure. :)
Hope every day gets a bit better. It's the little things in life sometimes that give us the greatest joy.

hugs,
Sharelene and Molly Muffin

[CaroleLark]

I surely am glad you are seeing an improvement in Lark!!! I know everyone here is pulling for your sweetie pie.

I am sorry some people just do not get it, Kathy and Carole. Believe it or not, I had a heart specialist (for my Clancy boy years ago) who told me (while treating Clancy) that his wife had an Australian Shepherd too who was in the early stages of heart problems (she was a canine heart specialist too) and her dog was only 5 - so put her down instead of treating...they come in all colors don't they. Well, we all know better - they are worth everything we are able to give them.


Wow, that's a sad story. I could see if the pet was very aged, not wanting to do painful or risky surgery and likewise with treatments but 5 years old? Not a ringing endorsement of their healing talents!

[CaroleLark]

Thanks Sharelene and Molly Muffin! Healing wishes back to you as well! One day at a time. Caring for loved ones in need is the important stuff fo sure.

[mytil]

Wow, that's a sad story. I could see if the pet was very aged, not wanting to do painful or risky surgery and likewise with treatments but 5 years old? Not a ringing endorsement of their healing talents!

Needless to say, I never went back to them after Clancy passed away 9 days later (way back when). I steer people away from them as often as I can, even to this day.

Again sure am glad Lark is feeling better (and so are you).
Terry

[Trish]

Hi - so glad to hear Lark is feeling better.

Thanks for the tip on the rabbit, my dog has been on low fat meat for a few months, not rabbit... but possum and venison. I wonder if that is causing some of his problems with bowels. Hmmmm will ponder that a bit further, this is what I love about this forum, always picking up tips like this!

Hope Lark continues to improve :)

[CaroleLark]

Hi - so glad to hear Lark is feeling better.

Thanks for the tip on the rabbit, my dog has been on low fat meat for a few months, not rabbit... but possum and venison. I wonder if that is causing some of his problems with bowels. Hmmmm will ponder that a bit further, this is what I love about this forum, always picking up tips like this!

Hi there! I've never heard of possum, that is so interesting! Are you feeding raw? I don't know extensively about dogs yet but I do know it's very important not to use prevailing wisdom for humans on pets. The whole grains, low-fat thing is deadly for pets and it is used to make dog food, with the worst but cheapest ingredients such as grain and corn and vegetable oils, sound healthy. Dogs fortunately are omnivores to an extent, so getting their nutrition is easier than cats which must have certain vitamins and are "obligate carnivores" so they only need animal protein. I do mix a special vitamin powder with my cat's food when I make the raw.

Dogs need things like raw meaty bones and organ meats. Which made me think because I remembered this book, I just looked up the website and found it here. I'm going to check it out when I get a chance.

http://www.rawmeatybones.com/

I was so surprised to hear that pets need to eat whole bones. My mother would always warn us, never give bones brittle bones to the dog because she could choke! I didn't know that is only cooked bones. But as I get up to speed and learn more on the optimum diet for dogs, I will report back.

But yes, animals do need fat, in fact once you cut all the grains out of the diet they need a good amount. I was speaking with our vet's aide one time and he was saying he couldn't believe how many diabetic pets he was seeing now. How they all looked unhealthy, bloated, arthritis, all the diseases of civilization that are exploding in humans. It must have some common denominator, it can't all be genetic. And because the adrenals and pituitary glands are part of the endocrine system, I can't help but wonder at all the things that whack out the hormones like steroids & antibiotics in livestock feed and soy isn't contributing to problems as well. It is in humans.

So thanks, it's so cool that people are interested in this as well. Feeding raw is so much work, it better be worth it. And I do admit, I don't have time to do 100% and depending on my work schedule is how much we do. But we have eliminated dry food which is the worst offender and supplement with good canned food or the premade raw diets (which sadly cost a fortune). But I have high hopes that Lark will be a lot easier to switch over than my cats!