9 Year Old Maltese with Cushings

[KennyJ]

I wonder why none of the vets have recommended to do an ultrasound on Gracie. Sorry, as you can tell I am still researching like crazy. I mean what if I spend over $2000 on the ACL and it turns out Gracie has some form of cancer?? I realize the leg has to be taken care of but these are the kinds of things that continue to race through my mind.

[molly muffin]

Wouldn't one of your vets have mentioned it if they thought that cancer was a possibility.
I don't know why no one has suggested an ultrasound, other than it's expensive and usually it is done by an IMS specialist. So far you've gone to vets, but not a specialist. It is possible that before surgery that they would do an ultrasound, but I don't know since it's an ACL tear if they would or not.
Cost is one of the largest factors in why people don't get them done more often. I don't know what they cost where you are.

Sharlene and Molly Muffin

[KennyJ]

I was talking about ultrasound of her liver. Keeping my appointment with the Vet School on Wednesday.

[molly muffin]

Yes, I know you are talking about liver, and I don't know why they wouldn't have suggested it. My vet didn't suggest it either. I requested it, just as I requested a referral to see an IMS for a consult. My vet wanted to start medication for cushings, which would be a bad idea if she doesn't have it.

See what the vet school says.

Sharlene and Molly Muffin

[KennyJ]

Sharlene, as always thank you. One of the things the Vet said that did the xrays was it looked like she had thickening of the intestines. He mentioned leukemia which of course frightened me.

[molly muffin]

I am surprised that with thickening of the intestines they went straight to leukemia.

Just for your information, these are some of the symptoms of canine leukemia:


ymptoms of Leukemia

Owners of dogs with leukemia may notice one or more of the following clinical signs:

Fever
Lack of appetite (inappetence; anorexia)
Weight loss
Weakness
Lethargy
General malaise
Abdominal pain (gastrointestinal disturbances)
Abdominal distention
Vomiting
Diarrhea
Pale mucous membranes (pallor)
Enlarged lymph nodes (lymphadenomegaly; lymphadenopathy; usually mild)
Enlarged spleen (splenomegaly; usually marked)
Enlarged liver (hepatomegaly)
Bleeding disorders (internal or external hemorrhage; nose bleeds [epistaxis]; unusual bruising)
Lameness (with bone involvement)
Dehydration
Difficulty breathing (labored breathing; dyspnea)
Elevated respiratory rate (tachypnea)
Elevated heart rate (tachycardia)
Increased frequency and volume of urination (polyuria)
Increased thirst and water intake (polydipsia)


Any sort of gastrointestinal irritations and inflammations, that are ongoing, long standing (happening over a longer period of time) can cause the lining of the intestines to thicken.

Sharlene and Molly Muffin

[KennyJ]

So was I. She has some of those symptoms but I know one thing for sure. She does not eat excessively nor does she drink excessively. So far 15 ounces of water is the most she has drank when I put it down in the morning and take her to bed at night. She never gets me up during the middle of the night wanting to go out. And she has left her food in her plate all day without eating it. When I get home she eats it. For some reason Gracie likes to eat when I am home with her. Once the Vet School visit is complete I will be looking for another Vet. Right now I have very little faith in any of them. I still do not understand why my regular Vet never suggested any lab work during any of her annual exams. It's not that expensive to have a CBC with chemistry profile completed. I mean we as humans have lab work with our yearly exam, why not our animals. If I sound bitter you are right. Right now I am very confused and angry. I am thankful I found this group or else I would be worse than I am now. I don't sleep, stay on the computer researching day and night for Gracie. Another thing that has always concerned me about Gracie. Any of the toys I purchase her, even the ones that say dogs can not destroy them she manages to do just that. She has the stuffing and anything inside that makes it squeak out in a matter of minutes. I have always worried that she has swallowed something.

[KennyJ]

Nice surprise. Drove all the way to work only to find out Gracie's appointment with the Vet School is today. Just returned from the Vet School. The surgeon said she did have a torn ACL but she said to restrict Gracie for 6 weeks to see if it gets well.

[molly muffin]

So the surgeon thinks if that 6 weeks of restricted activity can help it and she won't need the surgery?

That would be nice. Did they give you detailed instructions for the restriction? Are you feeling better after talking with the people at the Vet School?

Sharlene and Molly Muffin

[KennyJ]

Sharlene, that is what we are both hoping for. I thought for sure going to an orthopedic surgeon she would want to do surgery. I was quite surprised when she suggested this but at the same time very happy. She said dogs under 30 lbs can get better from an ACL tear, at least 85% will. I am hoping Gracie is in that 85%. And luckily my friend who is the internal medicine doctor at the Vet School just happened to walk by. We talked briefly about the possibility of her having Cushings. He said that any of the regular Vets where I live can test her for that and if she tested positive they can get it under control. He was very positive. I am not happy with the Vet that performed the xray wanting to do surgery within 10 days and said she most definitely needed it. Its not to say she won't end up having surgery but this coming from a specialist suggesting restriction makes me feel better. We will see. Oh yeah, the surgeon said although she didn't know that much about Cushings that Gracie did look like a dog that could possibly have it. Her undercoat was quite thin, something I have never paid any attention to. If you brush her hair back you can see that. She still doesn't have the excessive drinking or eating though.

[molly muffin]

Well not all dogs have the same symptoms. I do hope Gracie is in the 85% too. I feel good about what this specialist said. Sometimes I feel that it is just better to save your money and go to the specialist. I did read today that other hormones being elevated (besides just cortisol) can cause Very high ALP readings. So Gracie immediately came to mind. Now I am thinking that they might be referring to the intermediary hormones and the only place that tests for that is UofTenn. You do an ACTH test like normal and then it is sent to Uof Tenn for their testing. At least I think that is how it works. Others on here know more about that. Of course the cortisol is not usually high with that, but the other hormones are and the symptoms are the same, but maybe not all of them, since it's different hormones than the cortisols.
Just something to consider that came to my attention about the really high ALP today.
Still first things first and that is getting that leg better so then we can look into cushings and hormones further.
This is good Kenny and now you can get some sleep!!! :)

Sharlene and Molly Muffin

[KennyJ]

Sharlene I won't rest until I can get the leg healed so we can test for Cushings. I still can't thank all of you enough.

[Roxee's Dad]

That's great news Kenny. Now the task at hand is keeping her restricted. Any slip ups could ruin all the healing to date so keep vigilant and keep a leash on Gracie so she doesn't take off running or jumping.

6 weeks will go by before you know it. We will be standing by waiting for good updates :D:D

[mytil]

Am very glad to hear some concrete news here about Gracie's leg. And a plan of action is in place. Actually to me, it is a smart surgeon to look at alternatives first maybe making surgery unnecessary.

Keep in mind, Cushing's can be slow progressing and one cannot completely diagnose typical Cushing's with just a visual of the coat when no other symptoms are present - just cannot happen. So with your vets and your friend (all due respect to your friend) I would just take this into account....it would be like saying heck, you look tired Terry, so there is a good possibility you have cancer or some form of malignant tumor...cannot happen without testing and hard confirmation.
(actually I just work way tooo much and am sleep deprived :D )

Keep us posted
Terry

[KennyJ]

John, I have watched her like a hawk. However, this morning I put her down gently on a rug, get out the leash and just like that she takes off running and slips on the hardwood floor. I just close my eyes and go NOOOOOOOOOOOOOOOOOOOOOOOOO. I ordered a pet pen that I will set up in the living room when I am with her during the day. That way she can still be with me but have limited access to the house. During the day I have her in a very small bedroom. I do believe she does better the longer I am away. Of course she doesn't see it that way but for her leg I believe she gets more rest when I am not there with her.

[KennyJ]

Thanks Terry. Can't wait to get this leg healed and it still may mean surgery. But like you I was actually surprised this coming from an orthopedic surgeon recommending rest first. If I had listened to the Vet that performed the xrays she would have already had surgery.

[Budsters Mom]

I am happy to hear that you are finally starting to get the answers you are seeking and are now able to plot a course of action for Gracie.
We all worry about our fur babies so much!

Hugs,
Kathy

[molly muffin]

ack, they are great escape artist. When you get the pen, you can use those furniture felt strips on the bottom like you put on chair legs, so they can slide and not scratch. Also looks like you'll have to put the leash on before you put her down as she is ready to move immediately and thats not good for her.
Get a pair of long panty hose to put under her belly when you take her out to potty, then as soon as she is finished, lift up preventing her back legs from doing the kick off of a successfully number 2.
Tips of the ever creative parents on k9cushings.

You can do this Kenny!!
sharlene and Molly muffin

[KennyJ]

Sharlene, if I can just get someone to go purchase me a pair of panty hose. :)

[labblab]

Hey Kenny, if my hubby was willing to go out and buy me once-a-month you-know-what :eek:, I know you can man-up and go buy some panyhose for Gracie! :cool: :) :p

Marianne

[molly muffin]

You got your husband to do that! What a guy! :D

Have you seen the photo fad out of china of dogs Wearing pantyhose?! :eek::eek: That just seems cruel!

You can do it Kenny, I have faith in you. :) Can't ask Gracie to go in by herself, she'll come out with dog treats and everything else and forget the pantyhose. :D:D

Sharlene and Molly Muffin

[Roxee's Dad]

Should he get the shear, nude, with toes or without toes, control top... oh it's too confusing. :p

If you have a scarf, those work nicely and I remember one of the members here said they used one of those reuseable grocery bags, you know the cloth ones. They already have handles and you just need to cut out the sides and viola, instant Gracie support carrier. You can get them at any grocery store. They are wide enough to give her some good support around the belly.

But then again, I do remember Joe Namath, QB for the Jets wearing panty hose in a commercial. :p

Give that Gracie a little belly rub from me. :)

[frijole]

:D:D:D:D:D This thread is getting good. :D:D:D:D:D

That idea of using a cloth grocery bag is an awesome one because they can hold the weight and the handles would be so much easier. You can buy them at most grocery stores if you haven't received a freebie one. Kim

[molly muffin]

hmmm, yes the cloth bags would offer support, but then you'd have to walk with her all bent over. Kenny, I'm assuming you have some height on you? Then she'd probably think he was being all weird and wonder what he was up to. :eek:
I'd go with a reinforced support hose, extra tall. :D That way he could act like he wasn't really doing anything strange and she'd still poop and he'd catch the kick off before it occurred. ta da!

Of course Kenny, you could try both ways and report back on how each worked. We'd want all the gory details of course. :)

Sharlene and Molly Muffin

[frijole]

You gotta video this! :D

[Roxee's Dad]

How could I have missed "reinforced support hose" LOL

[Budsters Mom]

Well Kenny,
Did you man up and get Gracie her panty hose????:D Remember to video this for all to see!;)

Hugs,
Kathy

[KennyJ]

:) Thanks guys for bringing me a much needed laugh. No I have yet to purchase the panty hose. John gave me so many choices that I am now undecided.

[frijole]

:) Thanks guys for bringing me a much needed laugh. No I have yet to purchase the panty hose. John gave me so many choices that I am now undecided.

OMG! Just go buy the first pair you see and run to the counter and out the store door. I do think Gracie would look good in pink so maybe some pink tights would be good? LOL

[Roxee's Dad]

So you get a good idea of what the support sling should be doing.... The real deal. ;)


http://www.drsfostersmith.com/product/prod_display.cfm?pcatid=8082&cmpid=01csegpl&ref=6111&subref=AA&CAWELAID=525387060&catargetid=1570180291&cagpspn=pla

http://www.gingerlead.com/


Pantyhose !!! :rolleyes:

[molly muffin]

Gee, now I'm kind of stuck on the hot pink tights thought. :D:D

[KennyJ]

Wow, I am seeing more and more that Gracie does have accidents in the house. I just had her out and went to pick her up and she was wet. Looked down in the floor and she had peed in the floor. I just got her report back from the Vet School and they said she had a ruptured CCL. It also mentioned thin hair and some scaly skin. Said she was overweight but here's the thing. I only feed her a 1/4 cup twice a day. That should not be causing her to gain weight. She weighs almost 13 lbs. She has anywhere from 7-15 small to medium size lumps under her skin. Looking like more and more that she has Cushings. Still limping.

[Roxee's Dad]

Hi Kenny,
It very well may be cushings. Muscle wasting around the abdomen would most probably be the cause for the pot belly.

Stay the course and let's get Gracie through this. Hopefully with due diligence, her knee will be healing up in a few weeks.

Did someone ask you to pick up Pink Pantyhose??? :eek::eek::eek:

[KennyJ]

Lol no panty hose yet. Can someone explain how I can keep her at a healthy weight? Gracie only gets a 1/2 cup of food a day.

[Roxee's Dad]

That's a tough one Kenny. First I would ask if it's a good quality dog food where corn is not the first ingredient. Check the contents of the dog food. does Gracie get any treats or human food? :p

I have asked quite a few vets and by their own admission are not really trained in nutrition. Just a minor course in their training. Maybe you can contact a canine nutritionist or someone here in the forum can help.

Obviously Gracie can't exercise for a while, do you have access to a swimming pool. Swimming is great exercise and no weight is put on the injured leg. lose weight and build up muscle.

[Junior's Mom]

On the container of dog food you buy should be a list of total calories per cup, as well as a chart recommending how much to give her according to her weight and energy level. If she is not able to get any exercise, you would go by the low end of the chart. Total calories can vary greatly between different foods, usually the better the quality, the lower amount you feed.
Swimming is good exercise as it keeps the weight off the joints. An omega 3 supplement is wonderful for inflammation.

[Budsters Mom]

The biggest question on all of our minds is, Where are the panty hose?????? :D

[KennyJ]

Gracie eats one of the very best dog foods on the msrket. Fromms Whitefish with potato. Feeding guidelines is 1/2 cup - 1:1/2 cup a day. She is only getting a 1/2 cup a day. This food is very low in fat.

No panty hose yet.

[molly muffin]

Kenny, I just know I am going to have to drive down there and take you shopping. :)
How is Gracie doing? Are you able to prevent her from doing her kick off?
Yes I agree, Fromms is definitely one of the best out there.

Sharlene and Molly Muffin

[KennyJ]

Sharlene the last few days I have been able to keep her from kicking. I still cant figure out how you can heal a ruptured CCL with just rest. Makes no sense. What does scaling mean? That was listed on her report. I certainly do not see any scaling. This having to wait to get her tested is making anxious.

And yes please take me shopping.

[molly muffin]

Kenny, what exactly does it say about scaling? skin? It usually means that there is some loose skin, which some could see as dandruff, allergies can cause it, etc. You might try some coconut oil on her skin if you see some patches.
I know it worries you not to be able to test right now, but it is a waste of money to test when the results could be false and you'd have to do it all over again.
Well, the idea is to build up scar tissue that holds everything in place, but any sort of exercise, erodes that scar tissue and you're back to square one of trying to rebuild it all over again. It's not like with humans were we are aware of what we can and can't do and what will help to heal it the best and when to stop. Dogs are all out, exuberance, and they'll just go and even when they hurt themselves, keep on going. They never read the darn manual.

Sharlene and Molly Muffin

[KennyJ]

So is she not supposed to walk on that leg at all?? Thats impossible. I carry her down the steps but when I am with her in the house I let her walk around with me.

[molly muffin]

She can walk on the leg, but no running, jumping, etc, that could damage the progress being made.

[KennyJ]

Running and jumping I have pretty much under control. Paid $60 for a pet play pen but its too tall to set up in the living room. During the day I keep her in a small bedroom. When I am with her she stays on the recliner with me.

[Budsters Mom]

Kenny,
Buddy had surgery on his upper thigh in 2010. He had to have complete rest. That means zero walking!!!! He had to be carried out to do his business and carried back in. He had to crated or kept in a very small room at all times, unless he was leashed right next to me. It was horrible for both of us and next to impossible because I was still working. I had to take a couple days off and a friend came over stayed with him I while I worked for a couple of days. The rest did work and he was up and around in no time. When a doctor says to rest the leg, legs, hip, or whatever? That usually means to stay off of it. You might want to verify with your doctor, but I wouldn't let Gracie walk any more than completely necessary to potty herself until you know for sure. As regards to exercise....Swimming is terrific for building up muscle without putting pressure on joints or legs. We are back to the pink panty hose. Panty hose works great to hold them in place while they swim. It keeps their heads above water. They don't really go anywhere, but their muscles get a workout. BUY THE PANTY HOSE KENNY. You might wan to pick up a couple of pair. Maybe a nice lavender too!:D

Hugs,
Kathy

[KennyJ]

Gracie peed in our bed. This is not a good sign.

[SoggyDoggy]

Hi Kenny,

One of my dogs (Oscar) ruptured his ACL in his right rear leg last year. We were under strict instructions to minimise all activity as much as possible, so where some light walking is ok, try to minimise Gracie's movements around the house and yard as much as possible. Definitely no running or jumping as you are already doing, but minimal movement as well for at least 4-6 weeks will give the ligament a chance to heal. We ended up having to do surgery - he ruptured both anterior and posterior ligaments in the same knee, so there was basically nothing holding it together, but then after surgery we had a 9 week recovery period where he basically wasn't allowed to move for the first 4. I carried him everywhere, even fed him in his bed. When I wasn't around, he had constant supervision by others, or for short periods was crated. It's the only way to give the tissue time to repair. After 4 weeks he was allowed to walk outside, but it was still another 2-3 weeks before he was allowed to resume normal walking around the house, and another 2-3 after that before we started gentle walks at the park and light swimming again. It was then a good solid 6 months before I could say he was using his leg normally.

Of course, full recovery will depend on how bad the rupture is. If it's partial, it can repair itself pretty well, it's only when it's a full rupture that you face problems. If the ortho surgeon said try rest first that is your best bet, but that basically means strict confinement. I found with Oz that he would do really well for a week, then would do one thing when I wasn't watching and it would set us back another two weeks. It's a slow process, but if you want it to succeed, you absolutely have to make sure to limit any and all movement as much as possible.

As for Gracie peeing in the bed? Maybe her leg was sore and she didn't want to move. Blame it on issues you know exist, not ones you aren't sure of:p

[KennyJ]

So is it ok having her in a small bedroom during the day while I am at work??

[SoggyDoggy]

Yep, just try to keep her as confined and quiet as possible, for as long as you can. It is so easy for them to do more damage as they don't grasp what's going on until it hurts. It's hard for sure, but it's worth it long term.

[KennyJ]

Wow, I am reading some of the other posts where people lost their beloved pet and I am just heartbroken. It makes me that much more concerned for Gracie. Her little nose is so dry and cracked. Now peeing in the bed??? There was a spot there the other day in our bed and I thought it was from where she licks her paws all the time. She peed in the floor minutes after I just had her out. All the signs.

[molly muffin]

This is true, she is now showing more of the signs, has she also increased her drinking?

Keep in mind, that trying to treat her now, even if the test were reliable positive, will also increase her pain level, as cortisol keeps the pain manageable for her. It's a rough catch 22 in some ways.

Sharlene and Molly Muffin

[KennyJ]

Just came back from Gracies laser therapy on her leg. The vet took a urine sample to see if she may have an infection because she wet the bed. The vet said her urine was not that diluted nor was it that concetrated. Sort of right in the middle. Said it was something to watch for and that it could indicate Cushings.

[molly muffin]

Dilute urine is an indicator of cushings normally and is a result of the excess water they drink. My first thought with pee accidents is to usually check for a UTI and any crystals.

Sharlene and Molly Muffin

[KennyJ]

She said it didn't show an infection unless theres another test that should be run that the vet didn't do. Just said right now it was sort of in the middle. Something to keep an eye on. I haven't noticed any difference in water consumption. Panting may have increased but even thats hard to say. She pants like crazy when she gets excited. One thing that was different last night is that I couldn't sleep so I was up and down all night. Thats when she wet the bed.

[molly muffin]

She might have felt that you were upset or just not being settled and that would cause her some anxiety. Normally she probably sleeps through the night and doesn't give it a though to having to go to the bathroom.

No, no other test, if this one is negative.

Sharlene and Molly Muffin

[KennyJ]

But if her urine was borderline diluted she is still showing more and more symptoms.

[molly muffin]

Yes, I understand that it seems that she is showing more.
Normally I'd say go ahead and test for cushings. I just don't want you to throw away any money. Plus she might need that cortisol with the bad leg too.
Have you started her on the liver supplements yet?

Sharlene and Molly Muffin

[KennyJ]

Sharlene I started them last week. Its tough not having her greet me at the door. My nerves are shot.

[frijole]

You are doing the right thing and it's tough but you are doing it for her. My mom has a diabetic schnauzer that had a torn ACL. I tried to get her to take the dog to my vet who specializes in orthopedics but she elected to stick with her regular vet.

I was shocked to find out that after the surgery they just let her run the house and there was zero instructions to crate her, isolate her etc. It healed a bit but she would never regain it 100%. And a couple years have passed and poor Jessie pretty much walks on 3 legs. She is getting old and I fear so much for her because this just didn't have to be.

So any time you are feeling sorry for your girl imagine how much worse seeing her hopping all the time would be. Trust me it is worth every single minute of healing. Kim

[molly muffin]

I know it is hard Kenny, but hopefully the steps you are taking now, will allow her to be able to run to the door to greet you for a long time to come.

Sharlene and Molly Muffin

[KennyJ]

Thanks for the encouragement. Right now I need all I can get.

[Roxee's Dad]

Hi Kenny,
Patience is key here and we know how hard that is. :p The peeing in the bed may have just been an accident, could be her knee really hurts and she didn't want to get up, could be she was just nervous because you were not in your regular routine.

I couldn't agree more with Kim and Sharlene, it's a little discomforting now but it will pay off in the long run. If we keep Gracie quiet and resting, that is healing time. 6 weeks will go by before you know it... heck a week has already gone by. ;)

[KennyJ]

Looking ahead. I know I do not have a definite confirmation of Cushing's yet but it does seem all signs are pointing in that direction. Of the medications they have listed now to treat this disease which is the safest? And how do they determine the dosage? Gracie weighs around 13 lbs. Something else I noticed too. Each time Gracie has been given the laser treatment she starts to limp more. Does laser cause the tissue to become sore?

[Trixie]

I hope Gracie is feeling okay today. If you do end up getting the Cushing's diagnosis and if you chose Trilostane my advice would be low and slow. Trixie is 14 pounds and we started on 6mg twice a day, and then went up to 7mg 2x. Now we are moving to 9mg 2x. We went very gradually and the symptoms started to decrease after 2 weeks on the 7mg but still the numbers are high. We have avoided side effects so far by going low and slow and Trixie has been acting pretty much normally all along so far.
Of course you have Gracie's knee issue to contend with so you may not be starting anything with Cushing's just yet but if/when you do avoid overdosing by staying close to the 1mg per pound dosing.
Barbara

[KennyJ]

Is Trilostane always given twice a day?? Is like the other drug that is similar to chemo?? I hope not.

[labblab]

Kenny, I'll come back later to talk more about the Cushing's stuff, but first remind me as to who is doing the laser treatment? Does the surgeon know about this? Is it somebody she recommended?

Marianne

[Budsters Mom]

Take a big breath Kenny and exhale slowly. Now do about 5 more of those. I'll wait!!!;) Okay now, we have experts who can give you endless information on both drugs used for Cushings, so don't worry about that now. Right now, let's focus on Gracie's leg, ok? I know your brain is bursting with informational overload. It happens to me too, particularly when I feel stressed. Hang in there with us Kenny. It will be okay. NOW WHAT ABOUT THOSE PANTY HOSE:D

[KennyJ]

Marianne, it's another vet in Roanoke, Va that is doing the Laser. I did mention it to the vet school doctor but she didn't say anything either way. After reading another vet's comment on Cushings just now my heart just took a nose dive. My friend the IMS at VT said Cushings could be treated well but this guy really depressed me. Grant it the response to the question was a while back but he sure painted a bleak picture.




Expert: bigislandvet replied666 days and 2 hours ago.

I'll try to answer your questions in a semblance of your order of asking them! Yes, Cushing's is a fatal disease (there is an expiration date (!)) - 90% of the cases are due to a tumor of the pituitary gland and 10% are due to a tumor of the adrenal gland - if the hypercortisolemia produced by either of these tumors doesn't eventually kill my patients, the primary tumors will. Life expectancy is 1-3 years after diagnosis.

[labblab]

Kenny, if Gracie's leg is worse after the laser treatments, I would contact the vet school surgeon and specifically ask her if she thinks it is OK to continue them. I do not think it sounds good for her to be worse afterwards.

As for that Cushing's quote, good grief!!! Where on earth did you find that -- it looks as though it is over two years old and leads off with a couple of bone-headed comments. "Life" itself is a fatal disease since we all end up dying some day! As I say, more about Cushing's later. But please stop scaring yourself silly :o. We have tons of success stories right here at k9cushings.com! ;)

[KennyJ]

Found it when I was researching the medications used to treat Cushings. Needless to say it didn't do much to encourage me. Here is the surgeon that examined Gracie last week. When I asked Dr Leib about Cushings while at the vet school he seemed very positive about the outcome of dogs being treated for Cushings. He also said he wasn't needed that the regular vets could handle this. However, after getting the different opinions on her leg I am having my doubts about that.



http://www.vetmed.vt.edu/org/dsacs/faculty/barry.asp

[labblab]

Kenny, I see that Dr. Berry (the surgeon) has an email address listed. Did she tell you whether or not you could email her questions now while you are hoping that Gracie's leg will heal?

If so, here's a couple I would ask her:

1) Does she think the laser therapy is OK to continue even though Gracie limps more afterward?

2) If Gracie does have Cushing's, does she think that will either slow down Gracie's healing now or complicate a future surgery if the Cushing's goes untreated in the meantime? From her perspective, would she prefer that you test now, or wait?

I think the surgeon's answer to that second question may help you decide whether or not to go ahead with the Cushing's testing sooner rather than later. As you can see, normally we tell people to hold off on testing when there are other illnesses or problems going on, especially because the other illness can affect the tests. But if there's a particular reason why it seems important to know about the Cushing's sooner rather than later, that may affect your testing decision.

Marianne

[KennyJ]

Marianne, about the only thing all the vets agreed on was take care of the leg first. They didn't give a reason. Last night Dr Wilson took a urine sample to see if Gracie had an infection since she wet the bed. That was negative but she said Gracie's urine was somewhat diluted but not at the low end, whatever that means. Said it was something that could point towards Cushings. I guess I am just really impatient. Right now I have spent $1500 and that's just on her leg.

[KennyJ]

Dr Barry just responded.



Hi Mr. Jarels,

It's hard to say whether it's normal because laser therapy for cruciate
rupture is so new - we have barely any experience with it (and I
personally have no experience with it). If Gracie only limps a little
more for the rest of the day and seems back to baseline by the next day, I
wouldn't worry about it. It's worth mentioning the limp to Dr. Wilson to
see what she thinks - she has more experience with laser than I. It may
be that something about the way the laser is performed, or the way Gracie
is handled at the time of the laser appointment (sedated? Manually
restrained?) could be changed also in a way so that Gracie doesn't limp
afterwards. My overall impression is that the laser itself shouldn't hurt
Gracie's knee and you should be OK to continue. However, if Gracie is
lame for more than a day or so after treatment and/or if Dr. Wilson is
worried about this sign at all, you might discuss the pros and cons of
continuing the laser treatment.

I'M glad you have Gracie in the enclosed space. Remember, even if Gracie
starts to walk 100% normally, do not challenge her knee until it's had
time to heal! Make sure you keep her restricted for AT LEAST 6 weeks even
if she doesn't look like she needs rest any more. Also, once the 6 weeks
is done, bring her back to normal activity REALLY SLOWLY (I.E. over a
month at least).

I'm not the best person to comment about Cushing's. But if you are
becoming more concerned about it, I think it's OK to have Gracie tested
for Cushing's sooner - even before her knee has healed. We might choose
to not treat her quite yet if she has Cushing's, but at least you'll know
whether she has it or not instead of the thought hanging over your head
like this.

Thanks for the email - it's nice to hear about Gracie!

- Sabrina Barry

***************************************
Sabrina L Barry, DVM, DACVS
Clinical Assistant Professor, Small Animal Surgery
VA-MD Regional College of Veterinary Medicine
DSACS, 206 VMIA, Duck Pond Drive (0442)
Blacksburg, VA 24061
(540) 231-4621
barrysl@vt.edu

[KennyJ]

Marianne, did you read what the surgeon said?? Not sure what to do now.

[labblab]

Kenny, good job writing to Dr Berry! I can't believe you wrote and she answered so quickly! But if she doesn't think the Cushing's testing or treatment is a priority from her perspective, then it seems as though it is OK to wait until a time when the tests are less likely to be skewed. I'm really glad you asked her.

It sounds to me as though she's "OKing" the testing more to ease your mind rather than because she thinks it's an issue from her point of view. So if you're still content to be patient for a while longer, it will make your life easier to leave things status quo for the time being.

[KennyJ]

Just wish I had not stumbled across the comment made by that one vet online today. That put me in a bigger funk. And it sounded like Dr Barry was tip toeing around the subject of Cushings.

[KennyJ]

Dr Suttenfiled graduated from Virginia Tech as well. This is what she sent me in an email a few minutes ago.




We should probably start with an exam and see where she is and what she can/should not do. I see a lot of older dogs with Cushings rupture their cruciates and I think the elevated levels of steroids are a factor. Because of the Cushings too, they often aren't good surgical candidates. If we can't help her with exercise or therapy, she might be a candidate for a fitted leg brace. It would have to be custom because of her small size, but her small size means therapy stands a chance too. :-)

S.

Sally Suttenfield, DVM, CCRP
http://www.fourpawsvetrehab.com/

[labblab]

Kenny, who is Dr. Suttenfield? Is this somebody whom you've aready seen?

[KennyJ]

No, she is someone that lives here that is also certified in physical therapy. I was trying to see if water therapy would work for Gracie and Dr Suttenfield said she would not put her in water therapy if the leg is unstable. We continued talking so I asked her a few more questions.

[molly muffin]

Well I for one am not overly surprised by what I am guessing is a vet on the Big Island, Hawaii, said about cushings. We've had people on the islands, and you have no IMS available, and general limited testing abilities with things like ACTH. I think surgeries usually need to be done in California, if the latest islander experience is anything to go by. Even Oahu didn't have specialist surgeons. So, one year, maybe not so surprising. Not to cut them down, because that is not what I mean at all, simply that they do not have the options nor the funding for some of the things that main-lander vets have available to them. I'm sure they do the best with what they have available.

Here though, there are options and experienced vets, vet schools, IMS's, imagining, etc. We expect more and we get it.

So, pffttt on that. I wouldn't tell some of our good members who are on year 4 or 5 of treatment that quote. ;)

Sharlene and Molly Muffin

[KennyJ]

Is this vet talking about the ACTH test or the LSSD test being expensive? And am I reading too much into our conversation in the emails or does she sound not very positive?? I will be the first to admit that right now dealing with the ACL and the cost so far this has been extremely overwhelming for me.


Kenny:

I'm doing the rehab out of Appalachian Vet Services on Flanagan Rd in Christiansburg. Their number is 382-1100.

Some dogs do well with the treatment for Cushings but it is expensive to test for and testing is how you also monitor treatment. The agent you give to test the adrenal system is expensive and only one company makes it. :-(

S.

Sally Suttenfield, DVM, CCRP
http://www.fourpawsvetrehab.com/

[Roxee's Dad]

Hi Kenny,

1st of all I want you to know that with proper diagnosis, and follow up, Gracie can live out a good long and happy life.

The ACTH is not inexpensive and based on a survey, I would say the average cost is around 200 dollars. It really depends on your vet. You can review the ACTH survey at -
http://www.k9cushings.com/forum/showthread.php?t=1148

LDDS - http://www.k9cushings.com/forum/showthread.php?t=1158

So for the initial testing and this is just an my opinion based on the surveys and my personal experience, the initial diagnosis which would probably include a LDDS and if positive a follow up ACTH at around 200 dollars each. If positive, the cost of say Trilostane which is about 40 dollars depending where you get it compounded or name brand, then a follow up ACTH in about 10 days after initiating treatment which is about another 200 dollars. If all is going well, then another ACTH in about a month

So in the first month I would estimate about 800 dollars. Again it depends where you live. In AZ the testing was about 2 X the cost compared to when I lived in TN.

If Gracie's symptoms are under control after the first month, then it will only be the cost of the medication until the next ACTH which could be anywhere from 3 to 6 months. This is why it is good to get a vet or IMS with a lot of good experience in treating cushings.

The stimulating agent they use to inject is the costly part of the test. I don't have the link handy, but their is a way to save money on the agent. I am sure one of the other mods or admins will post it for you.

Once again, this is just from my personal experience plus reviewing the survey and comments under the survey. I was shocked at how inexpensive the ACTH test was in TN compared to AZ. May be the same for you, one can only hope. Bottom line, just ask the vet what the cost of the test are.

[KennyJ]

John, why did the one vet recommend the LDDS test over the ACTH to diagnose Cushings. The other vets say they would run the ACTH test as their first test. He was the one that did the xray on Gracie's leg? I wanted to add, one of the vets said the ACTH would cost me $140 and the place where I have always taken Gracie said around $130. Does that include everything?

[frijole]

John, why did the one vet recommend the LDDS test over the ACTH to diagnose Cushings. The other vets say they would run the ACTH test as their first test. He was the one that did the xray on Gracie's leg?

I'm not John but I'll answer. :D

There are two tests used to diagnose cushings - they work differently and frankly because cushing's is so often misdiagnosed most people have both done or one of them and an ultrasound. You just don't treat without knowing as it can cause dogs problems... trust me we have seen it all.

The 8 hour test is the low dose dex suppression test called LDDS. It is considered the best test as you might be able to tell if it is pituitary based cushings or adrenal cushings.

The other test is the acth test where the stimulant used is expensive. It measures the cortisol in the body.

The LDDS test often will come back positive for cushings in a dog that has other things going on... such as a torn ACL. So that would be why the vets are telling you to not do that one.

I know about these false positives from personal experience. And this is the reason many have suggested you hold off testing as Gracie heals. I hope that this helps. Kim

[KennyJ]

Thanks Kim. My worry is that its going to take a long time before Gracie is healed which means I will have to wait a while. The surgeon said I could probably go ahead and have her tested but maybe thats not a good idea. So should I stay away from the vey that wants to do an LSSD test? He was the one that wanted to sugery.

[frijole]

I can't tell you which vet to go with because you are the one that has all the info on each one. Go with your gut. I do think you should pick one and stick with them and quit shopping because as you are finding out they all have a different opinion and it gets more confusing rather than helping you! That's why I say write out the pros/cons and go with what you know to be the best vet. If that vet needs to bring in a specialist for surgery or whatever then so be it. I just think you are on information overload and I can understand why!

Sorry not to be more helpful but I don't know enough to answer your question. :o Kim

[KennyJ]

Here's the thing I don't understand. When I had her at the vet school my friend who is an internal medicine guy said the regular vets where I live could handle the Cushings as if there was no need to bring her to the school. But all the vets but one would run the ACTH test and since that isn't the most accurate one why would I choose that one? And yes you are right, right now I am on system overload. Thanks for listening. The lack of sleep because of all they worrying over the leg and Cushings is catching up with me.

[frijole]

I didn't follow your question:

When I had her at the vet school my friend who is an internal medicine guy said the regular vets where I live could handle the Cushings as if there was no need to bring her to the school. But all the vets but one would run the ACTH test and since that isn't the most accurate one why would I choose that one?

Let me try to be clearer re the 2 tests. Both are accurate and yet can have false findings. The LDDS test is the one that can tell you what type of cushings you are dealing with (small tumor near brain or tumor of adrenal gland). The other one measures cortisol (which is high in cush dogs). Two totally different types of tests. I agree with all of the vets that suggest IN YOUR CASE DUE TO THE LEG that if you were to do a test today - do the acth test.

That said - it's going to cost probably $200. If it is not your intent to start treatment until the leg is healed then you don't need to do anything at this time. If I read everything right that is what those same vets are saying as well. So with all you have going on right now I wouldn't clutter my mind with worrying about this right now. Does this make sense? Kim

[KennyJ]

Kim I guess what I am asking is why Dr Leib who is an internal medicine guy at the vet school saying any regular vet can treat for Cushings that there was no need to bring Gracie to see him. I know I am wearing you guys out with questions but this is the way my mind has been working the past several weeks. My regular vet is still out out with back problems and is not scheduled for any appointments for the month of June. Another reason why I have seen so many vets. And their choice of tests had nothing to do with her leg injury. That just happens be their method of testing. Hope that made sense.

Still no panty hose.

[frijole]

:D Well the IMS is right. If the local vets have experience and are up to date with the drugs etc they can handle treating cushings. If WE HERE can do it then certainly vets can right? The thing is that there are vets that get over their heads and don't understand the intricacies or take the time to learn. I suspect that the IMS you are speaking of is comfortable with the vet community in your area. Not all areas are like that.

[KennyJ]

I also didnt know that lumps under the skin could be a sign of cushings. Gracie has between 7-15 on her stomach, chest. Kim in your opinion how much water would you consider excessive for a 13 lb dog? Actually anyone can answer that.

[Roxee's Dad]

Hi Kenny,

I'm not Kim LOL but if Gracie is drinking around an ounce per pound every day... give or take a few ounces. Then there is no excessive drinking. Just my opinion, but I would think excessive would be up around double her weight. She's 13 pounds so if she was drinking 24 or more ounces everyday, I would consider that excessive. There is always going to be a day or 2 when she may drink more or less. Warmer and dryer weather may cause a bit more thirst.

I couldn't keep enough water in the water dish for Roxee, believe me you will notice the difference.

Regarding signs of cushings, did the vet say anything about the lumps? May just be what is called fatty tumors of little or no significance, I am not a vet but my Rozee (who is not a cush pup) has had them for over 8 years. My vet called them Lipoma's. They are checked when she goes into the vet for her check ups. So far no issues and she will be 18 years old soon.

[KennyJ]

John the most water Gracie has consumed in one day is 16 ounces. And she does not eat all that much either. Its just the liver enzymes and her pot bellied appearance. Of course the vets mention her undercoat is thin. I do wonder why her urine was somewhat diluted if she is not consuming large amounts of water.

[Budsters Mom]

Kenny,
I am with John. Gracie certainly does not seem to be drinking excessively. Buddy weighs 16 pounds. He would guzzle an entire bowl of water and be looking for more 10 minutes later. He didn't just pee, he created the Hoover Dam!;) That, is excessive drinking!

Hugs,
Kathy

[Trixie]

you would certainly notice excessive drinking. My 14 pounder was up to 50 oz of water a day...and some of that day she was asleep...so yeah...your Gracie is not over-drinking. I think it is a hallmark symptom of Cushings but perhaps it is not a symptom that every dog gets.
Barbara

[Roxee's Dad]

Hi Kenny,

Just to be clear, we are not saying that Gracie isn't in the early stages of cushings. There are a number of different causes for dilute urine and high ALKP , and cushings is one of them. I cannot speculate what may be causing this. Was the urine catch first thing in the morning after she woke up or mid day or evening? It does make a difference.

Keep giving her the Denamarin. Let's get her knee healed up for a bit. The quicker we can get her knee healed up, the sooner we can move on with the cush testing.

[KennyJ]

John they tested her urine for an infection because she had an accident in our bed. This was done at around 6:00 pm. So evening hours John would her urine be more diluted in the evening?

[KennyJ]

Wow, received this in my email this morning. John, still waiting to hear about the difference in urine from morning sample and evening sample. Thanks.



Virginia Tech: Stop Letting Vet School Residents Practice Without Faculty Supervision
By Lee H.
Riner, Virginia

Sign Lee's Petition


My beautiful cat Bertram, who had always been happy and healthy, was suddenly very ill and his regular veterinarian couldn’t figure out what was wrong. She referred him to the Veterinary Teaching Hospital at Virginia Tech expecting that one of the faculty would see him and evaluate his problem. Neither of us realized that the Hospital permits advanced residents to see patients without faculty supervision. This is something they don’t talk about – their website actually says “Residents and interns work closely with clinical faculty-members to provide you and your animal with an excellent health care experience.” They have admitted that they couldn’t write a press release that would make their referring veterinarians think letting residents practice unsupervised is a good idea.

The resident who saw Bertram didn’t pay attention to the information his regular veterinarian sent about him. The resident decided that he had pancreatitis, not an infection, and she discontinued the two antibiotics his regular vet had prescribed. No one was checking her work, so her conclusion went unchallenged.

Bertram continued to get sicker and sicker, and I took him back to the Teaching Hospital several times. On one visit, he was seen by a resident who had just started the program and couldn’t answer my questions – and the faculty member who was supervising her wouldn’t talk with me because “Everything has to go through the residents.” There is no evidence that he did anything other than sign off on her notes.

A few days later, Bertram died in the intensive care unit of the Teaching Hospital – this time cared for by an intern and a resident, still with no faculty involved. I asked for an autopsy, and learned that he died not of pancreatitis, but of a ruptured pulmonary abscess! The first resident who saw him said he didn’t have an infection (which is what his primary veterinarian was concerned about) and no one else ever questioned her conclusion.

I asked for a review of what went wrong. The review done by outside experts (four board certified veterinarians not affiliated with the Teaching Hospital) was very critical of Bertram’s care and made recommendations for changes, but the internal review made excuses. And when it became clear that I actually expected the Teaching Hospital to admit its mistakes and change its practices, the VA Tech legal department told the head of the Teaching Hospital to stop talking with me.

There is nothing more I can do to prevent this from happening to someone else. Please help future patients by signing this petition to tell the Veterinary Teaching Hospital at Virginia Tech that they are more than a training program – they are also a specialty referral center. Their patients deserve the attention of the faculty, at every visit, and on every day of inpatient care. Residents are there to learn, and they aren’t ready to handle complicated referrals on their own.
Sign Lee's Petition

[mytil]

Hi again Kenny,

I am not sure why this person sent you this petition information privately via email. I would caution that we really do not know all the facts here and I do not want you to be unduly alarmed.

Terry

[Budsters Mom]

That email is scary and weird!! None of us sent it to you. Members except for administrators and a few others, don't have each other's personal email addresses, unless we share them via PM of course. I'm sorry that you received such an alarming message.

Hugs,
Kathy

[KennyJ]

Kathy, I knew it didn't come from this group. I think once you sign a petition on Change your email is out there for anyone to see. When I took Gracie to the Vet school a 4th year student was the one that saw her to do the write up. Then he took her to the specialist.

[Roxee's Dad]

Sorry I didn't get back to you earlier. The first morning urine catch is likely to be the most concentrated as it is being held the longest whereas urine samples later in the day are not as concentrated. I was just curious as when the urine catch took place as it could be a factor.

Regarding the petition, It sounds like a very unfortunate incident occurred in the teaching hospital. A misdiagnosis, a lack of supervision by a qualified vet, and a very sad outcome. We need to remember that veterinary medicine is considered a practice and vets cannot know everything. This is why we often recommend a specialist in the field of concern, and we post information and articles in our resources section, so that our members can read up and be more informed about causes and treatments, and be an advocate for their pup.

For an example, last Sept we took our Rozee to the vet for what we thought was an eye injury. Vet saw nothing abnormal and prescribed antibiotics. A week later we saw no improvement and decided to take her to a specialist which found age related eye ulcers. The antibiotics did nothing to enhance the healing. The canine Ophthalmologist prescribed the correct medicine that helped her to heal. I don't hold anything against our vet, but I know he is just a general practitioner and not an expert in any one particular field. He even bowed out of doing a dental on Rozee because of her age, and recommended a specialist that would have the equipment needed in case of any complications.

[KennyJ]

Thanks John. Gracie's little nose is cracked really bad. Is there anything I can put on that? Also, should I be giving her something for her joints as well?

[Roxee's Dad]

I have seen many use vitamin E, you can buy it in gel capsules and just break them open and rub the gel on her nose.

Their may be other suggestions by some of our members.

Glucosamine is the first thing that comes to mind for joint health. May want to ask your vet.

[KennyJ]

Two symptoms I can most definitely rule out. Excessive food and water consumption. 12 ounces of water today. But she does have all the other symptoms.

[frijole]

So how is the therapy and home treatment going? Kim

[Budsters Mom]

Kenny, I know it's hard, but you're doing great!:)

Hugs,
Kathy

[KennyJ]

Kim, I have her restricted to one small bedroom during the day. When I am home I take her out long enough to use the bathroom. I pick her up and bring her back inside. I hold her in my lap when we are watching TV. She goes back in the bedroom when I have to leave or do something that she is unattended. My part of the physical therapy is not going well. She still goes for laser therapy but when I start doing the physical therapy she starts to get really tense so I don't push it. I do believe she is walking better but that's only for a few minutes because I carry her all the other times.

[KennyJ]

Thanks Kathy. And not sure if I posted this when I first started but if Gracie does indeed have Cushings then my other Maltese dogs had it too. All developed the pot belly look and my first one had VERY thinhair. She lived until she was 15. At one time they thought she had leukemia and wanted to start her on chemo pills. They gave her 8 months at the most to live. Decided to try something else. I gave her IP6 with inistol and all her blood work came back to normal. She lived another 4 years.

[frijole]

Kim, I have her restricted to one small bedroom during the day. When I am home I take her out long enough to use the bathroom. I pick her up and bring her back inside. I hold her in my lap when we are watching TV. She goes back in the bedroom when I have to leave or do something that she is unattended. My part of the physical therapy is not going well. She still goes for laser therapy but when I start doing the physical therapy she starts to get really tense so I don't push it. I do believe she is walking better but that's only for a few minutes because I carry her all the other times.

That is a great update. I'd be a sucker at therapy also... you might ask the vet overseeing this what you can do to get better at your part. If you are unsure if you are hurting her - ask. I would be the same way but just look in those loving eyes and you can do whatever is needed to help her. :D

[KennyJ]

I sent my friend at the vet school an email this morning about Gracie and Cushings. The first part is my email and then his response. He still didn't address some of the questions so I sent him another one.



Dr Leib it was great seeing you last week. Hey I wanted to ask you.
Should I test Gracie now for Cushings or wait until we give her time for
the leg to heal? She does have a ruptured ACL but Dr Barry suggested we
do the conservative treatment with 6 weeks of restricted movement. I
also give her laser treatment with Dr Wilson of Brandon Animal
Hospital. There are so many tests out there including the ACTH stim
test and the LDDS method. Which one would you use at the vet school? And
you did tell me with treatment that Gracie could live out her normal
life expectancy and do very well on medications, correct? What happens
if I don't treat it at all? I have to be honest, I would feel more
comfortable having you do the testing and diagnosis than I would with
the vets in Roanoke unless there is one there you would highly
recommend. Matter of fact with Michael Hairfield still out with back
problems I will most likely be looking for a new vet in the area. Anyone
you could recommend to me? At this time they do not know when he will
return. Thanks again for your help. Have a great weekend.

--


Kenny






Hi Kenny,
She should be tested for cushings. Any vet can test her and treat her.
If you want to come to the VTH you need to be referred. Treatment is
worth doing, there are many clinical signs of cushings, some are quite
dangerous. Treatment has to be carefully monitored by your local
veterinarian, we cannot monitor treatment, it often requires frequent
visits.

Good luck.

Mike


Michael Leib DVM, MS
Diplomate ACVIM
C.R. Roberts Professor Small Animal Medicine
Virginia Maryland Regional College of Veterinary Medicine
Virginia Tech
Blacksburg, VA 24060
540 231 4621
540 231 1676 fax

[Budsters Mom]

FWIW - I still feel like you need to get Gracie's leg taken care of first because false positives are common on Cushing's tests. I know how worried you are. We all second guess ourselves sometimes.;)

Hugs,
Kathy

[KennyJ]

Thanks Kathy. He still didn't answer my questions like I had hoped. I did send him another email so maybe he will address those later. Still confused as to which test we should use since one vet said he would use the LDDS while the others suggested ACTH. I know just by doing my research the LDDS seems to be more accurate if I read the material correctly. Now something else that is on my agenda is finding Gracie the best vet available. None of them are specialist but since Dr Leib said they would not be able to monitor Gracie I need to find a vet in the Roanoke/Salem Va area that is the best for my little girl. I guess I am concerned by putting it off until her leg is better that I allowing precious time to slip away.

[Roxee's Dad]

Actually Kenny, they should do both the LDDS and an ACTH. If the LDDS proves positive, they will use the ACTH to confirm and as a baseline before starting medications. Then about 10 days later they should do another ACTH to monitor the progress of the medications.

A bonus and big bang for your buck will be an Ultrasound to check the conditions of her organs and get a good look at the adrenals and Liver.

[KennyJ]

Thanks John. Only one vet said he would do the LSSD test. The others said they would do the ACTH stim test with no mention of the other tests.

[molly muffin]

Hi Kenny,
I had both ACTH, followed by the LDDS. If I have had done it the way we did the first time, I would have had the LDDS first and then if that was positive followed with the ACTH as John mentioned.
So I would do LDDS, if positive follow up, ACTH.
Call around to the vets and ask questions. How much experience treating cushings, success rate, what medicine do they use to treat, etc. Get as much info as you can to make a decision with.

Sharlene and Molly Muffin

[KennyJ]

John or anyone. I spoke with the vet again that took Gracie's urine specimen and she said Gracie's wasnt that diluted it was right in the middle. Again that was taken during the evening. That really doesn't mean anything does it?

[Roxee's Dad]

Let me clarify myself as I wouldn't want you to be confused.

My input on the ACTH and LDDS is post Gracie's leg being healed. Most vets and most of us here would insist on both test to get a positive dx of cushing's.

Urine - The vet doesn't seem to concerned and it makes sense as Gracie is not drinking excessive amounts of water.

[molly muffin]

Kenny, her urine seems fine to me. I wouldn't worry about that.
Just keep limiting her movement and concentrate on the leg.
You can make calls to find a vet, you have the time to do that in the next 4 weeks or so.

Sharlene and Molly Muffin

[mytil]

How is Gracie's PT going?

Terry

[KennyJ]

Terry about the only PT she gets is the laser therapy. The stretching exercises I am supposed to do never happens. The reason? Because I am afraid I will hurt her.

[frijole]

Then that isn't therapy and you know it. Either talk to the vet and have him watch you do it to find out if you are doing it right or find out how much harm you are doing by not doing it - in other words if you skip out on all of your sessions can she ever heal naturally.

[KennyJ]

I did discuss this with both Dr's. They know I am concerned about hurting her leg. The vet doing the laser therapy suggested I hold her and rub her stomach to see if I can get her to straighten it out. I have been successful doing that a few times. But when Gracie tightens the injured leg when I try to stretch it I back off. The restriction has helped according to the vet performing the laser therapy. She says Gracie is not as tight now. I hope she is correct. The last thing I want to do is cause anymore damage to her already ruptured ACL. When she tenses up, I quit.

[frijole]

Great! Keep trying. Just envision a healthy Gracie and what you can do with the money you save from not having surgery. :)

[KennyJ]

There are times Gracie never pants and other times she pants like crazy.

[Roxee's Dad]

Panting could be pain . Could be cushings. Did she pant before she tore up her knee?

[KennyJ]

John yes she did but I never really paid much attention to it. All of my dogs would pant like this at times.

[Roxee's Dad]

hot or humid weather? thirsty? does Gracie always have access to water?

[KennyJ]

She is on my lap now panting. The water is in the bedroom where she stays when I am not home. I never let her down now since her leg injury. I keep the house at 72 so its very comfortable inside.

[Roxee's Dad]

is she on any meds... pain meds?

[KennyJ]

No I took her off the meds the first week after finding out her ALP was so high. She is only on Denamarin now.

[Roxee's Dad]

Well is could very well be pain. Comfort her as best you can and ask vet for a pain med that may be safer to use.

[KennyJ]

They told me I could still give her the rimadyl for a while. But she has panted like this before the leg injury. Right now she is not panting.

[goldengirl88]

Kenny:
I missed your thread for some reason, and wanted to give you a belated welcome. Sorry your baby is having troubles. What a cutie pie doggie!. Stay with this group and they will guide you more than a vet will. Hope it all works out for you. Blessings
Patti

[molly muffin]

Hi Kenny, if you rub the belly or back down the spine, it might encourage her to stretch the back leg out. Then just keep doing it. That will get the leg in the stretching out position and repeated rubs should get her to usually retract when you take your hand away, rub down again and she'll stretch it out. Keep doing that.

You want it to heal well, so that she doesn't become lame because there was no stretching involved in her healing process.

Sharlene and Molly Muffin

[KennyJ]

Sharlene, she only lets me do that a couple of times and then she moves. I tried once again to stretch her leg and she resisted so I quit.

[molly muffin]

Don't try to pull the leg so much as to just do a firm petting motion, straight down the spine, which will make her stretch the leg herself. Remove hand, she should retract and then repeat the rub. I talk silly to molly while I am doing so she thinks of it as more of a play, loving than an exercise. It gets the same stretch out her, without her actually thinking that she is being Made to do something.
This is just an idea and one that works for me. They will sometimes do it when they are rolled over on their back and getting a good tummy rub. The key to get molly to do is is for her to always think it is her idea and that she is just getting loved on.
Something to try since you are having trouble with stretching her leg. I never touch the leg myself and let her retract herself and stretch it herself.

[Budsters Mom]

Yes Kenny, The spine rubbing thing works for Buddy too. I do it as part of his twice-daily massage. As soon as I run my hand down his spine, he stretches out of his back leg. When I turn him over and do it again, he'll stretch out the other legs. It works on both sides. Love her up when you do it, and she'll think it's a game.:D;)
You are such a great dad Kenny;):D

Hugs,
Kathy

[KennyJ]

For some reason Gracie will not stretch out her legs when I rub down her spine.

[Budsters Mom]

I'm sorry about that Kenny. It could be that it's painful to stretch it out herself, so she won't do it. I wish I could help more.:(

Hugs,
Kathy

[KennyJ]

Could someone please come to my house and take my laptop away so I can't read anymore on Cushings???? :confused:

[Budsters Mom]

I'll be right there Kenny!;) When I found out that Buddy had a suspected macro-tumor, I was obsessed too!;) Sometimes you just have to force yourself to leave it for a while, for your own sanity. You'll get through this Kenny.:o We are in this together. You'll can leave it for a while. We will still be here when you get back.;)

Hugs,
Kathy

[Roxee's Dad]

I think Addy started the tradition of putting Cushings in the drawer and shutting the drawer for a few days or so.


;)

[Harley PoMMom]

For some reason Gracie will not stretch out her legs when I rub down her spine.

When my Pom boy, Sampson, is laying on his back if I rub the sides of both of his legs (thighs, I guess) at the same time he will stretch both of them out.

[KennyJ]

I will read something that is very positive and click on something else that is so very depressing.

[KennyJ]

Gracie will sometimes stretch both legs out.

[frijole]

Kenny, As you know not all information on the web is accurate. I can't stop you from reading all over the place but I can tell you without a doubt that this site has honest members with more experience than alot of vets out there - simply because we have been reading and studying it non-stop for decades. Alot of local vets have only treated a handful of dogs and it isn't their fault.

I can only tell you that: as of now your dog has not even been diagnosed. She does not exhibit the two major symptoms of cushings. The vets are suspicious due to thin hair and a tummy. I understand that however my mom's dog looks like that but she doesn't have cushings.

The majority of dogs that have cushing's disease are successfully treated. They live normal lives. It's easier said than done but you shouldn't be worried about losing Gracie to cushing's disease.

As someone posted earlier - take a break from it. You are driving yourself crazy. Focus on that cute little white ball of fur. Keep giving her hugs, treats, love, therapy for the leg and enjoy life. We're here to help and we don't charge a dime. Don't be so down. :D;):D

[KennyJ]

If her ALP hadn't been so elevated I may not be so worried. But 3500 is extremely high. She pants a lot as well.

[Concernedmom]

Hi Kenny
I'm gonna chime in here. I know you're worried about Gracie but I think Roxee's Dad might be right that her panting is probably pain. I think I even mentioned that in a previous post. That's what the Rimadyl was for. If you are concerned about the rimadyl and her liver then find another pain medicine. I use tramadol. Maybe it's time to figure out why her ALP level is that high because it seems that is what your most worried about. Everyone can correct if I'm wrong but isn't it true that there's no rush to treat cushing in dogs anyways?
Hope Gracie's leg heals quick. She's a beautiful Maltese.

[doxiesrock912]

Kenny,
I would avoid the vet who wants to do the surgery and the Cushings test.
Stick with the specialist that told you to restrict movement for at least 6 weeks.

Cushings is NOT fatal. Dogs rarely die from Cushings in fact. Daisy's vet treats numerous dogs with Cushings and he assured me that it is treatable.

There is no rush to treat the Cushings. Heel Gracie's leg and then address possible Cushings.

[KennyJ]

If the low suppression test is the most accurate of all the tests why do most vets do the ACTH test?




The Low Dose Dexamethasone Suppression Test
(usually takes 8 hours in the hospital)

Dexamethasone is a cortisone-type hormone that is used therapeutically for numerous conditions. When given dexamethasone, the dog's pituitary gland will perceive that there is a steroid and shut off its stimulatory message to the adrenal glands. In the normal animal, this means that a drop in blood cortisol level will be seen 8 hours after a tiny dose of dexamethasone is given intravenously.

If there is a pituitary tumor, the pituitary is not about to shut off its stimulatory message and it ignores the dexamethasone. No drop in cortisol level is seen at the end of eight hours.

THIS TEST IS CURRENTLY CONSIDERED THE MOST ACCURATE
TO CONFIRM CUSHING'S DISEASE.
APPROXIMATELY 90% OF DOGS WITH CUSHING'S DISEASE
WILL TEST POSITIVE WITH IT.

[labblab]

Kenny, both the LDDS and the ACTH have their own strengths and weaknesses. So which test may be best for any given dog depends on the circumstances. The LDDS is the more "sensitive" test of the two. What this means is that the LDDS is less likely to come back with a false negative if a dog truly does have Cushing's. The ACTH is the more "specific" of the two tests. What this means is that it is less likely to come back with a false positive if a dog doesn't really have Cushing's.

So when a vet is wanting to test a dog who has classic Cushing's symptoms and no other known illness or physical issue that might be elevating its cortisol level, the LDDS will probably be the preferred initial test. This is because you are wanting the test that is least likely to miss making a Cushing's diagnosis.

On the other hand, if you have a dog who does not exhibit the most classic symptoms and has some other known physical issue going on at the time of testing, the vet may opt for the ACTH. This is because you'd rather be more conservative and have less risk of misdiagnosing Cushing's in a dog who does not really have the disease at all.

This is why, if Gracie were my dog, I'd opt for the ACTH first. She is missing some classic symptoms and we know she is having issues and perhaps significant pain from her knee injury. This could affect her response to both the ACTH and LDDS tests, but the LDDS is the one that is most likely to give a "false positive" in such a situation.

So you are balancing the risks of a false diagnosis one way of the other. And in my mind, the risk of mistakenly treating a dog for Cushing's who doesn't really have the disease is more of a short -term danger than holding off for a while longer on treatment even if a dog has Cushing's but the initial diagnostic blood test didn't show it. There is always time to retest again once you know the leg is healed.

Marianne

[KennyJ]

Has anyone tried this?? It mentions that Vets are actually trying this on some of their patients. It's called DogTORX.

Follow up: I just spoke with the vet in California that participated in the study of DogTor RX. She said this was an amazing product and she does indeed give it to dogs that has Cushings. It also helps with the healing of ruptured ACL's . And she went on to say that it was extremely safe. I am going to purchase it today. I spoke with Dr Ackerman.

http://www.petequinox.com/us.html

http://www.petequinox.com/clinical-parts.html

[KennyJ]

Thanks Marianne. I think I will hold off at least 4-5 more weeks and give the leg a chance to heal. That seems to be the best approach from what everyone is saying on the forum. I realize I am getting impatient but it does seem everyone on here thinks I should wait until the leg is healed.

[KennyJ]

Say what???? The majority of dogs they don't treat the Cushings???



Mr. Jarels,
I would have to see the entire labwork to see the full picture but a ALP of 3500 does make us think that your dogs has Cushings disease. The test that we usually start with is called a acth stimulation test in which we measure the cortisol and then administer a medication and see their response. Based on these results a ultrasound or further testing can be done. We have diagnosed numerous dogs with Cushings but the majority of the dogs we elect not to treat. If you would like to discuss it further we would love to meet with your and go over the exam findings and labwork.

Another vet, both graduated from the vet school at Virginia Tech told me they very seldom treat dogs for Cushings as well. The reason?? Because he said the meds were dangerous and can cause severe problems in addition to the expense of testing.



A lot clients elect to not treat the cushings disease unless there is severe clinical signs(peeing in the house, severe panting, etc). The treatment will help with these signs and the quality of their life. However, cost can play into the decision because of the medication and labwork that needs to be done every 6 months. There are a few "all natural" medications that we can discuss as well if you would like to try if the dog is not symptomatic. We have lots of dogs with cushings disease that have a normal lifespan and very few clinical signs but every dog/situation is different

Jonathan Amos


Jonathan Amos, DVM
Big Lick Veterinary Services

[Budsters Mom]

Say what????:confused: I would be looking for another vet to manage my Cush pup! :mad: They obviously don't know enough about Cushing's. It is good to know up front, then have them make costly mistakes later.:eek::rolleyes:The "all-natural" products do not work! If they did, we'd all be using them! ;) I have lots more to say, but I think I better cool my jets for now!:D

Hugs,
Kathy

[lulusmom]

Has anyone tried this?? It mentions that Vets are actually trying this on some of their patients. It's called DogTORX.

Follow up: I just spoke with the vet in California that participated in the study of DogTor RX. She said this was an amazing product and she does indeed give it to dogs that has Cushings. It also helps with the healing of ruptured ACL's . And she went on to say that it was extremely safe. I am going to purchase it today. I spoke with Dr Ackerman.

http://www.petequinox.com/us.html

http://www.petequinox.com/clinical-parts.html

Hi Kenny,

I remember this product. Who wouldn't remember a product that can have such a profound impact on so many human and canine conditions, including normalizing adrenal function. Did Dr. Ackerman tell you what normalizing adrenal function means and did she tell you what testing was done prove it? In order to do that, I believe Dr. Ackerman would have to maintain a strict controlled environment in which proper testing is conducted with test subjects who have been properly diagnosed with cushing's by way of appropriate diagnostic and validating testing. She would have been required to do a good number of those tests again during treatment to validate that this product reduces cortisol to therapeutic levels. I seriously doubt that Dr. Ackerman has done any true clinical trials and is using anecdotal evidence, and probably a paycheck from the manufacturer, to justify her glowing report of this product.

Kenny, companies like this prey on people like you, me and anyone else who has walked in your shoes as a newbie to cushing's. They count on people being driven to distraction with worry and fear, because those people are more likely to read their ridiculous claims and buy their product without asking any questions, or more importantly asking appropriate questions that they can't answer. One of my favorite sites is The SkeptVet Blog. This vet shares my views of these shady ecommerces who pedal their snake oils. Please take a look at his blog on this product that was posted in 2011. He hits on all the salient points.

http://skeptvet.com/Blog/2011/09/dogterrx-from-pet-equinox-style-without-substance-and-a-model-of-snake-oil-marketing/comment-page-1/

If I can find some time, I'll write to this company and Dr. Ackerman to ask some very pointed questions. I've written to a number of these questionable companies in the past and none yet have admitted to doing proper testing for safety and efficacy.


We have diagnosed numerous dogs with Cushings but the majority of the dogs we elect not to treat.
Jonathan Amos


Jonathan Amos, DVM
Big Lick Veterinary Services

The $64 thousand dollar question is why? If he says because the treatments are worse than the disease, I would have to agree with Kathy and say that you need to pass this vet up for somebody with a lot more experience.

[Roxee's Dad]

Hi Kenny,
Yes, this can be very confusing and a big part of the reason both you and I and all the other members and staff are here :) This is why we ask our members to learn as much as possible using our resources section. In the final analysis, if Gracie does have cushing's, you will be educated on which medication will work best for you, Gracie and your schedules, and you will have to make that decision to give her the best chance at a normal life.

As far as most vets not treating.... All doctors have opinions, in many cases the owner cannot afford diagnosis and treatment, maybe some owners don't take the dx serious enough, maybe like me, they were just afraid. At the time my Roxee was diagnosed, Lysodren was the treatment. I didn't find this forum for quite a while and stumbled upon it when I found out this "new" drug was being used successfully, and it was supposed to be the most safe, best thing since sliced bread. When I stumbled upon a thread and found this forum, it was like the flood gates open up with information, experiences and support.

So quick lesson, simplified.
Lyso works by eating away just enough of the adrenal gland tissue to reduce the production of Cortisol. There is a loading phase and then it goes on to just maintenance.

Trilostane is a blocker and blocks the signal from the pituitary to the adrenal gland so the adrenal gland does not over produce cortisol.

Some dogs do better on one or the other. Trilostane is the newer of the 2 drugs and like any medication including aspirin, there is a possibility of side effects. The important part is to be informed of what signs to look for and be observant. Not to forget to have a vet that is experienced and willing to work with you as a team. I have seen and read about vets try to take the proverbial bull by the horns, ignoring the owners inputs with not so good results. It is important that your vet listens to you about your observations, after all, who knows Gracies personality better than you?

All this doesn't really matter, if we don't have a verified and correct diagnosis. There are some papers by our very famous Dr Bruyette who is a specialist in the treatment of cushings and has performed some ground breaking surgeries. There is also Dr Mark Peterson also an expert in cushings. You can check our resources section and/or google him and read his papers on the subject.

[Roxee's Dad]

Ha... I was one of those people :( Spent money ... got a diet in return.:mad:


Kenny, companies like this prey on people like you, me and anyone else who has walked in your shoes as a newbie to cushing's. They count on people being driven to distraction with worry and fear, because those people are more likely to read their ridiculous claims and buy their product without asking any questions, or more importantly asking appropriate questions that they can't answer.

He also had the same diet for dogs with diabetes.... :mad:

[KennyJ]

I actually spoke with Dr Ackerman. She has a practice in California. Her study was on only 3 dogs but all improved with the DogTor RX. Not saying it will help but could it possibly help with her ACL in the healing process? Also, there are other veterinarians that use it for their clients. Again, I am not saying it works but could I use it while her leg is healing before I get her tested? Is there anything in this product that would harm Gracie?? After discussing Cushings today with two local vets I am very quickly losing faith in veterinarians in my area. The last one gave me the least amount of hope and they all graduated from my vet school here at Virginia Tech. So how on earth will I finally find a vet that can do this the right way and give Gracie the best possible chance??:confused:

And is the newer medication the same as chemo like Dr DeRolf said it was??

[Roxee's Dad]

I will echo what was suggested by Glynda, if there was an over the counter treatment that successfully treated cushings, we would all, every one of us be buying that treatment. I can only imagine the joy of all the rescue's that have cush pups trying to gather up enough funds to purchase prescription meds breathing a sigh of relief knowing they can now treat and save those cush pups. All the fur mom's and dad's struggling to come up with the funds to treat their precious babies.

I can only give you my opinion based on experience both personally and through the many members of this forum. I have no idea of what is in DogTor RX as this is a newer one. One of the many that have come across our air waves. We all hope one day that one of these will be the one. :o

To help Gracie knee heal, just keep her calm, no jumping or running. Ask a vet or holistic vet about vitamins and or glucosamine. I am sure many of our members here have suggestions for bone and joint health that has worked for them. :) and also keep in mind, not everything natural is always healthy for our pups.

[frijole]

That vet is making money selling that stuff. Please google all of the ingredients and see what that tells you. Kim

[molly muffin]

Hi Kenny,
As far as vets not treating for cushings, I think John gave you a very good response as to why. Many cannot afford the testing that goes along with treatment or the medication. Others if there are no symptoms, choose not treat.
It is ALWAYS up to the owner as to what course they want to pursue. A vet should give you the options and then let you make the best informed decision as to which option you want to pursue. A vet who will not even consider treatment, is probably not one that I would bother with.
Also, not all vets are equal. Not all have taken the time to learn the ins and outs of the disease, the medications and the testing protocols, all of which they Need to know if they are to be any good at all to their patient.
If the vet states right off the bat that they Don't treat cushings, and I'm not sure that is exactly what was said, more that, the customers don't treat due to expenses, fear of medication, or no symptoms to treat, but if the vet themselves wouldn't entertain treatment as one option, then I wouldn't entertain that vet. Pretty simple.
You do what is best for Gracie. That is all you can do.

Sharlene and Molly Muffin

[Roxee's Dad]

Sorry, I missed this question.


And is the newer medication the same as chemo like Dr DeRolf said it was??

Actually the newer med is Vetoryl also known as Trilostane, does not erode the adrenal gland tissue, it blocks the signal path from the brain (pituitary gland) to the adrenal gland, thereby preventing the adrenal glands from over producing cortisol. That is the simple easy to understand explanation :)

[KennyJ]

Ok here is another one. Dr Wadstrom said I neeeded to get her tested now for Cushings. Said he performed the LSSD test and he would only have me come back in 3 months after the meds start. I asked if Gracie could live her normal life expectancy after being treated and he said probably not. So hes the the only vet that says to test her now. I am beginning to think none of these vets know what they are talking about. Also said Gracie needed surgery.

[molly muffin]

That's right, now you know much more so you able to judge when a vet knows what they are talking about vs when they are out to lunch. You know that the first test following medication should be 10 - 14 days and the second test 30 days and then if all is well and no adjustments needed, then you'd go to 3 months.
:) See how much you are learning already.
Knowledge will always be your most powerful asset to use when it comes to cushings or anything, that affects Gracie.

Sharlene and Molly Muffin

[KennyJ]

He said he was treating 4 dogs now with Cushings. Is there a vet anywhere that knows how to treat this disease?????

[StarDeb55]

Kenny, I want to tell you that the vets you are talking to are full of it when it comes to treating Cushing's. Not only have I been through a torn ACL more than once, I have had 2 cushpups. Barkley, the first ACL pup, was my first cushpup as I mentioned earlier. He was successfully treated with lysodren for nearly 8 years, crossing the bridge at 15 from causes unrelated to his Cushing's. My 2nd boy, Harley, was 13 at diagnosis, so he was a little senior fellow when he was diagnosed. He was doing well on lysodren for nearly 2 1/2 years when we discovered what was probably a malignant mass on his jaw that had already spread to his lungs.

Now, I used both an IMS & general practice vet in treating both boys. Barkley's Cushing's was managed by my regular vet for nearly 6 years when he developed lymphoma. He & I were having to see an oncologist & derm vet at a speciality clinic, so I moved the management of his Cushing's to the IMS in that same clinic. The GP vet had done nothing wrong, it was simply easier to have his care all under one roof. The IMS did a great job. Fast forward something like 5 or 6 years when Harley was diagnosed. Same GP vet had run the UTK panel to make the diagnosis. I took Harley to the same IMS for his ultrasound to get a confirmation, & the IMS did initially manage Harley's cushing's. Unfortunately, this IMS had totally changed how she ran her practice, including having no direct communication with owners except during appointments. I had a serious disagreement with her concerning Harley's care, basically fired her, & moved Harley's cushings care back to my GP vet.

I guess the morale to all of the above is there are vets out there who are well experienced in treating cushings, & they don't necessarily have to be an IMS. It sounds like the VT vet school is not the best solution, so you start calling around to vets in your area. You ask about experience in treating cushings, how many dogs are they currently treating, how successful have they been, what medication do they prefer to use, among other questions. These are just my thoughts, but let me emphasize as a number of other members have, getting Gracie's leg healed up is the priority.

Debbie

[KennyJ]

Debbie, so that you don't have to scroll all the way back up. I asked Dr Leib at the Vet School if they could treat Gracie for the Cushings if she turns out to actually have the disease. He said they could do the tests but that they would not treat it. He said a regular vet would have to do that. Why is that?? I mean they are a vet hospital for crying out loud. With all the conflicting opinions from the regular vets I don't know who to turn to. Some say they dont' treat it unless the symptoms become a problem for the owner and that it doesn't increase life expectancy. Some say they will treat it but it still doesn't increase life expectancy and that the tests are expensive and the meds are dangerous. How on earth am I to choose a vet that can treat this disease and get Gracie back to being herself. One vet said the liver enzyme ALP being so high could suggest something else going on. I understand that talking her to different vets I may get different opinions but good Lord never in my wildest dreams did I think I would get such a wide variety of opinions. And then Dr Wadstrom whom I have known for about 15 years said test her NOW. And he would do the LSSD and medicate her and I wouldn't come back for another 3 months. He also said I should have done the surgery on her ruptured ACL, even though an orthopedic surgeon was the one that recommended conservative management. Well that's the complete opposite of what the other vets said and what I have read on here about the Cushings protocol.

[labblab]

Kenny, I can try to answer the first part of your question. Hospitals at veterinary schools generally see patients only for consultation, diagnostics, and specialized treatment that is not widely available. Patients are referred to them for specific testing and consultation, but the day-to-day care is handled by the original vet at home.

However, when your friend said that any regular vet could handle Gracie's Cushing's, I think he may have confused you. It would have been better had he said: "Any vet in your hometown who is experienced with Cushing's diagnostics and treatment should be able to oversee her care." The key is finding a vet who does, in fact, have adequate experience with handling the disease. So that leads into the rest of your questions, which is a whole other subject. But I just wanted to clarify that most vet schools see patients only for specific consultation, testing, and special treatment procedures. So that is not unique to VA Tech.

Marianne

[Budsters Mom]

Kenny,
You are doing an awesome job with Gracie.:) It is all to easy to become overwhelmed with all we read and hear. :( Stay the course with Gracie's leg treatment. Cushing's testing will come later.;):)

Hugs,
Kathy

[KennyJ]

Thanks Kathy. With all the different opinions from the vets it's going to be difficult to decide on a vet to test her. Some give me hope while the others want to tell me what a nasty disease it is and that Gracie most likely won't live out her life expectancy. And the difference of opinion on how they would test then treat her. Just wow.

[Budsters Mom]

Kenny,
Definitely choose one that offers hope:D Cushings in itself is not a death sentence. You don't want anyone treating our sweet Gracie who sees Cushings as a lost cause. Those vets do not have the experience they need to treat Cushings successfully.;)

Hugs,
Kathy

[frijole]

Kenny this is just plain wrong. You've read enough to know this. We refer to the opinions from experts in the field not local vets. So when we are going against the grain of a local vet that is why. It's based on what the leaders internationally are saying and doing. Kim

And then Dr Wadstrom whom I have known for about 15 years said test her NOW. And he would do the LSSD and medicate her and I wouldn't come back for another 3 months

[KennyJ]

Took Gracie for another laser therapy treatment. The vet says she wants me to try walking Gracie for about 3 minutes. If she does ok try 5 minutes. Said the leg felt soft. I thought that was bad but she said no that meant good. She felt a popping noise but she doesn't think that has anything to do with the ruptured ligament but instead her knee. She said Gracie doesn't look that much like a dog with Cushings as far as a pot belly. I showed her the DogTorX and she said it should be fine to give that to her. Also, I called several of the vets on the list that sold the product and all of them liked it very much. One of the vets has a practice in Colorado and she gives it along with the regular meds that treats Cushings. She says she mostly prescribes it for dogs that has some of the symptoms that look like Cushings. A few of the vets on the list said they never sold it and not sure how they got on the list. But the ones that do sell it say they have had good results with their dogs. There has to be something causing Gracies extremely high ALP so I am still thinking she has Cushings.

[goldengirl88]

Kenny:
I am curious about the dogtorx. What exactly is it and where is it available. Is it a safe? I never heard of it before. I thought maybe Kathy might use it if Buddy's symptoms come back too strong. Good Luck. Blessings.
Patti

[KennyJ]

Patti, I called Belmont Pet Hospital, Hampden Family Pet Hospital, Healing Center for Animals, and the vet that does Gracie's laser therapy here in Roanoke, Va. . Here's how I am looking at it. Until I can get Gracie tested for Cushings I don't see why trying this would hurt. There is nothing in the supplement that will harm the dog according to the vets I spoke with. Now, having said that, there was some on the list that said they do not carry the product and do not know how they ended up on the list. That I can't answer. I know the one vet online skepvet said it was snake oil and that's ok but Dr Ackmeran from Belmont Pet Hospital has at least 25 dogs on this supplement and said they were doing good. It's not a cure and certainly may not even help but with Gracie's leg problem and the possibility of Cushings I feel it's worth a try. I purchased mine from Bark'n Purr Pet Center out of Austin, Texas. Oh I forgot one more clinic I called that uses the product, Lifetime Pet Wellness Center. The vet I spoke with at Hampden Family Pet Hospital gives this supplement while treating Cushings with the traditional meds. She was very nice and we talked about Gracie for about 20 minutes. She was quite concerned that Gracie's ALP was that elevated.

Update: Patti, I am going to continue calling clinics today and will add if they sell the product and what they have to say. Here is one more. The Animal Hospital of Gurnee in Wadsworth, Il. The vet loves this product. Will continue to update. The vet from Animal Holistic Care in NY said he would not give this unless he has seen the dog. But he does give it to his animals after his examination. Advanced Canine Rehabilitation said they do not have anymore of the product and she said they got mixed results.




Hi Kenny,

Thank you for contacting us, we appreciate the inquiry.

We did in the past carry and prescribe DogtorRX for a few select patients. Unfortunately, we never saw any appreciable effects, so we stopped using it or recommending it. We have not ordered any in quite some time (several years).

Regarding cranial cruciate tears/ruptures, we do have wonderful success with acupuncture, laser therapy and a rehabilitation therapy/injection called prolotherapy. Prolotherapy is used in a number of canine rehab centers. We have performed prolotherapy on a little over 10 patients now and have been very happy with the results.

The Cushing's Disease would be something we could have Dr. Wilke consult with you about as well.

If you would like to learn more, please call our office at 515-274-3811.

Thank you again for the inquiry, and we look forward to hearing back from you soon!


Jessica
--
Iowa Veterinary Acupuncture Clinic
3836 Beaver Avenue
Des Moines, IA 50310
515-274-3811
www.apvet.com







www.barknpurr.com

[goldengirl88]

Kenny:
Thank you for the info. I sure hope your baby is doing well. I take Tipper for laser therapy and it has helped her a lot. Maybe give it a thought. Blessings
Patti

[KennyJ]

Thanks Patti. Gracie has been getting laser treatment twice a week. Just so stressed over the Cushing's disease and all the different opinions.

[goldengirl88]

Kenny:
How is Gracie doing with the laser therapy? Did they tell you it can make her tired? God Bless You Both
Patti

[KennyJ]

Patti, the vet never mentioned that. I know it makes me tired because Gracie stresses out when I take her to the vet and it's like holding a pit bull.

[goldengirl88]

Kenny;
Tipper stresses out also. This vet has a rubber cushioned floor, and we all sit on the floor, while I hold Tipper on my lap in a pillow. It isn't the most comfortable place to be, but Tipper needs it so I do it. The reason they get tires is the laser makes cell that aren't working come to life by energizing them. When all these cells start to heal and work again this makes them tires. Tipper went for 5 sessions intense sessions, then they told me to keep it going she only needs 1 treatment every 3-4 weeks. She charges 37.00 so that is not bad to keep her up and walking around free of pain. I believe it is some of the best money I have spent. Tipper is just stressed period from so many vet visits and the testing is the worst. She gets growly now when I have to do certain things to her as she has had enough already. Jack Russells are not know for being gentle, so she can be a handful too. God Bless
Patti

[Budsters Mom]

Sending healing vibes to you and our sweet little Gracie.:) Keep up the great work Kenny. :)Healing takes time. Keep her quiet as much as possible, so she can have the best possible chance to heal without surgery. You can do it Kenny! ;)

Hugs,
Kathy

[KennyJ]

Has anyone tried Glycoflex 3, Nordic Natural Omega-3, and Hyalun for their dogs?? If so how well did your dogs do on them?

[Budsters Mom]

Kenny,
Your brain must be throbbing from all of that research!:eek::D
Hugs,
Kathy

[KennyJ]

If I continue at this pace Gracie will out live me. I was also told to get Gracie off city water and give her bottled water. This coming from Dr. Porter a veterinarian in Nebraska.

[Budsters Mom]

Yes Kenny,
I definitely give Buddy filtered water! Great idea!:D:D
Hugs,
Kathy

[frijole]

If I continue at this pace Gracie will out live me. I was also told to get Gracie off city water and give her bottled water. This coming from Dr. Porter a veterinarian in Nebraska.

Nebraskans are clueless. ;););):D:D:D

What the heck are you doing calling vets across the country? Kim

[doxiesrock912]

Kenneth, Daisy and the cats only get filtered water.

[goldengirl88]

Kenny;
I use the Glycoflex III on Tipper. I believe it has helped her a lot. When she was having tracheal issues and would do the inverted sneezing, I started her on this. It did help her because she no longer does this and sneezes better than she did. A lot of people use it and have good results. I get it on Amazon it has been cheaper on there. Blessings
Patti

[KennyJ]

Kim I was calling the vets that were listed as using DogTorx to see what they had to say about the product. This guy talked my ears off.

[Budsters Mom]

Hi Kenny,
Just dropping in to see how Miss Gracie is doing today?
Hugs,
Kathy

[Roxee's Dad]

me too... Just wanted to see how Gracie is doing. It's been about 3 weeks since she injured her knee, how is she doing?

[KennyJ]

Hey guys according to the vet that is doing laser therapy her muscles are soft which according to her is a good thing. The leg does seem better. She wants me to walk Gracie about 2 minutes each day.

[goldengirl88]

Kenny:
I am very interested in the soft muscle statement told to you by the laser Vet. I am not understanding this, as when a dog is in prime shape their muscles are rock hard? Please would you get some clarification on this I am curious. Hope Gracie continues to do well on her treatments. God Bless
Patti

[KennyJ]

Patti the way she explained it to me was when she first started seeing Gracie her muscles were tight and tensed. Now they are soft. Like you I asked the same thing. She said this was a good thing. I had a scare yesterday. She was on my lap and jumped off before I could catch her. Luckily I didn't see any difference in her walking. There is no doubt the leg has improved.

[Squirt's Mom]

Kim I was calling the vets that were listed as using DogTorx to see what they had to say about the product. This guy talked my ears off.

Hi Kenny,

Let me ask you a question....if it was your job to sell something, wouldn't you talk the ears off of anyone willing to sit and listen? These doctors, if they truly are doctors, do NOT have Gracie's best interest at heart - how could they, none of them have actually seen her nor her file. Their only interest is in selling this product.

I looked up this product and cannot find an ingredient list anywhere other than egg membrane. If egg membrane is all it takes for this "miracle" to occur, why spend money on their egg membrane when you can get yourself much cheaper from actual eggs? Also, with no ingredient list, how do you know what you are putting in Gracie's body? If she has an adverse reaction, what caused it? Egg membrane? I can't tell you NOT to use it - she is your dog. But if you choose to try it, make sure you are prepared for the unknown and possible negative consequences.

Sweetie, you are letting your fears dictate your thoughts and actions which are all over the place as a result. Your fears allow you believe any and everything you read - most of which is hogwash. You are talking to one vet after the other who haven't seen Gracie and therefore cannot give you accurate information about her - only very general info which is bound to be contradictory and confusing. For Gracie's sake, you must get a grip, you must follow the directions concerning her leg to the Tee, you must choose one vet to care for her and trust them unless they prove they don't deserve that trust. At the moment, you are playing a football game with no coach, using Gracie as the ball. You toss her at this vet then that one, hoping one of them will catch her and make a touchdown for you. Not gonna happen, honey. ;) You have to find a coach, you have to develop a team with your coach, and you have to follow the plays as they are given to you. Otherwise you are running pell-mell all over the field and no one wins. ;)

Hugs,
Leslie and the gang

[KennyJ]

Actually the vet that talked my ears off does not sell Dogtorx. I took the bottle to the vet doing Gracies laser therapy and she didn't see anything in the ingredients that would harm her..

[KennyJ]

Here are the ingredients in DOGtorX.

Crude protein 3%

Crude Fat 3%

Crude Fiber 0.1%

Moisture 0.5%

Omega 6 Fatty Acids 2%

Selenium 0.694 mg/kg

Omega 3 Fatty Acids 0.2%

Vitamin E 5,555 IU/kg

Rice Flour, Dextrates, Vegatable fat, Silicone Dioxide, Dehydrated Poultry liver, natural pork flavor,

[frijole]

Interesting. Note I work in the food industry.

Rice Flour (this is strictly a thickening agent), Dextrates (this is saccharides/sugar) , Vegatable fat, Silicone Dioxide (this is sand) , Dehydrated Poultry liver, natural pork flavor,

Now tell me which ingredients could possibly help relieve cushing's symptoms. Sorry but calling a spade a spade. Kim

[KennyJ]

Something else I just noticed. There is a DOGtorx and there is a DOGtor RX.

[lulusmom]

I wrote to Petequinox three days ago asking them if they did appropriate testing to prove their claims that Dogtor RX normalizes adrenal function. I also asked them what that meant exactly. I also asked them to provide citations for the studies or clinical trials they allege were done. My questions were very pointed and very specific. I've not received a response and I don't really expect one but I'll let everybody know if I do.

Kenny, you have talked to a few vets who claim to have had good results with Dogtor RX. What exactly were the results? Did you ask them exactly how this product works? Did they to do appropriate testing to determine if cortisol levels were actually lowered by this product?

[KennyJ]

Dr Ackerman has 25 of her dogs on the product and said all had good results. Some were dogs with Cushings and others had ligament problems. The guy at pet equinox has called me twice and responded to all my emails. However, I did not ask him about the testing. The other vets that are using the product said they too have had some good results but one said she used it in conjunction with traditional meds. She was at the Hampton Vet Hospital in Colorado. But my big question now is what is the difference between DogtorRX and DogtorX?? I never noticed the difference until now. I took the bottle into the vet doing the laser therapy and she didn't see anything that would harm Gracie but she also didn't say it would help her. I am thinking about possibly just using Omega 6 and Omega 3 along with some joint supplements.




Silicon Dioxide

Silicon dioxide is also called silica. It is added to foods and supplements for several reasons. Although the recommended daily amount is not known, scientists think that 5 mg to 10 mg per day may be adequate. Because silicon is important in human nutrition, silicon dioxide is added to vitamins and other food supplements as an active ingredient so that you can be sure you get enough of it for good health. In other uses, silicon dioxide functions as an anti-caking agent to prevent foods from absorbing moisture and clumping together. It's often found in the flavorings added to potato chips and other snack foods, as well as powdered mixes such as gravy.

Read more: http://www.livestrong.com/article/520897-what-is-silicon-dioxide-in-supplements/#ixzz2WVrtNoCA

[KennyJ]

"In 2004 I conducted a small study at the Belmont Pet Hospital to support the safety and efficacy of the DOGtorX™ formula. The study focused on aging dogs with orthopedic challenges and dogs with suspected or diagnosed Cushing's disease. Laboratory work, including chemistries, CBC's, thyroid and cortisol levels, was performed both before and after the administration of DOGtorX™. No adverse effects were noted.

One participant, an aging Labrador Retriever with significant mobility problems, was taking Rimadyl and Glucosomine prior to the study with little or no results. The owner was considering euthanasia. Within a very short time after adding DOGtorX™ to his diet, the dog became as mobile as a puppy. Nothing else was added or changed in his treatment. Now, two years later, this same dog is taking only DOGtorX™ and no more drugs.

Remarkable results were also shown on dogs with Cushing's disease who became active and playful again once put on the DOGtorX™ regime.

Presently, I have about 25 patients on DOGtorX™ and the responses are overwhelmingly positive. "

Ava. V. Ackerman, DVM
Belmont Pet Hospital
Belmont, California

[Squirt's Mom]

It's also a pesticide. ;) http://www.epa.gov/oppsrrd1/REDs/factsheets/4081fact.pdf

[KennyJ]

I need to look at my vitamins as well to see if that is one of the ingredients. That's scary. Ok, had to go back and correct my last post. There seems to be a difference. In my vitamins its silicon dioxide. In the DogTorX it's Silicone Dioxide. Apparently there is a big difference.

[KennyJ]

Hi Kenny,

DOGtorRx and DOGtorX is the same product, some states( such as Texas , Virginia, Ohio ) don`t laud the Rx version to be sold at Pet stores only at Veterinary Hospitals, so we decided to have only under one label the DOGtorX version. The active ingredient in the tablet is a chicken embryo extract, each tablet contains 50 mg.

Pleas see attached study.
Regards
Emeric


650-637-9594
Clinical experiences with DOGtorX in our Hungarian practice
The DOGtorX formula is a dietary supplement that contains natural growth factors oligopeptides, amino-acids, small amounts of iron, copper, selenium, and zinc. Each natural growth factor is comprised of peptides which are transported through the bloodstream to their specific receptor sites to achieve their bio-stimulant effect.
NGF (Nerve Growth Factors) FGF (Fibroblast Growth Factors) EGF (Epidermal Growth Factors) IGF-1, IGF-2 (Insulin-like Growth Factors 1,2) CTGF (Connective Tissue Growth Factors)

1. NGF (Nerve Growth Factors)
Promote neural cell survival which
alleviates anxiety and depression.
This in turn keeps the animal alert,
and enhances the ability to concentrate.

2. FGF (Fibroblast Growth Factors)
Essential to the development of the skeletal
and nervous systems.

3. EGF (Epidermal Growth Factors)
Promote skin tissue and hair growth and
development, speed up the healing of wounds.
The dog’s fur will become shinier, EGF reduce shedding.

4.IGF-1, IGF-2
(Insulin-like Growth Factors)
They play an important role in growth and development,
enhance liver, kidney and brain functions, and
have a beneficial effect on the adrenocortical hormone production.
5. CTGF (Connective Tissue Growth Factors)

Promote collagen production, which improves
ligament functions and alleviates joint pains.
Scientific research has clearly indicated[1] that the natural agents of the DOGtorX formula may help to regulate production of cortisol and insulin in the physiologically optimal amounts, which naturally helps alleviates several common dog diseases.

This document was written by Dr.Robert Gipper and has been professionally translated from Hungarian to English.
Among the above mentioned beneficial effects of this formula, personally I was most interested in cases where the disease is a result of hormone imbalance. As you know, the alternatives are scarce or very expensive in the treatment of these.

Diabetes mellitus
Patient No. 1: 4 year old female Poodle. In this fortunate situation, diabetes was diagnosed early, no major complications were present, and the blood sugar level was not excessively high either (12 mmol/l).
We started giving her the Eukanuba weight diabetic control feed, and the DOGtorX supplement (2x50 mg).
The blood sugar level was normalized within a few days and remained unchanged for the next four weeks.

Patient No. 2: 6 year old male, mixed breed, who has been suffering from diabetes for a longer period of time, and has been given insulin twice a day. After two weeks of taking the DOGtorX supplement (2x50 mg), the insulin could be reduced to half, after four weeks to one quarter of the original amount. It has been six weeks of treatment now, and the dog is not being given insulin at all.

Patient No. 3: 10 year old female Rottweiler, who has been receiving insulin-therapy for a while, and there was no improvement in her condition even after spaying.
She has been taking the DOGtorX formula (2x150 mg) for the past six weeks, and we only need to give half of the original daily dose of insulin now. We achieved this result around the 4th week of treatment, but our attempts to reduce this amount any further have been in vain so far: if we gave a dose smaller than half of the original, the blood sugar level invariably bounced back up too high.

Diabetes insipidus
Patient No. 1: 8 year old male Fox Terrier, who has been suffering from this type of diabetes for a longer period of time, and has been given Minirin (desmopressin). He has been taking the DOGtorX formula (2x50 mg) for four weeks, and at this point he only needs one quarter of the original Minirin dose to show no symptoms, that is, he does not drink and urinate excessively.

Patient No. 2: 9 year old Dachshund mix. This is a recent case, he has been taking the DOGtorX formula (2x50 mg) since the onset, for 6 weeks. He drinks significantly less water and he does not have urinary incontinence problems any more, but he is not asymptomatic yet.

Cushing’s disease
Patient No. 1: 10 year old female Dachshund. In her case, the disease has been diagnosed some time ago, she has been taking Nizoral pills (Cetoconazole) to reduce the symptoms, and has been fed Eukanuba Light feed to lose the excess weight. At this point, she has been taking DOGtorX formula (2x50 mg) for six weeks, she is not on Nizoral any more, but we are continuing with the lower calorie diet. Right now her water intake and urination are normal, she has lost a considerable amount of weight, and we observed a significant improvement in her fur and skin condition.

Patient No. 2: 11 year old male, mixed breed. He is a recent case, he has been taking Vetoryl pills and the DOGtorX formula (2x50 mg) since the onset of the disease, that is for four weeks. By the end of the fourth week, he only needs a quarter of the Vetoryl amount to make it through the night without having to be taken outside to urinate. The owner cannot afford to put him on a special feed, so all we could do to change his diet was that they limit the amount of food intake at home, and improve the quality of that food as much as they can.

Patient No. 3: 7 year old female, West High Terrier. She has been suffering from constant eczema issues, and was undergoing Prednisolone therapy coming from a different clinic. She has just recently come to us for treatment. The Cushing’s disease was a result of the continuous doses of glucocorticoid, and she was showing the classical symptoms. As the first step, we ran allergy tests which revealed nutritional problems. We changed her diet to the Eukanuba Dematosis feed, and ever since the onset of the disease three weeks ago, she has been taking the DOGtorX formula (2x50 mg). We stopped giving her Prednisolone altogether, but in the beginning of our treatment program we used skin soothing shampoo and antihistamine to reduce itching. As far as water-intake and urination, her condition has improved, but she is not asymptomatic yet, her weight remained unchanged. There has been a visible improvement, however, in her fur and skin condition already.

Hypothyroidism
Patient No. 1: 10 year old female Boxer. When she came to my clinic, she was considerably underweight, and showed symptoms of alopecia, hyperpigmentation, and shedding. The results of the blood test suggested hypothyroidism. We also detected mammary tumor and cystic transformation of the ovaries. We performed the necessary surgeries (ovarihysterectomy, removal of tumoral mammary tissue), changed her diet to Eukanuba Senior, and started her on the DOGtorX formula (2x150 mg). After four weeks of treatment, her condition was significantly better, the shedding ceased, and there was a substantial improvement in her overall well-being.
It is important to note that in the above mentioned cases of hormonal imbalance, we doubled the dose described in the “directions for use”. Based on clinical experiences with this formula in the US, they recommend a higher dose in similar cases.

Idiopathic colitis
Patient No. 1: 7 year old Cane Corso. He came in with constant diarrhea and was in a very bad shape. Based on various laboratory examinations, idiopathic colitis was diagnosed.
At this point, his treatment regimen is determined as follows: Salazopyrin pills, Eukanuba Intestinal feed, and DOGtorX formula (2x150 mg, twice the normal dose). After four weeks of treatment, the consistency of the feces is better, and although the complete resolution to solid stool has not occurred yet, his
condition visibly improved, his fur is becoming shinier, and he is happier and more playful than four weeks ago.

Other cases
In 10 cases, we gave the formula to dogs who were recovering from surgery, or who were in weak condition after an illness, and older dogs in poor physical condition. After 24-48 hours, there was a noticeable improvement in their mood and appetite. Their condition generally improved within two weeks, and the older dogs regained their youthful energy.

In 10 cases we treated dogs suffering from skin problems. While addressing the underlying causes, we also put the dogs on the DOGtorX formula.
In two weeks, after successful treatment of the underlying causes, generally their fur and skin condition also considerably improved.
In 10 cases we gave the formula to dogs with locomotor disorder. For various reasons, surgery was not an option for them, only symptomatic treatment was possible (i.e.: hip and elbow dysplasia, other arthritic conditions, etc.). Beyond pain relief, we gave them the DOGtorX formula instead of mussel extract. As a general conclusion, we can say that this treatment reduced the locomotor symptoms substantially better than previously used regimens. In four cases, we could stop giving pain relief pills after two weeks, they only take the DOGtorX formula now.
In two cases we gave the formula to dogs with persistent, recurring panosteitis. In addition to and following the usual treatment (antibiotics and non-steroids), continuous administration of the formula successfully prevented recurrence of the disease.
To summarize the above, I am confident that the DOGtorX formula considerably improves the medical conditions stated in the indications. In the treatment of hormonal imbalance, this formula fills a prominent gap: in a lot of cases, we lack alternatives.
I am happy to recommend this product, because I believe it will be a useful formula in the everyday practice of numerous colleagues, not only as a supplement, but also in helping to address the underlying causes. The planned consumer price is very reasonable even for our not-so-wealthy clients, and that is something to consider in today’s world.
Dr. Róbert Gippert
Lead Veterinarian
Kaposvár, Hungary
REFERENCES
1. Gippert R., Clinical experiences with DOGtor Rx in our Hungarian practice, Small Animal Practice Periodical 2008, 2nd issue, page 78.

[KennyJ]

He responded to my email immediately. I sent him another one about slicone just now.

[KennyJ]

Here is his response just now to my silicone question. I wrote him back and said I believe there is a difference between silicon and silicone.


Silicon dioxide is a common additive in the production of foods, where it is used primarily as a flow agent in powdered foods, or to absorb water in hygroscopic applications. A study that followed subjects for 15 years found that higher levels of silica in water appeared to decrease the risk of dementia. The study found an association between an increase of 10 milligram-per-day of the intake of silica in drinking water with a decreased risk of dementia of 11%.[43] In pharmaceutical products, silica aids powder flow when tablets are formed.

From: "kjarels@vt.edu" <kjarels@vt.edu>
To: Emeric Delczeg <edelczeg1@yahoo.com>
Sent: Monday, June 17, 2013 3:30 PM
Subject: Re: DogtorX vs DogTor RX

But this product has silicone in it. Isnt that dangerous?

[Budsters Mom]

Kenny,
We all desperately want to find a miracle cure that would cure Cushings and make our nightmares go away. There are many claims out there from people who prey on those searching for a cure. If there were such a cure, all of our babies would be well and happy and there would be no need for this forum. Although, I'd like to think we'd all still chat about how awesome our fur babies are and discuss vacations that we can now afford to go on. This it reality Kenny. There is no such cure as of now. You are exhausting yourself searching. Please don't buy in to false claims. Spend your time cuddling sweet little Gracie instead.;)
Hugs,
Kathy

[KennyJ]

So are the vets that I spoke with lying to me or they in this for the money?? I just got another email from pet equinox saying that silicone was a misprint, its supposed to be silicon. Here is the clinic that Dr Ackerman works for. They were extremely nice to me.


Dear Kenny -

Thank you for bringing this to my attention. This is an unfortunate typographical error which will receive my immediate attention.

It should read "SILICON DIOXIDE."

Attached is a copy of the original label which we put on our container prior to the latest batch of containers with the error on the label. I am now trying to determine when and how this occurred so that I can rectify the situation.

Best regards.

Emeric Delczeg





http://www.belmontpethospital.com/about-us.shtml

[StarDeb55]

Kenny, if these vets have signed contracts with the company to be a paid endorser or spokesperson, you will never know, & they will never admit to it. Please take Kathy's advice to heart. If there were truly an effective homeopathic option to treat Cushing's, every single pup in these forum would be on it. I am highly skeptical as a lab tech for the type of claims the company along with these vets are making, when they can't show lab testing & documentation that validates that their product does, indeed, lower cortisol effectively. I think you know already that Cushing's isn't an inexpensive disease to get diagnosed or treated initially, so the $$$ you are spending on all of these homeopathic type products would be much better spent went you have to get Gracie tested.

I don't mean to sound harsh, but we've all been where you are, praying for an alternative to the standard treatments, & there just isn't.

Debbie

[KennyJ]

Well there is one thing I can say most definitely I have proof of. Not saying what caused it but the only thing I have added to Gracie's diet is the DogTorx. She had 7-15 fatty lumps all over her stomach and chest. One was almost the size of a golf ball. Some have completely disappeared and the large one has shrunk in size. I had a friend that felt the cysts on more than one occasion come over to see if I was going crazy. She was amazed. Maybe it was my moms prayers or something else I don't know. All I know is that I have been giving this supplement for over a week now and it does have selenium and Vitamin E in it.

[Squirt's Mom]

I did a little research on this Dr Ava Ackerman last nite - there is a doctor by the same name who has been accused of fraud in connection with a global warming petition....accused of falsifying her credentials.

Her name is associated with this product everywhere EXCEPT with the hospital where she works...there she is known for her work with EXOTIC ANIMALS.

EVERY testimonial for DogTorRX says the same thing over and over and over. I've never known of one single substance that worked like a miracle for every dog who took it....have you? Not one report of it not working perfectly, not one report of adverse effects of any kind. Even pharmaceutical studies don't have that kind of result!

To bluntly answer your question, yes these "doctors" are lying to you in order to line their pockets with funds from your pockets. There is no "miracle cure" for her leg nor for Cushing's. As Barbara said, if products like this worked, every dog here would be on it and you would have never heard of k9cushings nor met any of us as there would be no need whatsoever for forums like ours. ;)

Now, if you want to learn some ways that will be actually beneficial to healing Gracie's leg, join this group -

http://pets.groups.yahoo.com/group/ConservativeManagement/

I learned a great deal there that helped my Crys, who had multiple skeletal deformities and other issues due to starvation as a puppy. You will learn about supplements, exercises, tips/tricks, etc. that can actually help Gracie. Again, her leg is where she needs your focus needs right now, today, immediately.

My heart goes out to you because I fully understand your angst to find something, anything, that will help NOW, quickly, and once-and-for-all. I am dealing with the same feelings with a foster of mine - she is dying from a inoperable mass in her chest and I want to FIX IT NOW! I've been told there is nothing we can do...but I can't accept that just yet so I keep looking, searching, digging, talking, praying for that "miracle cure". Every wall I hit, I just bounce off of and go on to bash into the next wall. I know your love for Gracie is driving your search for a cure; just don't let that love blind you, allowing you believe garbage because you have such high hopes. ;)

Hugs,
Leslie and the gang

[KennyJ]

Leslie, I called the clinic where she worked so not sure what you mean that she doesn't back this product at her practice. Maybe I misunderstood what you said but Dr Ackerman does give this to her clients at her practice. That much I know. Now the other thing you mentioned about the petition I will check into as well. And some of the vets say they give this in addition to the traditional meds and found that for some of the dogs they could reduce the traditional meds because of this product. One of the vets said she would never prescribe it though without seeing the dog first. Also, a couple have said it worked well for some of their dogs and only somewhat for others. The only reason I am trying it is until I can finally get her tested I didn't think it would hurt. I will still get her tested once I get the leg healed which seems to be improving. Thanks for the group link, I just joined.

[goldengirl88]

Kenny:
I do know that I read somewhere that dogs with Cushings need selenium, vitamin c, and vitamin e. It may have been in something Dr. Peterson wrote I am not sure where I saw it. My vet told me he personally take selenium every day. Blessings
Patti

[KennyJ]

I have no idea if this can help her in any way shape or form. However, I am not testing her until I get this leg under control. A couple of vets locally said I could still get her tested. But I want this leg healed. I do know for a fact that the lumps on her chest and stomach have shrunk in size and some have disappeared all together. I don't know what caused that to happen but glad that something caused it. I do know that Dr Ava Ackerman gives this to her clients. I called twice. Her dogs have had good results, not all of them were for cushings, some were for ligament damage. I will still get her tested for Cushings but meanwhile I don't see how this product could hurt. I took the product to the vet doing Gracie's laser surgery and she looked at what was in it and she didn't think it would hurt her as well.

[KennyJ]

I wanted to thank everyone again for all your support. I am still getting people including vets that say 2 years is the average life expectancy after being diagnosed with Cushings and I just come right back here and read otherwise.

[Roxee's Dad]

Hi Kenny,
We will always be here for you and Gracie :) Glad to see she is improving. :D

[KennyJ]

Just wow. Talked to Valley Hospital about testing Gracie for Cushings and the vet told me most of the time they don't treat the disease because it's so expensive and it doesn't increase their life span. Only helps with the symptoms. This is the hospital that has a 5 star rating and did the xrays on Gracie's leg.

[frijole]

I wanted to thank everyone again for all your support. I am still getting people including vets that say 2 years is the average life expectancy after being diagnosed with Cushings and I just come right back here and read otherwise.

My Haley lived 4 1/2 yrs after being diagnosed. Deb's dogs lived longer than that. Haley died at 16 1/2 of old age - not cushing's. Anyone that tells you the 2 year thing is full of crap and it's a sign of someone that doesn't know anything about this disease. Don't listen to them for a minute - cross them off of your list of people to trust. I truly mean that.

I've been active here for over 8 years and there are many many dogs that beat those odds. More do than don't and those that don't usually die of something else. Kim

[Squirt's Mom]

What you're hearing there isn't all that uncommon. When Squirt was first diagnosed, I traveled to see a close friend quite often and wanted to be sure there was a vet close by who could see Squirt if needed. I called 14 vets in the area and only ONE treated Cushing's and he was 45 min. away. The rest either didn't test for / treat it, or they sent their patients into Memphis, TN - about 2 1/2 hours away.

When we returned to ARK, I started looking for a cush savvy vet. Of the vets in town who treat Cushing's, they all started telling me that the protocol Squirt was on wouldn't help her - even tho her tests proved otherwise - and would insist on changing her meds. I ended up with a vet in the next county over who admitted he knew next to nothing about Cushing's and who had no cush patients. Why choose him? Because of all the vets I talked to, he was the only one who was willing to listen to me, willing to admit he didn't know it all, and willing to learn. I'll take humble ignorance with a willingness to learn over arrogance every time. ;)

[molly muffin]

Hi Kenny,

Keep looking. 5 stars for most things maybe, but we on this forum, Know how hard it it to find a good vet to treat cushings and we Know how many don't or who don't do it correctly if they do. If not, then we would not be what we are, which is one of the foremost resources for information and support on the net, with members from all over the world.

We exist because there is a need for us to exist and because we have some very kind hearted people who have kept this forum going through thick and thin and with a dedication of their own personal time.
There has not yet come a time, when vets with knowledge and a willingness to treat cushings exist in abundance. They are hard to find. If you do find a good one, keep them.

I had never heard of cushings when Molly was given the diagnosis. Probably most people haven't. A lot of vets while knowing of it, don't follow all the research and treatment papers that have been done on it. We do to the best of our ability to get access to vet and university vet hospitals papers.

My IMS had been to a recent conference where they talked about cushings and I think that it is usually the IMS (Internal Medicine Specialist, small animal) that probably keep up with the research. I doubt that many regular GP vets do, other than through their contact with the med reps.

Anyway, I'm just saying don't give up, and don't believe everything you hear and read. We live and breath cushings here every day of the year. We have almost 3000 members world wide and over 400 of those are considered active. That should tell you alot right there. I'm not tooting our own horn so to speak, I'm showing you what kind of need is out there in the world when it comes to cushings and our beloved dogs.

We will do everything we can to help you become more knowledgable so you can help Gracie. As Leslie said, just find a vet who will work with you, who is willing to treat and who cares about you and Gracie. We can provide you with all kinds of information to give to your vet. Our resource section is full of protocols and information.

Hang in there!!!
Sharlene and Molly Muffin

[Roxee's Dad]

Hi again Kenny, :)

In many cases a cush pup will be laid to rest within the first year or 2. But only because the owner didn't care enough to pay attention to the signs of distress, The owner didn't care, the owner didn't learn more about cushings and the treatment of cushings, the owner was afraid to speak up as an advocate for their pup and followed blindly the recommendations of the vet. Some vets have more or less experience, some vets don't keep up with the newest recommendations.

All vets are not created equal and they are not specialist. They are general practitioners. That is why many members use both a vet and an IMS to treat cushings. The vet realizes he may not know enough and want to enlist the help of an IMS. I was lucky that I found a vet that was willing to work with me as a team, willing to listen to my observations, to learn and we even got involved in some heated discussions, but always came to an agreement in the end that was best for our Roxee.

You are here because you want to learn all you can about cushings to ensure Gracie get's the best possible care.... and we are here for the same reason. Read, learn, and you will be a great advocate for Gracie. :) Your here, so you are already on the right track. ;)

[KennyJ]

John the only internal medicine vet happens to be at the vet school and he will not treat Cushings but will do the tests. I do not have any faith in any of the local vets here. All have something different to tell me. Most only want to run the ACTH test but the clinic that wants to do lssd test also says that most clients decide not to treat. He said this test cost anywhere from $255-$350. I am so aggravated right now at all these vets.

[KennyJ]

And all are so negative about the outcome.

[Budsters Mom]

They are actually right about one thing Kenny. The tests are expensive! The low-dose Dex test cost me almost $300. Each time Buddy needs an ACTH test, it costs $290. Vets vary on their prices, but these prices are pretty standard. You can usually get tests for much less at teaching hospital like UC Davis. This is why we didn't want you to spend your money on so-called cures that do not work. It is not cheap to test and treat for Cushings. Many of us struggle with the expenses involved. Let's get Gracie's leg healed first, then go from there. If all the vets you've talked to are negative, you have not found the right one yet.:D
Hugs,
Kathy

[Trixie]

When Trixie's diagnosis was confirmed I was talking to my vet and of course feeling worried and pessimistic and he was very upbeat and said " the medication can work really well and many dogs do just fine". It was indeed good news to me. The expense is a lot to deal with and that is true but that is a whole other issue than saying "they don't treat Cushing's because it doesn't increase their life span".
I think everyone here on the board has shared their experiences both good and bad about treating and what better source is there? Someone posted last week that their dog has been on trilostane successfully for the last 3 years. That's sounds good to me.
Barbara

[Roxee's Dad]

Just a thought... When you are talking with the vets, did they ask or did you tell them that Gracie doesn't have a ravenous appetite or excessive thirst or urination?

My thought is that many vets and owners don't treat until the symptoms appear and become a problem. Part of the whole treatment process is monitoring symptoms.

One more thing, many IMS don't actually treat cushings, but they usually work with a vet. The vet being the main care giver with the IMS as a consultant.

[lulusmom]

Just wow. Talked to Valley Hospital about testing Gracie for Cushings and the vet told me most of the time they don't treat the disease because it's so expensive and it doesn't increase their life span. Only helps with the symptoms.

Well duh! Isn't that vet deep? Every renown endocrine specialist in the world will tell you that the goal of treatment is to remedy the symptoms and they will also tell you that they have treated thousands of dogs and extended their life expectancy. I'd say you need to kick that vet's butt to the curb and yell "NEXT!"

Given the inordinate numbers of vets you have talked to, most of whom are wearing their ignorance on their shirt sleeve, you are either not listening to the members on this site or you don't believe our first hand account of our own dogs' success with treatment. The only way to remedy the symptoms is to reduce the excessive production of cortisol. By reducing the cortisol, its negative impact on the internal organs and the immune system is mitigated, which is why many of us who have chosen to treat our dogs have seen them live well beyond the two year survival myth that you have cited time and time again. It seems that our factual stories, proving these vets wrong have fallen on deaf ears. I believe I already told you that my first cushdog was a rarety, being diagnosed at three years old. She was happy and full of life for seven years after diagnosis. My second dog, who was very senior when diagnosed, lived another five years. You've heard many others share the same stories yet you don't seem to believe it and continue in your quest to find a vet who will validate us. If that's what you are looking for, you need to be armed with knowledge before you start quizzing more vets. The next time you talk to a vet who tells you that they don't treat because it has no impact on the prognosis, ask them read this excerpt from Chapter 118 of the Textbook of Veterinary Internal Medicine authored by Drs. Stephen J. Ettinger, and Edward C. Feldman. If any of the vets you talked to were an internal medicine specialist, they would have learned this tidbit in school, including your friend, the internal medicine specialist, who erroneously thinks that any general practitioner can safely and effectively treat cushing's.


Pituitary-dependent hyperadrenorcorticism is a serious disorder. We have been able to monitor more than 500 treated dogs. Of the dogs that have died, the life expectancy averaged 29.7 months. These included dogs that lived only days and several lived longer than 10 years. It appears that good owner observation improves the prognosis.

Gee, longer than 10 years? You betcha and if you spend more time reading reference material published by the world experts like Dr. Edward Feldman, Dr. Mark Peterson and Dr. David Bruyette, instead of talking to general practitioners who possess about a thimble full of knowledge by comparison, you can be that good owner that will improve Gracie's prognosis. You, Kenny, are Gracie's best chance to live a long happy life, whether she has cushing's or not. Instead of tuning us out and wasting your time calling vets who aren't telling you what you want to hear, hunker down and become smarter than the average general practioner. How else are you going to know what to ask the next time you interview a vet in an effort to find the right one for Gracie? Questions like how many cushingoid dogs are you currently treating and with what success. Which drug do you prefer to prescribe to your patient and what adverse effects should I be watching for? What treatment monitoring protocol do you follow? Do you prescribe prednisone to have on hand in the event of an addisonian crisis? Do you have a special interest in internal medicine and have you taken continuing education courses in cushing's or any other endocrine disorder? I could go on and on but you get the idea. If you don't know why you should ask any of those questions, you still have a lot of homework to do.

[mytil]

Hey Kenny,

I do agree with Glynda here.

And I have spoken to a number of vets over the years and to use this quote to their clients about not treating is more times than not because they have no confidence the owner will actually do the job from their end. Now having said that, this is different than the owner making this personal decision regarding treatment; of which that is their choice and there can be so many extenuating circumstances because of this.

You are Gracie's advocate. :)
Terry

[KennyJ]

Sorry I had to use the quote feature to respond to this one. Yes I do listen to what the group members say on here. However, if the IMS at the Vet School will not treat Cushings only diagnosis it my options of finding a qualified vet are running out. I mean I certainly can't drive several hours each time Gracie needs to be tested or her dosage needs to be changed. I am doing my homework and asking questions and I still get the same answers. This is exactly why I am asking so many questions to so many different vets. I want a vet that I feel is qualified to treat Gracie for this disease. If I had found such a vet I would have ended my search and stuck with that particular vet. That hasn't happened yet. These vets all come highly recommended by people that I trust. I even joined Angies list to see how each clinic is reviewed. The Valley Animal Hospital has a 5 star rating and was just named Vet Hospital of the year. Dr ReRolf was named top vet 5 years straight and even he said a lot of dogs do not do well on the medications for Cushings and usually live 2 years after diagnosis. Dr Wadstrom says test Gracie now with the LSSD test even with the injured leg. I let him know what members said about it giving a false positive and he still said test her now. He was another one that said the disease would most likely decrease her life expectancy. So I am asking questions but so far I don't feel comfortable with any of the vets in my area. There is only one Dr that told me that Gracie could live out her life expectancy and that was the IMS at the vet school here in Blacksburg, Va. But he will not treat her. Said the regular vets could do that. So I feel I am stuck. Now my vet is of course out with back problems and has been for several months. I may wait and see when he will return. But I am trying. None of the vets are IMS vets all are GP's. Some have an interest in internal medicine but that's about it. And I wanted to add, I hope this didn't come across as being mean because I certainly didn't mean for it to. Matter of fact if it wasn't for this group I probably wouldn't be asking all the questions to the vets. All of you have been most helpful. So again, thank you.







Well duh! Isn't that vet deep? Every renown endocrine specialist in the world will tell you that the goal of treatment is to remedy the symptoms and they will also tell you that they have treated thousands of dogs and extended their life expectancy. I'd say you need to kick that vet's butt to the curb and yell "NEXT!"

Given the inordinate numbers of vets you have talked to, most of whom are wearing their ignorance on their shirt sleeve, you are either not listening to the members on this site or you don't believe our first hand account of our own dogs' success with treatment. The only way to remedy the symptoms is to reduce the excessive production of cortisol. By reducing the cortisol, its negative impact on the internal organs and the immune system is mitigated, which is why many of us who have chosen to treat our dogs have seen them live well beyond the two year survival myth that you have cited time and time again. It seems that our factual stories, proving these vets wrong have fallen on deaf ears. I believe I already told you that my first cushdog was a rarety, being diagnosed at three years old. She was happy and full of life for seven years after diagnosis. My second dog, who was very senior when diagnosed, lived another five years. You've heard many others share the same stories yet you don't seem to believe it and continue in your quest to find a vet who will validate us. If that's what you are looking for, you need to be armed with knowledge before you start quizzing more vets. The next time you talk to a vet who tells you that they don't treat because it has no impact on the prognosis, ask them read this excerpt from Chapter 118 of the Textbook of Veterinary Internal Medicine authored by Drs. Stephen J. Ettinger, and Edward C. Feldman. If any of the vets you talked to were an internal medicine specialist, they would have learned this tidbit in school, including your friend, the internal medicine specialist, who erroneously thinks that any general practitioner can safely and effectively treat cushing's.



Gee, longer than 10 years? You betcha and if you spend more time reading reference material published by the world experts like Dr. Edward Feldman, Dr. Mark Peterson and Dr. David Bruyette, instead of talking to general practitioners who possess about a thimble full of knowledge by comparison, you can be that good owner that will improve Gracie's prognosis. You, Kenny, are Gracie's best chance to live a long happy life, whether she has cushing's or not. Instead of tuning us out and wasting your time calling vets who aren't telling you what you want to hear, hunker down and become smarter than the average general practioner. How else are you going to know what to ask the next time you interview a vet in an effort to find the right one for Gracie? Questions like how many cushingoid dogs are you currently treating and with what success. Which drug do you prefer to prescribe to your patient and what adverse effects should I be watching for? What treatment monitoring protocol do you follow? Do you prescribe prednisone to have on hand in the event of an addisonian crisis? Do you have a special interest in internal medicine and have you taken continuing education courses in cushing's or any other endocrine disorder? I could go on and on but you get the idea. If you don't know why you should ask any of those questions, you still have a lot of homework to do.

[Roxee's Dad]

Hi Kenny :)

Yes it can be so frustrating, but like I mentioned before, many IMS will not actually do the treatment, but will diagnose and consult with your vet. It is usually the vet that actually is the regular care giver. If it's a good vet, he will consult with the IMS if he or she has any hesitations or questions.

For follow up testing such as the ACTH to monitor treatment, it is usually the vet, not the IMS. Very seldom will you read that an IMS is handling day to day cushings treatment, although it does happen, especially for difficult cases and we do have a few of them here.

I wanted to ask my earlier questions again.


Just a thought... When you are talking with the vets, did they ask or did you tell them that Gracie doesn't have a ravenous appetite or excessive thirst or urination?

My thought is that many vets and owners don't treat until the symptoms appear and become a problem. Part of the whole treatment process is monitoring symptoms.

Hang in there, we all know how frustrating it can be, especially since you feel kind of helpless at the moment not knowing for sure. Waiting can take quite a toll, but you and Gracie will get thru this.

[KennyJ]

John, I did tell the vets that Gracie does not drink a lot of water. At the most in a day it's been 16 ounces. However, she does urinate a lot. The vets say not all dogs will show the same symptoms for the disease. The vet that did the xrays has already written on her chart that she has Cushings and that's without testing. That bothers me. The vet that is doing the laser surgery checked to see if Gracie had an infection. . She said the urine was not all that diluted but it was probably somewhere in the middle which I know doesn't mean much when it comes to Cushings. Getting back to the water intake, Gracie drinks on average 12-14 ounces of water a day. She weighs right at 13 lbs. So she does have a lot of the symptoms for Cushings, excessive panting and urinating but not the water drinking or ravenous food appetite. And oh yeah the extremely elevated ALP.

[Squirt's Mom]

...the urine was not all that diluted but it was probably somewhere in the middle which I know doesn't mean much when it comes to Cushings.

Actually, that means a great deal in Cushing's. A cush pup cannot concentrate their urine so it is almost clear - unless an infection is present. The kidneys are affected by the excess cortisol making it hard for them to do their job properly and the vast majority of cush pup's urine IS dilute. ;)

[KennyJ]

Valley Animal sent me an email a few minutes ago and I wanted to see if you guys agreed or disagreed.




I spoke with Dr. Poage briefly and discussed your questions regarding Gracie. Dr. Poage agreed that all our doctors have similar levels of experience treating Cushings and the response to treatment is usually favorable but, results may vary depending on the type of Cushings (typical vs atypical). I also asked Dr. Poage if he felt Gracie's recovery from her injury could cause false positives when blood testing for Cushings and said it would not. With that said, he does not see a problem with waiting until after Gracie has recovered from her injury before addressing the Cushings. If you have specific questions please respond to the email and I will be sure Dr. Poage addresses each one. Thanks and have a great day. David

[Roxee's Dad]

If you have the time to read, this is a good article by Long Beach Animal Hospital. It's long but it really goes into understandable detail, and it has pictures too .... LOL;)

http://www.lbah.com/word/cushings-hyperadrenocorticism/


Treatment
Before we discuss treatment we need to keep things in perspective. This is a chronic disease, and most dogs do not die from this disease. We tend to treat when the symptoms described previously are affecting a dog’s quality of life or are a major nuisance to a pet owner. We do not routinely treat just because the tests say your dog has Cushing’s- the symptoms of the disease need to be present also.

Plenty of articles by a very well known Dr Mark Petterson and Dr David Bruyette both specialist in diagnoses and treatment of cushings. Don't know if you checked, but some are in our Resources section too. :)

[KennyJ]

John, I haven't read the article yet but what you just said makes perfect sense. The symptoms that Gracie has certainly hasn't bothered me but I am wondering how much it is bothering her? And I still am very much confused as to if we are just treating the symptoms and not the disease how will that prolong her life? Does that makes sense?

[KennyJ]

I thought most of the tumors were benign. And after looking at the symptoms of that article and seeing the ruptured CCL. Wow.



Pituitary Dependent (PD)

Up to 90% of all Cushing’s cases in dogs fall into this category. The pituitary gland is invaded with a slow growing cancer called an adenoma. This causes it to secrete an excess amount of ACTH. The cells in the zona fasciculata area of the adrenal glands respond to this excess ACTH by hypertrophying (enlarging) and secreting excess cortisol. It is this excess of cortisol that is circulating in the bloodstream that causes the symptoms we see in this disease.

[lulusmom]

Hi Kenny,

I'd like to comment on a few things in your post below. See my comments in blue text.


Sorry I had to use the quote feature to respond to this one. Yes I do listen to what the group members say on here. However, if the IMS at the Vet School will not treat Cushings only diagnosis it my options of finding a qualified vet are running out. I mean I certainly can't drive several hours each time Gracie needs to be tested or her dosage needs to be changed.

There are a number of us who never found a qualified general practitioner vet and settled for the lesser of two evils, so to speak. We became more than a proactive participant in our dogs' treatment and took the lead on making sure that our vet's adhered to proper dosing and monitoring protocol. It's easy to make that call because we are the ones who have more control over making sure the vet follows proper protocol. We make the appointments, we are the ones who make sure our dog is given their dose with food and we get them to the vet within three to five hours after dosing. In looking back over the years, I can honestly say that gp vets did little more than do annual senior panels, blood draws for stim tests, provide me with the results and recommend dosing changes based on the those results. Some recommendations were unacceptable and I felt sorry for the other cushdogs, with ignorant owners, who would never be completely controlled because these vets had no idea how to assess a stim test for purposes of monitoring treatment. My dogs were being treated with lysodren and needed their pre and post cortisol to be within the therapeutic range of 1 - 5 ug/dl. Both were perfect between 2 and 3 but I was told it was too low and to discontinue treatment. Argh! Inside I was angry and wanted to say, "Dude, if you are going to take on the responsibility for treating a cushdog, for heaven's sake take some continuing education courses on endocrine disorders so you know what in the hell you are doing." Instead, I calmly explained that he was wrong and promised to bring him credible reference material to read so that he doesn't repeat his mistake with his other patients. It's difficult to remain tactful with vets who have such unmerited egos, as they stand before you in such an authoritative manner, while delivering their inofficious and beyond ridiculous assessment of your dog's status. It's mind boggling but in reality, not so unusual in the canine cushing's world. I think you are beginning to understand that reality. Bottom line, had I followed this vet's instructions, I would have lost complete control of both dogs and would have incurred hundred and hundreds of dollars for unnecessary meds and stim tests and never regain complete control of their cortisol. I loaned this same vet a cd of a lecture given by Dr. Edward Feldman that went into great detail about how to diagnose cushing's, which treatments work, how to dose and how to assess treatment of whichever drug you have prescribed.

As for gp vet vs IMS, if there was a questionable stim test result, I would fax the test to the IMS and ask for his feedback. I never changed my dog's doseage without consulting with the IMS. He was my dogs' primary vet and I used the gp vets for discounted blood tests. I would certainly hope your friend, the IMS, would guide you if you needed his help. If not, we're here to do that or you could try to find another IMS who will associate in with the gp vet you ueventually choose for Gracie.

Now about expenses. Diagnostics are not cheap but once you start treatment and get a dog stabilized, the expenses drop considerably. In addition to the lecture audio, I also gave two vets copies of Dr. Mark Peterson's blog about how to save money on the acth stimulation test by splitting the vial of cortrosyn, the stimulating agent used in stim tests. This can save those of us with small dogs lots of money if the vet will cooperate. All it takes is reading instructions that Dr. Peterson has put out their for vets who want to learn and help their clients help their dogs. I'll be happy to provide that information to you if you should ever need to have this discussion with the vet you choose for Gracie.

I am doing my homework and asking questions and I still get the same answers. This is exactly why I am asking so many questions to so many different vets. I want a vet that I feel is qualified to treat Gracie for this disease. If I had found such a vet I would have ended my search and stuck with that particular vet.

Can you tell us the specific questions you are asking and what answers you feel are acceptable? Just remember that sometimes a wrong answer doesn't matter as long as you have the right answer.

That hasn't happened yet. These vets all come highly recommended by people that I trust.

If these people have never had a dog with cushing's, you cannot trust them to steer you to a cushing's savvy vet. Only someone who has lived and breathed the disease should be giving you recommendations for an appropriate vet. Have you asked these trusted people if their recommendation is based on their first hand experience with canine cushing's or the vet's proven experience with cushing's?

I even joined Angies list to see how each clinic is reviewed. The Valley Animal Hospital has a 5 star rating and was just named Vet Hospital of the year.

There are untold numbers of excellent vet facilities who provide excellent care to their patients but that doesn't mean their excellence extends to canine cushing's. Ten years ago, I was still giving my old gp vet rave reviews and I referred people to him all the time. He had treated my dogs for umpteen years and trusted him to do what was right, but my adoration for him turned to sheer anger when I finally knew enough about cushing's to realize that my poor baby girl paid a heavy price for his umitigated ignorance.

Dr ReRolf was named top vet 5 years straight and even he said a lot of dogs do not do well on the medications for Cushings and usually live 2 years after diagnosis.

There are probably a lot of members here who given the opportunity would vote for Dr. ReRolf's as a vet to stay away from if your dog has cushing's. There are scores of threads on this site that clearly show that there is a definite trail leading from an sick and/or overdosed dog to an inexperienced vet and an uneducated pet owner. The same, if not more, threads have have repeatedly blown Dr. ReRolf's two year survival prognosis out of the water.

Dr Wadstrom says test Gracie now with the LSSD test even with the injured leg. I let him know what members said about it giving a false positive and he still said test her now. He was another one that said the disease would most likely decrease her life expectancy.

Unless Dr. Wadstrom knows something about Gracie's medical history you haven't told us about that could take her life prematurely, he too gets my vote for a vet to stay away from.

So I am asking questions but so far I don't feel comfortable with any of the vets in my area. There is only one Dr that told me that Gracie could live out her life expectancy and that was the IMS at the vet school here in Blacksburg, Va. But he will not treat her. Said the regular vets could do that. So I feel I am stuck.

You aren't stuck at all. If you have to settle for less than what you need in a vet, we've got your back. We can provide you with the tools you need to make sure you are doing what you need to do and that your vet is doing what s/he should be doing. None of us are veterinary professionals...far from it but you can bet your bottom dollar that we have practiced what we preach and we can provide credible science based references to support whatever feedback we're giving you. I'd like to see what Drs. Wadstrom and ReRolf could give you, other than their own limited and apparently failed experience, to support their unfounded comments.

Now my vet is of course out with back problems and has been for several months. I may wait and see when he will return. But I am trying. None of the vets are IMS vets all are GP's. Some have an interest in internal medicine but that's about it. And I wanted to add, I hope this didn't come across as being mean because I certainly didn't mean for it to. Matter of fact if it wasn't for this group I probably wouldn't be asking all the questions to the vets. All of you have been most helpful. So again, thank you.

I didn't find anything you wrote to be remotely mean and I sincerely hope you don't think I'm mean. I'm just outspoken and beyond passionate in my desire to help members and their precious pups. We've all walked in your shoes, Kenny, but I can't say that I've ever seen many members with the depth of committment you have shown in your tireless effort to find the right vet to partner with you so that Gracie gets the best care possible.

[Budsters Mom]

Yes Kenny,
Believe what Glynda had told you. Every single word of it!;) My trusted vet was on vacation when all of this Cushing stuff started with Buddy. She had Trilostane dosing directions wrong. She gave me the wrong directions for the ACTH stim test. She did diagnose Cushings correctly. That's about the only thing that she had right. Glynda, Marianne and several others came forward to steer me in the right direction. I was then able to correct my vet's mistakes and insist that everything was done according to proper protocol. They have your back just like they have mine. You are in the best hands ever!:)
Hugs,
Kathy

[KennyJ]

Kathy, I am trying to find Glynda's post. Must be back several pages.

[frijole]

nope it's the one right before Kathy's (#490) Her comments are inside of your quote and she wrote in blue.

[KennyJ]

Oh ok, sorry haven't gotten use to all the names yet. Thanks.

[frijole]

:D We understand - don't worry about that.

[Budsters Mom]

I am so sorry Kenny. Glynda is Lulusmom on the forum. Her message is right before mine. When I mentioned Marianne, she is Labblab on the forum. We have many very knowledgeable members. You can trust them to know what to do, when the doctor's don't. That is why you see so many of us run home and post our test results as soon as we get back from the vet. We want our members to interpret them for us to make sure that our vet has made the right call.;)
Hugs,
Kathy

[KennyJ]

Gracie seems to be doing much better on her leg. She will sometime shift her weight on the other leg but I have seen much improvement. The panting is what concerns me. Other than that she seems like a normal little dog. And the one thing that has really taken place is the 7-15 fatty tumors have either decreased in size or completely gone. I don't have an explanation for that. The only thing that has changed is the addition of dogtorx. That's it. Whatever caused it I am elated.

[KennyJ]

This place is about two hours from where I live. Would it be worth it to let them test Gracie for Cushings?


http://vavetspecialists.com/about-us/doctors/

[Squirt's Mom]

There isn't really anything complicated or special about the testing for Cushing's - just about any vet can do them, other than the ultrasound. All the vets do is pull the blood, mix the appropriate agent, and then they send it off to a lab. The trick is in interpreting the results and knowing what to do with them. So who does the testing isn't all that critical as long as they can follow some very simple directions. It's who does the actual caring for the pup that matters - what they know about the disease; how much success they have had in treating it; what drug, if either, they prefer and why and have had the most success using; whether they are willing to listen to you and talk to you on a level you can understand; whether they will work with you as a team, not boss and underling; if they will be available to you; if they have a good IMS they work with and can refer you to IF needed; whether you and Gracie are comfortable with them. You don't want to have a vet far away to care for Gracie if you can help it - you need one close enough that trips aren't a burden on you or Gracie, who is close enough to get to in an emergency or to pick up meds easily. If, and that is IF, Gracie has Cushing's, you will be making numerous trips to the vet for a while and afterthat, many more than have been normal for most folks. So be as practical as possible while doing your best to make sure the vet you choose is one you are happy with and trust.

May I ask why the vet she has seen to this point wouldn't work? If you have said why, I apologize for asking you to repeat yourself.

[KennyJ]

My confidence level in the vets here locally is pretty low right now. Animal Valley said they would do the LSSD test as the first test and 3 of the other vets said ACTH would be their first choice. Animal Valley and Dr DeRolf were the ones that said treating Cushings in dogs does not prolong their life it only helps with the symptoms but that most dogs die within 2 years. I don't like that response. Gracie is only 9 years old and Maltese normally live a very long time. So their prognosis makes me think they have not had much success in treating this disease. The clinic that I have taken Gracie to since she was a pup also suggested the ACTH as the first test. However, my vet is still out with back problems and I don't have clue as to when he will return. It also bothers me that he never suggested anything at all last year that Gracie looked like a dog that had Cushings. And trust me she hasn't changed much from that time to now. If I hadn't suggested the CBC with chemistry profile I would most likely not be talking about Cushings right now. I realize taking her to all the different vets has caused me a lot of confusion but how on earth can they different that much on the method of testing?? That's why I am nervous about having any of these vets treat her.