Cushings meds....do they work?

[Jubilee]

My dog is perhaps just starting on the road of this disease. She has been on prednisone, off and on, for a year, usually at 20mg doses. I read this disease could be prednisone-induced and she is now weaning off this drug. She had a blood test and shows the elevated levels indicating Cushings and she has the weak muscle symptoms. The vet is sending me to get an ultrasound because the liver is enlarged, the belly extended and she wants to see the adrenal glands and if there is anything else going on in the liver. After that, she wants to send me to the LDDS test, if necessary, to accurately diagnose.
My question is...has anyone here had this Cushings diagnosis, went on the meds and what has been the results for your dog? My dog is 11 years old. Did it just prolong the life and your dog still had terrible difficulty walking? Did it vastly improve the quality of life? Is it worth it for the dog to take the meds in the long run? Does it cure them of this disease? If they take the meds for the rest of their life, does the disease eventually take them down? If it does help, how long does it extend their lives? Will my dog be glad that I did this for her?

[Harley PoMMom]

Hi and welcome to you and your girl,

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

Steroid induced Cushing's, known as Iatrogenic Cushing's, occurs as the result of over administration of corticosteroids such as prednisone.

Prednisone mimics cortisol in a dog's body and therefore will skew any tests done for Cushing's. Also, prednisone will create Cushing like symptoms in a dog. So, until your girl has been off the prednisone for a while, with a slow tapering, no tests to diagnose Cushing's should be done.

Could you tell us more about your girl? Such as why she is taking the prednisone. Does she have any other health issues? How much does she weigh? Also, if you could copies of all tests that were done on your girl and post the abnormalities that are listed, that would be of great help.

One thing I want you to know is that a Cushing's diagnosis is not a death sentence for a dog, in fact it is a treatable disease. But, we shouldn't get ahead of ourselves here, because I really do not think your girl has the typical Cushing's disease.

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

Love and hugs, Lori

[mytil]

Hi and welcome from me too.

I would be very suspicious that the Cushing's diagnosis is being caused by the prednisone; especially if testing was performed while still on it.

Is your girl completely off of it? How long ago was this? The clinical signs (symptoms) are all symptoms of prolonged use of steroids like this.

Like Lori mentioned being diagnosed with Cushing's is not a death sentence and can be treated and monitored effectively by an experience vet. Many here end up working with an IMS (internal medicine specialist).

Keep us posted
Terry

[Jubilee]

Thanks, Lori, for the quick response.

Jubee started taking prednisone last year because the vet thought she had an autoimmune disorder. She had problems with her back legs and sometimes she couldn't stand up. The nose is peeling (maybe discoid lupus) and her paws occassionally swell, the pads crack and they get inflammed. (Allergies perhaps?) Blood test was done for SLE (lupus) but showed negative but the prednisone calmed all the problems so she would do prednisone and antibiotics. The paws had a scraping and showed a yeast infection. So she would go off and on the prednisone. This past month, she had a complete break-down, the ears, the paws, couldn't stand up, so she went on an 80 mg dose per day for a week, then it tapered down half a dose each week and she is now on 10 mg per day for two weeks and then she will go to 5mg until we can get her off it. Does this sound right to you for a tapering schedule? This is per the vet.

I feel awful if this Cushings has been induced by the prednisone. She's been to four vets and not one ever mentioned this could happen. They dispense the prednisone like aspirin.

I'll have to get a copy of the blood work that was done. I can get that today and post her numbers.

Do you think I should have the ultrasound done? Or do you think I should do a wait-and-see with the prednisone reduction to see if she improves on her own?

Her paws are calmed down now and her only problem seems to be the unsteadiness on her feet. Last week she did a "knuckling" with one hind paw. A couple times the front legs buckled. She has a hard time getting her legs under her to get up. She drinks a ton of water.

She weighs 78 pounds. She's a husky.

I so appreciate your input.

[Harley PoMMom]

Increased drinking, elevated liver enzyme levels, pot-belly, enlarged liver, muscle atrophy, all these can be attributed to the prolonged use of prednisone. If you Google "Iatrogenic Cushing's" it is not that uncommon, and the vets should of mentioned that this can happen. If this were me, I would hold off getting an ultrasound or any Cushing's tests performed.

The knuckling with her paw sounds like either a neurological or spine/disc/nerve issue, did any vet suggest this?

Some dogs with allergies have found relief when given a medication named atopica (cyclosporine) and it does not contain steroids. Maybe ask your vet about using this instead.

Please keep us updated.

Love and hugs, Lori

[Jubilee]

I came to that same conclusion myself today. I thought we would just slowly get her off the prednisone and see how things go after that. It didn't make sense to get the ultrasound and then have to wait until she's completely off the prednisone to go forward with the Cushings test. I'm giving her some herbal remedies for healing the liver. Some milk thistle and dandelion and burdock root and some Sam-E. And feeding her some good high protein foods to help get that muscle mass back. I'm happy she can get up and get out to the back yard to do her business! I wasn't able to pick up the results of her blood work today because they were waiting on another test to come in. So I'll check back in when I get those numbers.
Thanks a lot. Really good information here on this forum.

[Jubilee]

Update on Jubilee....Last month I believe Jubee had acquired a prednisone-related Cushing's from being on-and-off prednisone for the past year. The vets were prescribing prednisone for all her issues. She had a bad yeast infection in her ears and on her paws and she had a slight limp. Her paws would flare-up bad and they would up the dose on the prednisone as well as give her antibiotics. On April 12th, she went on a high dose of prednisone. Then she reached a really low point on May 20th when she could hardly use her back legs, her front legs would buckle when she tried to stand up, she was knuckling on a back paw, her belly was distended, and she was drinking gallons of water and then became incontinent. She had a blood test and her liver numbers were really high and the vet wanted her to get an ultrasound. But by this point I'd become so discouraged with the vets, and decided to just see what I could do at home. So I put her on SAM-E, milk thistle, dandelion, burdock root. to detox her liver. She's getting a good diet of sardines and protein. As of today, all the symptoms I just listed are completely gone. She still isn't chasing squirrels like she use to 6 months ago, but she is managing to take a slow walk around the block in the evening. Most important she looks good. She will be completely off the prednisone by June 22nd. She's down to 2.5 mg every other day. Fingers crossed, she will continue on this path of good health.

[mytil]

Oh I am so very glad to hear that Jubilee is doing much better - thank you for letting us know. Good job!!!

Continue to keep us posted.
Terry

PS - I merged your two threads together so everyone can see the history and progress.

[Jubilee]

Thanks for re-routing my message, I get kind of lost on this forum, not sure what I'm doing. But anyway, there it is....posted!
I will keep you posted.

[Budsters Mom]

Thanks so much for coming back to update us on Jubilee. We always love to hear good reports! Hopefully she'll be up to chasing the squirrels soon. ;)

Hugs,
Kathy

[goldengirl88]

Hello:
Welcome. sorry your baby was having troubles. I hope you have a handle on things and that she continues to improve. It is very hard when they have so many issues at one time. Prednisone is good and terribly bad. My Tipper had allergies as a puppy and had to have it too many times to mention. She was diagnosed with Cushings last August. Prednisone certainly needs to be used at times, but I agree some vets dispense it like it has not bad long term effects. God Bless you and your baby
Patti

[molly muffin]

That is great news! Slowly but surely things are improving. :)
I know what it's like to have a dog who has been on prednisone for a long time.

Sharlene and Molly Muffin

[Roxee's Dad]

I haven't posted to you before, but I just wanted to come by and give you a pat on the back :) I read your latest update and got goosebumps :D You did very good, you researched, sought information and acted on it :D Good job !!!

Keeping fingers and paws crossed for continuing improvements :)

[Jubilee]

Just a little history...a while back I think Jubee acquired the Iogenic (spelling?) Cushing's, induced by prednisone. She has totally weaned off that drug and is doing so much better. All the symptoms from the prednisone are gone. Appetite and drinking are back to normal and she is walking around the block twice a day. Her legs are functioning much better. She is taking Sam-E and milk thistle for her liver and glucosamine for her joints. Is Sam-E an OK thing to continue or should I wean her off that as well? Her last blood test, her liver enzymes were off the chart, she hasn't had a recent test.

Anyway, now I see something on her legs which is a darkening of the skin, it looks black, and there's patchy hair loss in those areas. It's not really new, I noticed it only slightly a while back, but now it's more prominent. She doesn't chew or scratch any of the areas and only occasionally do I see her lick her paw. I have her on one of the over-the-counter flea meds. I read where this could also be a symptom of Cushing's? Does anyone have any experience with this condition? I also read it could be mange and all kinds of awful things. I guess another trip to vet is the best to do. But if anyone has seen this before it would be great to get some information. Thanks.

[Squirt's Mom]

Hi and welcome to you and Jubilee! :)

I had a solid black Tennessee Walker filly by that name once. She was a hoot and a half! Typically there were rags and bags hanging in the pockets of my jeans. Jubilee would come tearing through the field, slid to a stop when she reached me, snatch a rag or bag from my pocket then take off across the field with it in her mouth, flying as she ran. :D It was a great game in her mind!

Now we will play 20 Questions with you for a bit so hang on! ;)

I'm not sure how long it takes for all the effects to disappear with Iatrogenic Cushing's. I guess it's possible the skin changes could be a result of the steroid. How long has she been completely off of them?

Is the skin changing on the paw where she is licking? Any hair loss there?

Is the hair loss on the front, back, or both legs? Inside or outside of legs?

Over the counter flea and tick treatment....by that do you mean something you get at WalMart, PetCo, etc.? What are you using - brand, etc.

Are there any changes in the darkening skin other than loss of hair and the dark coloring? Any hardness or little areas like hard black heads or flaking, etc. in those areas?

Do the dark areas seem to be spreading, getting larger?

I think a trip to the vet would be a good idea but I wouldn't worry over much about Cushing's at this point. She needs plenty of time to get all of the steroids and its effects out of her system as well as rule out any other possibilities before we even start to consider Cushing's.

I'm sure others will along with their thoughts and questions as well. We just LOVE details so the more you can tell us the better. I'm glad you found us and look forward to learning more about your sweet girl.

Hugs,
Leslie and the gang

[doxiesrock912]

THAT IS AMAZING!!!! Good for you and Jubee!
Please keep us posted and if the symptoms return after a time, feel free to let us know and I'm sure that you'll get great advice :)

[Harley PoMMom]

Two conditions come to my mind regarding the "black skin." One is hyperpigmentation caused by hypothyroidism, here's a link with info about this: Hypothyroidism (http://www.lbah.com/word/hypothyroidism/)

The other one is called Alopecia, which Nordic breeds are more prone to have, here's a link with info: Alopecia X (http://www.marvistavet.com/html/body_alopecia_x.html)

Please keep us posted.

Love and hugs, Lori

[addy]

My Zoe has hyper pigmentation with hair loss from her Cushings. Hers got worse before it got better. (Zoe has true Cushings, not caused by corticosteroids). The skin and hair follicles have a cycle to go through of about three months. If it is not related to the conditions Lori suggested, I wonder if it is from her body going through a healing process now that she is off the prednisone. Just a thought as we are going through it. Here is a good article about allergies, hair loss and endocrine conditions:

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=715262&sk=&date=&pageID=4

[Jubilee]

I'm losing my postings. I wrote in about Jubilee having a condition where the skin on her legs is turning dark, almost blackening, and there is splotchy hair loss. Is this a Cushing's symptom? I think she had the prednisone-induced Cushing's and she is now completely off that drug and is doing much better. She had this issue while on the prednisone but now it seems more prominent. Anyone ever have this issue? I guess it's back to the vet for a diagnosis. I also have her on a flea med. She doesn't chew or scratch anywhere on her body, I see no signs of fleas. I hope this post makes it to somewhere I can find it later.

[Tina]

Hi,
It looks like the moderators moved your post to add it to your original thread. We like to have all the posts about your pup in the same place, it makes it easier to follow all that is going on. Check here:

http://www.k9cushings.com/forum/showthread.php?t=5310

When you post again, look for your thread and add a reply there, and everything will be in one place. Hope that helps.

Tina

I forgot to say that when they see this, it will be moved to your original thread also! :)

[Jubilee]

I'm not sure what to do on this forum.. I seem to get lost a lot. Anyway, I'm trying to reply to someone who had 20 Questions...The darkening skin and hair loss is on the top of both front paws and it goes up the inside of front legs. Back legs not so much. She had a dose of Frontline Plus last month because I saw live fleas on her and flea eggs. She isn't usually on any fleas meds because I don't usually find any fleas on her. The darkening areas are spreading on her front paws but the rest of her coat and chest and belly look good.

[Squirt's Mom]

Hi,

We like to keep all posts about each baby in their own thread so the staff has been merging your posts into Jubilee's original thread. By keeping all posts together, it is easy to look back through the history if needed - plus this thread can act as a sort of journal for you and Jubliee where you can come look for information giving or keep track of things with her. ;)

So anytime you want to post about Jubilee, you will do so here in this thread that is titled - "Cushing's med....do they work?" If you would like the title changed to something that is easier for you to find, just let me know and I will be glad to do that for you.

[Squirt's Mom]

How long has she been off the steroids?

This doesn't really sound like it is connected to Cushing's, not even Iatrogenic. So I think I would ask the vet about other possibilities for the skin changes you are seeing.

[Jubilee]

Thanks for the directions for the forum! That helps a lot.

Jubee's weaning off the prednisone ended only a couple days ago. I can watch her and see if it starts to get better, if it's related to the prednisone. If I see it spreading more, I'll take her in to the vet.

[addy]

Are you sure she doesnt have a mild yeast and bacteria infection? Though I dont if that would cause hyperpigmentation of her skin. Do you see any brownish crud between her toes or on her pads? I do know if a dog has a ear infection they can lose hair on the outside of their ears and down their neck, so if she has yeast or bacteria it could possibly travel up her back legs. Zoe had mild yeast and bacteria, she did not itch but she lost hair on her back feet where all the crud was and the hair loss went up to her elbows.

[Jubilee]

Jubee was on an antibiotic, Baytril, three weeks ago for a yeast infection on her paws. Those symptoms showed up as crusty, swollen pads and inflammation between the toes. So this could possibly also be more of the same, as you suggest, maybe just another form of yeast or bacteria. She seems to be prone to these things, they re-occur frequently. She also had some crusty stuff in her ears a while back. That cleared up with the Baytril and the paws are also improved. She is kept so clean, and we don't go to the park anymore, this must be an internal condition that keeps surfacing.

[Jubilee]

Can someone please tell me how to post Jubee's photo by her name?

[Squirt's Mom]

Here is a link to our How To and Comments section that tells you how to upload an avatar (the little pic beside the posts).

http://www.k9cushings.com/forum/showthread.php?t=2018

[Jubilee]

Thanks so much!! There's my baby girl, Jubilee! Of course, that was in her younger, call-of-the-wild days...but she is still that essence in spirit.

[molly muffin]

Awww and isn't Jubilee a lovely lady. So glad you figured out how to post her avatar.

Sharlene and Molly Muffin

[addy]

She is beautiful. :):):)

Sounds like the hair loss on her paws could be from the yeast infection she had, the hair falls out and hopefuly grow back in the next hair follicle cycle. Just keep checking her paws for any reoccurance, you can also give her a Betadine iodne foot bath once a week, it kills yeast and bacteria but is soothing and wont hurt her if she licks her paws afterward, no need to rinse it off. Just mix it will water until it is the color of ice tea and let her soak if she will for five minutes.

[Harley PoMMom]

Jubilee sure is a beautiful girl!! Looks like she has husky in her? So that black skin issue could be Alopecia since the Nordic breeds can be prone to it.

[Jubilee]

Thanks for the info on soaking her feet. I'll try anything. I'm thinking I might take her to the vet. Maybe they can just take a little scraping off the skin and give a definitive answer, though I never seem to get one of those!

She does have husky in her. I was reading about that black skin issue too. I think she has the discoid lupus on her nose or the zinc issue that huskies also have because she has the crusting on her nose. I think she inherited all the husky issues, poor girl!

[molly muffin]

Awwww poor thing. Guess she just has a Lot of Husky in here. :) Scrapping would be a good idea. Could be yeast.

You're doing awesome :)
Sharlene and Molly Muffin

[Jubilee]

How is Molly Muffin doing? I read the synopsis under your message. All those tests and no results. That's so frustrating. We want answers so we can know how to treat them properly and fix them! It's so hard to not have our puppies perfectly healthy and happy all the time. She is so dang cute in that picture, I bet she gets cuddled a lot.

[molly muffin]

Thanks. Well, Molly sure thinks she is cute. Maybe because we always tell her so. :D

She is actually doing okay. I continue to monitor her lab results about every 3 months. If anything goes out of whack then I address it at that point. There isn't much else we can do without a clear cushing diagnosis and without clear symptoms. I could treat her based upon the ACTH test and the ultrasound, but then how would I know that things are going well. We use the symptoms as a judge of how the medication is working.

This actually started a couple years ago for us, with a diagnsosis of cushing and yet again an LDDS test that was negative. That is before the ones mentioned in my signature. In the mean time, we'll just keep trucking along. Her ALKP's started to go up with her first urine crystals, so again, it shows you that every dog is different. ALKP's which tend to be one of the highest numbers and a signature cushings elevation, does not always mean traditional cushings. When I say traditional, I mean with all the usual symptoms.

We're just trucking along.

Did you end up taking Jubilee to the vet to get a scraping from her feet?

Molly licks her feet every night before she goes to sleep. She doesn't bother them at all during the day, only night. It's a habit for her, just like sucking her tail is another nervous habit that she does sometimes. Dogs can have all kinds of things going on in their heads I think. :D Probably much of it I don't want to know and much that I do. Confusing eh. :) :confused:

Sharlene and Molly Muffin

[Jubilee]

It seems like whether it's human doctors or vets, it's all a bit of trial and error. I myself have been to the doctor and lab results come back with a possibility of something but not definitely anything, and they give me a prescription and say come back in 6 weeks. I think at some point, we just don't have answers and we end up just treating symptoms as they appear.
I just take one day at a time with Jubes, as you seem to do with Molly. If we can play a little soccer and she can walk around the block, it's a good day.
I'm going to try to get Jubee to the vet tomorrow. I'll let you know what we find out.

[Tess]

Hi. I am new to this forum. My name is Kathleen and I live in the North East of England. I have been reading the thread on Jubilee with interest. I have three 'rescued' dogs named Tess, Murphy and Poppy. I recently had to have a much-loved Jack Russell euthanized. He was 13 years old and I now suspect he probably had Cushings. Two weeks after he died, Tess started to drink and urinate excessively. I took her to the vet who suspected Cushings and carried out various tests. The results indicated that she did have this disease. As I am strongly into complementary medicine and I also use a homeopathic vet as well as my conventional vet, we all agreed that I would try the homeopathic approach first because there is an established homeopathic protocol for treating Cushings disease. I am therefore using a remedy which has Quercus rubor (derived from oak) and ACTH in it. It is in a liquid form. For the first 5 days, Tess was given one drop twice a day. She now has one drop once a day. I also give her homeopathic Arsen alb, Sulphur and Hepar sulph to help with the excessive thirst etc. And I have also modified her diet and no longer give her commercial dog food. She is on a high protein, low fat diet with lots of vegetables and some pasta. I prepare her food freshly every day. I add tinned pumpkin and milled flaxseed to her food and I give her Vitamin E oil, Vit D3 oil and Aloe Vera gel. I will let you know how we get on.

Administrative Note: For anyone who wishes to reply directly to Tess' post, here is a link to her own newly created thread: http://www.k9cushings.com/forum/showthread.php?t=5440

[Jubilee]

Taking Jubee to vet today, if I can get her into the car. On Monday evening she was able to walk around the block, and then suddenly her back legs lamed-up and now she can hardly hobble around. It comes on so fast with her. One day, she is walking OK and the next she can't. Just her one back leg has a swollen paw and ankle. Does this sound familiar to anyone? That seems to be the leg that bothers her the most. When she lays down she keeps it straight out from her side. Previously, when her paws would get inflamed from the yeast infection, they would swell-up then, too. Is the swelling significant for anything?

[Jubilee]

Just in case my vet prescribes a NSAID, does anyone have experience with Rymadel, Deramaxx, or Tramadol? The prednisone seems to work the best, and I'm so desperate I'm considering putting her back on a low dosage of that. She's been completely off the prednisone now for 9 days and now that it's out of her system, all her symptoms of lameness have returned. Maybe I could try a very low dose, like 2.5 mg or 5 mg per day and see what happens. I could go in and get some blood work today and see where she stands on her liver enzymes and then go from there.

[addy]

I have used Tramadol with Zoe twice a day after her surgeries. It pretty much knocked her out which was ok at the time, I needed her quiet. I could only use half the dose the vet prescribed. Rimydl, Zoe cannot take, she cant walk, it is too much for her. My Koko had it for 4 days after a dental, he was fine on it but it is very hard on their liver and stomach.

I'm glad you are going to the vet. Not sure why it would come on so fast and swell like that. Sounds like an injury but I dont know her whole history, so it is hard to say.

[lulusmom]

All three drugs work very well. Rimadyl and Deramaxx are both non-steroidal anti-inflammatory drugs (NSAIDS) and while I'm not thrilled about giving either to my dogs, I'd take them over prednisone any day. I prefer Tramadol over all of them. I have given it to many dogs...my own and my rescues. I have a pup on it now for the major dental surgery he had done yesterday. Tramadol doesn't really address inflammation so depending on the problem, it may not be the most effective treatment. I hope this helps.

Glynda