Belle, 6 y/o English Bulldog - Calcinosis Cutis/Skin infection

[Belle's Mommy]

Hey yall, I'm Jennifer, mommy to 6 1/2 yr old English Bulldog Belle. She was diagnosed with Cushing's Disease mid April this year and soon we started to see red spots like a rash on her skin. The doctor started Simplicef then Cephalexin for the skin but no relief. The hair began to fall out and her skin has become black and hard across her back.
She has been taking Vetoryl for the cushing's for several weeks now and her water intake and appetite has pretty much gone back to normal. The doctor took a skin biopsy to find out what was going on and the results came back yesterday. She has Calcinosis Cutis caused by the Cushing's, but has a secondary bacterial infection in her skin.:( We will begin a treatment for the bacterial infection, but I'm afraid that her hair will never grow back. She is my baby and I just want her to be better. Any thoughts on the skin problems? I've heard that it doesn't occur in all dogs that have cushing's.

[molly muffin]

Hello Jennifer and welcome to you and Belle! :)

So glad you found it but sorry for the reason. Well, welcome to the family. :) yes, some dogs do get cc, and others don't. It's a hard one to get under control. One of our other members dog also has the black crust and has been trying some manuka honey on it and I just sent her an email to ask how that is working. It's only been a couple days though.

Another member, has had good results with her french bulldog. Her thread is here and you can read through and get some idea. She has been using a cream prescribed by her vet, which you might be able to ask your vet about. She has had really good luck with it.

http://www.k9cushings.com/forum/showpost.php?p=92010&postcount=90

Her report today, is that hair has started to grow back. This has been a really well fought battle and so I'd say yes there is hope for the hair to return, if it does, and that it is usually one of the last symptoms that clears up.

What dosage of vetroyl is she on? Also could you post results of your diganostic tests, specifically the cushings tests, she should have had an ACTH follow up by now if she has been on a few a few weeks. First follow up is at 10 - 14 days. Do you have those numbers? Oh and what does she weigh?
Sorry for so many questions, but it all goes hand in hand when it comes to cushings.

Some of the others will be by soon with more welcomes and probably more questions.
Welcome again,
Sharlene and Molly Muffin

[Budsters Mom]

Welcome Jennifer and Belle,:(
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help. Others will be popping in to welcome you also. So again welcome to you and Belle.

Hugs,
Kathy and Buddy:cool:

[Peety's Fur-mom]

Hi Jennifer and Belle, Welcome to this community of wonderful and caring new friends. I am so sorry to learn of Belle's problem. I am also dealing with CC, or black skin disease. Peety was just diagnoised with Cushings, at least I think so. His skin has been a wreck since January. We started with a small sore on his neck and now it is all over his body. He has patches of bald spots. The black skin is like elephant skin. We are not on any meds yet. The Derm Dr. put him on DMSO but I refused to use it because it was to toxic. I have been using a variety of home remedies. The latest is Manuka honey. I wrap him in it and also put it in his food. I cannot say yet if it is helping but I was sold on the medicinal qualities, like antibiotics, antiinflammatory, antibacterial, it is suppose to be great on wounds. I have read alot about it. Dr Oz even had it on his show and was 100% impressed with the medicinal properties for wounds.

I have an appointment Fri with a new Vet and I am hoping that they know something about this. I have some pictures posted so check it out and see if it is the same thing. I had to have him shaved, didn't want to, but it was the responsible thing to do. His whole back is black thick elephant skin and his legs are bald. I bathe him like every other day in Hibiclens and I wrap him in honey and then love him to pieces. We also go to the beach so he can soak in the salt water. Not sure if the new Dr. will put him on meds. I also have him on Omega3 a daily vitamin and Brewers yeast. My lil guy is still beautiful to me. As long as he feels good and he loves me and is patient with me, that's all that matters. Everyday I hope to see lil improvements. I'll be checking in with you to see how the two of you are doing. And I'll let you know how our appt goes on Fri. Hang in there you now have lots of friends to support you. Big hugs to you and Belle.

Pat Peety's #1 fan

[Belle's Mommy]

Good morning! I posted some pictures of Belle before her diagnosis and then pictures of her skin just after cushing's diagnosis. I also posted pictures of her skin this morning after learning that it is CC with bacterial infection. Belle weighs 55.6lbs.

Her Jan2013 bloodwork showed ALKP level 395 U/L, it was retested April 5, 2013 and the ALKP level was 570 U/L. Together with her other symptoms of excessive water intake, urination, bloating, acting starved, and panting the Vet wanted to test for Cushing's with the ACTH test. ACTH Test on April 6, 2013 - Results of 20.8 ug/dL (High).
ACTH Level (Endogenous) Test on April 10, 2013 - results 89, which determined Pituitary dependent Hyperadrenocorticism. Perscribed one 30mg tablet of Vetoryl per day.

ACTH Re-Test May 4, 2013 - Results 1.3 ug/dL (Low) after being on Vetoryl for two weeks. Notes: results a little low but they want to continue the Vetoryl dosage. Recheck in 4-6 weeks.

We started Baytril last night for the bacterial infection in her CC. Pathologist noted that it may 2-12 months for the resolution of the CC. My vet also said to continue bathing regularly, twice a week. I use oatmeal shampoo which seems to help. Although she hasn't had a bath in almost two weeks because of the skin pulgs they took and we can't get the sutures out until Saturday, so she is a little itchy.

Please let me know if there are any other test results that you need. I got the vet to make me copies of her tests.

[labblab]

ACTH Re-Test May 4, 2013 - Results 1.3 ug/dL (Low) after being on Vetoryl for two weeks. Notes: results a little low but they want to continue the Vetoryl dosage. Recheck in 4-6 weeks.

Thank you so much for this additional info. I am sorry that I only have a few minutes right now to add a reply, but I am very worried about the 14-day ACTH result of 1.3! I understand that due to the calcinosis cutis, your vet is wanting to be aggressive about maintaining a low cortisol level. But 1.3 is too low, no matter what. And the experience of the manufacturer of brandname Vetoryl (and our experience here) is that cortisol levels continue to drop even further within at least the first month of treatment even while remaining on the same dose. Belle is already too low and cannot risk going any lower.

We have seen Addisonian issues arise very quickly in dogs with low cortisols, and this can become a life-threatening situation. Here is a link to Dechra's U.S. Product Insert for Vetoryl. You will see that they state without exception that Vetoryl should be termporarily totally discontinued for a dog with an ACTH lower than 1.45 ug/dl, and then replaced with a lower dose once the cortisol has had a chance to first rebound.

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Please take a look at this information, and I'll try to come back again later on to talk some more about this.

Marianne

[Belle's Mommy]

I sent a message to the Vet noting the concerns of her results.
Pre ACTH Test - 0.9 ug/dL
Post ACTH Test - 1.3 ug/dL

[molly muffin]

Love the pictures of Belle. Hopefully having the cortisol in control will help the cc.
However, like Marianne, that is scary low when you consider that the numbers will continue to drop even more and then you can be in crisis before you know it. Do you have prednisone on hand just in case? If not make sure you get some.

Sharlene and Molly Muffin

[Belle's Mommy]

No I do not have any prednisone on hand.

[Belle's Mommy]

Belle gets her sutures out tomorrow and I believe I see little sprouts of hair coming through her CC on her back.

[labblab]

That's great that you are seeing some new hair growth!

When you take her in today, though, I would print out a copy of that Vetoryl Product Insert and make sure that you talk to a vet about it. I cannot emphasize enough the danger that can come from allowing Belle to be overdosed on the drug. Not only does it lower cortisol, but it also lowers aldosterone which regulates the balance of potassium and sodium in the body. If that balance is out of whack, a dog can be thrown into Addisonian crisis quickly, and this is the condition that can be life-threatening. That is why a blood draw checking those blood chemistries is recommended alongside each ACTH monitoring test.

You should also be given some prednisone to keep in reserve for an emergency situation at home should Belle's cortisol ever drop too low at a time when you cannot immediately take her in to the vet.

I remain very, very worried about her, especially at the start of a long holiday weekend. Please tell us how your discussion with the vet goes today.

Marianne

[molly muffin]

Hi, popping in to check on you and Belle. How did it go yesterday? Healing nicely and sutures all out?

Sharlene and Molly Muffin

[Belle's Mommy]

Belle is doing great. Suture spots are healing nicely. Right now she is rolling over her back and then popping back up to make sure that I am paying attention to her. We talk to the vet again on Tuesday regarding dosage and her next set of tests.

Jennifer

[molly muffin]

Yay! So glad that Belle is obviously feeling pretty awesome. pay attention mom, I'm being cute!! hahahaha
Don't you just get the hugest smiles when they feel good. :)

Sharlene and Molly Muffin

[Peety's Fur-mom]

Isn't it wonderful when they entertain us. It's like they know we need something from them to let us know all is ok :) So glad Belle is doing so good.

Hugs from Pat and Peety

[Belle's Mommy]

To update yall, we go Tuesday the 4th of June for our one month ACTH test. She has been doing great, although this morning we woke up with a sore on our next. She had a CC spot on her neck and I htink she may have scratched it during the night so she had some blood on her foot. Cleaned that up and put a dab of neosporine on it and she was ready for some more beauty sleep.

Jennifer

[molly muffin]

Yay, really glad to hear that Belle is doing so well. Hope for good results on the ACTH! :)

hugs,
Sharlene and Molly Muffin

[Belle's Mommy]

Okay so the vet is going to keep Belle on her antibiotic for her skin which I think is helping. Although she has lost some more hair along her sides but the CC isn't as thick as her back. I will post new pictures of her hair loss and gain tomorrow. She has more new hair sprouts on her back.....Yay!

Post ACTH test results came back today, 2.4 ug/dL. The vet is going to keep her on the same dosage and recheck again in a couple of months. Her playful energy has returned and she is just as sweet as ever.

[molly muffin]

This is very good progress. :) I'm glad to hear that her cc is getting better, and sometimes they do lose hair before it can regrow in. It all takes time and cc is often one of the last things, along with muscle weakness to get better.
Yay for Belle! :)

hugs,
Sharlene and Molly Muffin

[Belle's Mommy]

Thank you for the support. It helps to have a support group that have animals going through the same situations. I talking to co-worker the other day about Belle's case and it just so happens that they had a dog with cushings but without CC.

[molly muffin]

Not all cushing dogs get cc. Luckily, it is not one of those things that is one of the easier symptoms.
It's hard to get rid of once it gets started. I think you are doing a good job and I am hopeful that eventually it will be gone. I like that 2.4 post number, keep it there and I think Belle will do pretty good.
I agree completely, a support group is really good to have and this forum is wonderful at supporting everyone.

hugs,
Sharlene and Molly Muffin

[Peety's Fur-mom]

Glad Belle is doing good. Keep an eye on the CC, everyday. Glad you're seeing new sprouts. Peety has sprouts in the thicker part of the CC. So I am encouraged that something healthy is under there. Big hugs to both of you.

[Belle's Mommy]

Belle's sprouts are in the thick part as well. The pictures will be up tomorrow so you can see. Bigs hugs y'all as well.