My 10 y/o Staffy was just diagnosed with Cushings (Mack is at the Rainbow Bridge)

[Tania]

Hi Everyone,
My names Tania and my 10 year old Staffy named “Mack” has just been diagnosed with Cushings disease. I adopted him in December 2012 and at the time I wasn’t aware of his condition. When I adopted him he was 26kg and at his heaviest he was 31.8kg. He is now around 30kg.
He has always drunk a lot of water and been slightly overweight but it wasn’t until he started getting a pot belly and his hair became patchy that I decided to take him to a vet after I did some research and found out he may have Cushings disease. The vet did a T4 blood test on him and it came back that he had an underactive thyroid not Cushings. I treated him for 2 months with thyroid medication. His stomach did start to get smaller but I wasn’t convinced he didn’t have Cushings disease. I took him to a different vet and just last week she did an ACTH test on him and told me that when he had his injection of cortizol his levels went up a lot and she diagnosed him with Cushings disease. I also thought Mack might have a UTI which she confirmed. He has been on medication for the UTI which is almost done now and also has been having antibiotics incase he has a stomach infection which is causing his sloppy poo.
I’m unsure if the problem is with his pituitary or adrenal gland but the vet said we can start treating him with Trislostane and see how he responds after his follow up blood test 10 days after he starts the medication. The vet is going to order me in a generic brand of Trislostane as its cheaper. I have never had experience with Cushings disease and Mack already has a sensitive stomach so not sure the meds are going to agree with him.

[mytil]

Hi Tania and Mack, welcome to our site. I am sorry you are having these troubles.

Firstly when you get the chance, post the actual numbers of the ACTH test performed. I will say that only one test does not effectively diagnose Cushing's.

Here are great links that describes Cushing's, tests for diagnosing and treatment options. http://www.kateconnick.com/library/cushingsdisease.html and http://www.k9cushings.com/forum/showthread.php?t=180.

I think your vet is referring to Vetoryl. Take a look at this link - http://www.k9cushings.com/forum/showthread.php?t=185. This is the link to Trilostane/Vetoryl so you can be more versed prior to giving your Mack this medicine.

Keep us posted and I love your avatar of your boy.
Terry

[Tania]

Hi Terry,

I don't actually have the resutls. The day the vet got the results she phoned me and told me what they were. I haven't seen her in person since then, Ive spoken to her about my options on the phone and once I get enough money saved up for the meds then I need to make him an appointment. I know about the other tests that you can do, but the vet doesn't think they are needed. He looks very much like a Cushings dog. Trislostane and Lysodren are the names of the drugs here in Australia but think they are called something different in some other countries :)
He has also previously had an ultrasound of his stomach area as the first vet I went to said his liver felt enlarged, but there was nothing wrong with his liver or kidneys from what they could see on the ultasound.

[addy]

Hi and Welcome,

Sorry to hear about your pup. The problemwith testing for Cushings is no one test is perfect so we can get false positives especially if something else is going on. It is not unusual for a Cush pup to have urniary infections or a lower T4. Sometimes the lower thyroid is resolved once Cushing medications are started. Other illnesses can mimic Cushings so we are always careful to make sure a pup is properly diagnosed. A big part of diagnosis is history.

A lower starting dose is always best. My pup had colitis and we started her on only 10mg of Trilostane, she weighed in at about 18 pounds and her colitis did flare. She did adjust after 3 weeks. I had to increase low doses very slowly.

Sorry this is so short, I'm running late this morning. Others will be along soon.

[Tania]

Hi Addy,

Thank you for the welcome :)

I am a little bit concerned that him not being on any thyroid meds at the moment isn’t doing him any good. I checked with the vet and asked her if she thinks it was worth getting some more of the thyroid meds and treating him with them until I can afford to start with the Cushing’s medication, but she said that it might help a little bit but probably not much so not to worry about it.
At the moment he doesn't have diabetes either. He has had quite a lot of testing done on other parts of his body but only the one test for Cushing's.

[Simba's Mom]

Hello and welcome to you and Staffy, so sorry your furbaby is having problems but happy you found this site....get ready for lots of info and encouragement too..

[Tania]

I should also mention that when he arrived at the pound his teeth were in a terrible condition which I assume was due to an unhealthy diet from his previous owners and his age. I don't think that it was from anything Cushing’s related. He is missing quite a number of teeth now as the pound removed them before adopting him out. He has at least one other tooth that needs to be removed that the vet noticed last week, but we aren't dealing with that at the moment but I am a little worried because Cushing’s dogs are more susceptible to infections that his tooth may also cause him problems soon.

[Tania]

Thanks Letti :)

[Budsters Mom]

Hello and welcome from me too.:)
I am sorry for the reason that brought you here, but so glad you found us.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. So again welcome to you and Mack.:);)

Hugs,
Kathy

[molly muffin]

Hi and welcome from me too.
Poor guy, he's had a real time of it. Teeth, thyroid, cushings, UTI. It's a rough patch that he hit. I'm so glad that he found a home with you.
Compounded trilostane can save money over the brand name vetoryl, that's for sure, so I'm glad that your vet was willing to go down that path since funds can certainly be an issue.
Did your vet sound like she would want to put him back on the thyroid medicine at some point or wait to see if it levels out with cushing treatment? You'll have to keep an eye on it. Thyroid levels can run a bit lower with cush pups, but you want to make sure it isn't an issue all it's own too.
You'll want to get copies of all testing results from your vet and keep it in a home file to be able to refer back to. Believe me it can come in handy to have.
Again, welcome to the forum.

Sharlene and Molly Muffin

[Tania]

Thanks Kathy and Sharlene for the welcome :)

My vet is pretty good and knows people have limited rescources which is why when I went to get a second opinion from her she didnt want to start at the bottom again will all the testing he had already had she jumped right into the ACTH test.

I just got her Treatment Plan she wrote up for me and it says she would start Mack on 120mg of Trilostane once daily with food. He weighs 30kg which I think is around 66 pounds?

[frijole]

Hello and welcome! I just wanted to mention that the dosing recommendations for trilostane have changed significantly and not all vets are aware of it. The dosage you mentioned is in line with what used to be recommended. However, a significant number of dogs have found that dose to be too high and had to lower the dosage. As a result the recommended dose is now one mg per lb of weight so you dog's dosage would be 60 vs 120.

I strongly encourage you to do some reading here and bring this up to your vet. If you just read some of the threads you will see first hand over and over dogs that were started at the higher rates and have struggled. THeir cortisol goes down too quickly and they become quite ill.

The manufacturer has changed their recommendation but I don't think they have changed their packaging yet. Kim

[Tania]

Hi Kim,

Thank you thats good to know. I will certainly mention that to my vet :)

[Trixie]

I love the photo of your dog! What a sweetie! Your dosage does sound kind of high. My dog started the same medication almost 7 weeks ago but a very low dose. My dog also has a sensitive tummy but with a low dose twice a day we have been able to avoid any nasty side effects. It took a bit of time for the symptoms to subside but finally they have and my dog is much better. I'm still new at this myself but the others here who have advised you know their stuff and I would definitely listen to them about the amount of medication. Better off starting out low and slow with this drug...your dog will do much better in the long run. Also make sure that you give it with his food.
Hope your pup feels better real soon!
Barbara

[Tania]

Thanks Barbara :)

I will give my vet a call next week and see if I can speak to her about the dose rate. :)

[Tania]

It's with deep regret I have to tell you I had to put Mack to sleep yesterday, the 30th here in Australia. He vomited out of nowhere and his body went into some kind of shock, his tongue was hanging out more than usual because of his lack of teeth and it went blue. His gums were so cold. By the time we took him to the vets he was having trouble breathing and had abdominal pain because he kept arching his stomach up. He also did a poo on the floor without getting up, which I knew wasn't good.
The vet gave him pain relief and a breathing mask and she was going to give him an x-ray to see what was going on internally and then when I was leaving while they did that he pooed blood. The vet put a needle into his stomach but couldn't get any blood out. His breathing mask had fluid in it from him drooling. The vet said he was slowly dying, and while I was trying to find the words to tell the vet she could put him to sleep he was pretty much already gone.
His head was floppy when I lifted it and his eyes weren't really with me even though the vet said they were responding to light. The vet said he could have had a stroke or had internal bleeding, but I'm worried its because he had finished his thyroid meds and wasn't getting anything into his body. He finished the meds on the 21st of May, I was told he had Cushing's on the 27th and on the 30th he left
me.
The vet said it was probably Cushing's related but I'm blaming myself.

[mytil]

Oh no, my heart just sank when I read this. I am so incredibly sorry for your loss. Please be kind to yourself. I am not sure Cushing's caused this immediate complication; IMO, it was something else that could have not been controlled.

You brought him in and gave him a loving home and he knows this.

Please stay with us - many have gone through this horrible pain and grief and we are all here for you.

(((((hugs))))) and always remembering your boy Mack
Terry

[Trixie]

Tania,
I am so sorry to hear about Mack. Please don't blame yourself. You obviously loved your dog a great deal. Here you were searching for help and doing everything you could for him.
It sounds like you gave Mack a great life and saved him from the pound with a second chance. I'm sure he felt your all your love and now he is not suffering anymore. It seems to me there were a few health issues happening all at once...there was probably little that could have been done without causing him more suffering. I'm sorry for your loss, you did your best for Mack don't compound your sadness with any guilt...it's not your fault.
Barbara

[Roxee's Dad]

I am so very sorry for your loss. Mack certainly knows he was loved.

Rest in Peace Mack, Tonight you are our newest and brightest star in the sky.......

[addy]

Oh dear, I'm just so sorry to read this. It is not your fault. It could have been many things going on, could be no one even knew about a problem yet, that is always the issue, things we don't know about yet.

I am so sorry. Please don't leave us, we are here for you, to help anyway we can.

[molly muffin]

Oh no, my heart just dropped when I read your post. :( I'm so very sorry. It is so unfair. :(
I know that whatever caused this, and I'm not convinced of cushings, as I don't recall anything like this previously, you did everything possible to give him a good home a good life. That is what is important. His last days, were happy days.

HUGS,
Sharlene and Molly Muffin

[Tania]

And that's worries me if he didn't pass away from Cushings related illness was it because he had finished his thyroid meds.

[frijole]

I am sure it had nothing to do with thyroid meds. From the description of how he passed something much more serious was going on inside his body. He might not have even had cushings but that doesn't really matter. You can be sure that you had nothing at all to do with his death. Your man is now free of whatever that was and is running with our other angels as we speak. RIP dearest angel Mack. Look over your dear mom as she grieves your loss and know how much she loved you. Kim

[Trish]

Oh Tania
I am so sorry to read this about Mack. It does sound like there was more going on than just Cushings. But what a shock for you. So pleased you were there with him. Please do not blame yourself, we all so often do that thinking there must have been something else I could have done.... but sometimes it is just time to say goodbye no matter how awfully hard that is and I think you most definitely can rest easy knowing you did everything you could.

Big hugs for you
Trish

[mytil]

No I do not think it had to do with finishing his thyroid meds at all.

Terry

[Simba's Mom]

So sorry to hear of your precious Mack, now he is free and in no pain and making lots of new friends....you are a great Mom to him and there was nothing else you could've done, try to remember the good times, sending hugs and prayers.....

[Budsters Mom]

Tania,
I am so sorry to her about the passing of your dear Mack. We all second guess ourselves at times. Please don't blame yourself. There Is nothing you could have done to prevent this. Sometimes these things just happen. Mack knows how much he is loved and will always be with you. We are here for you. Please keep in touch with us.

Many hugs,
Kathy

[Tania]

Can I just ask everyone how does a dog with Cushing's usually pass away? Could Mack have had pancreatitis?

[Mel-Tia]

Tania

There is no typical time, each dog is different, they have different complications and or no complications, it's a very tricky disease

My Tia was a Staff. Although smaller than your guy, she was diagnosed when she was 9 and 2 months and passed when she was 12 and 3 months. She was on the medication for that time but we were unlucky her pituarty tumour grew.

It's so tough and raw for you right now and unfair that it was sudden so you didn't get the chance to make him well. I am so sorry that we cannot take that pain away. All I can say is keep talking to us, it has helped me to share what I feel on here

Big hug to you

Mel
Xxxxxx

[Tania]

I'm just at a loss as to why he passed away if people are saying that it doesn't sound Cushings related. I fed him some dog treats about 10mins before he vomited that I knew were just past there use before date. He has had then many times before though without any problems but could that have done it?

[frijole]

Oh no, don't blame yourself for giving expired dog biscuits - lord knows we have all done that and there is usually padding on the shelf life by manufacturers. (I work for a food manufacturer)

Cushings is a very slow developing disease that affects the organs and so dogs don't tend to die out of the clear blue from it. Most of us were clueless and didn't know for years our dogs had it. With treatment cush dogs typically don't die from cushings but other old age related illnesses. That is why we've said it was most likely from something else. Could have been pancreatitis, some form of cancer - really hard to say.

If cushings is not treated dogs don't pass from 'cushings' but rather from things that happen as a result of not treating cushings such as a heart attack, diabetes or other organ failures.

Please don't be hard on yourself. You did every single thing right. Chances are something else was going on and you would have no way of knowing - none of us would have done anything different. Take care, Kim

[labblab]

Can I just ask everyone how does a dog with Cushing's usually pass away? Could Mack have had pancreatitis?
Hi Tania, like the others, I am so very sorry about your loss. And yes, I do think it's very possible that Mack might have suffered a severe, irreversible attack of pancreatitis. This can turn fatal very, very quickly by also affecting other organs and causing bleeding. If this was the case, as sick as Mack was, I don't think there is anything that anybody could have done in time. And it would have been brewing totally aside from the dog biscuits or anything else that day.

So as hard as it is, I hope you will be kind to yourself and release the guilt that you may be feeling. When things turn so bad so quickly, there really is nothing to be done.

But now, I am sending you healing thoughts for yourself. I know how much this must hurt, especially happening so quickly.

Marianne

[Fellasmom]

Hi Tania
My heart breaks for you and your dear Mack.I'm so sorry that you are going through this but please know you did nothing to cause this to happen.Since you just recently adopted him,he very well may have had an underlying illness or unfortunately suffered an acute onset of a fatal condition that neither you nor anyone could ever have predicted or treated.I recently lost my dog and constantly second guess myself as you are doing now.So glad you found this site as it has helped me tremendously to work through my ongoing grief.

Please know it was nothing you did or could have prevented.Homeless dogs eat garbage to survive and do so for many years so the expired treats in no way harmed him.

Although very short,how thrilled he must have been to finally have a home and such a wonderful caring loving mom.Older dogs get passed up for adoption so frequently.You showed him love and compassion that he otherwise may not have had in his final days.
Patty

[scoora]

I am so sorry to hear of the passing of your sweet boy Mack. My thoughts and prayers are with you.

[Tania]

I had a chat with the vet on Tuesday about Mack and the reasons why he may have passed away so suddenly. She gave me a few reasons why but she said he more than likely had a bleed somewhere which is why he passed a poo which was mainly blood. She said if he had pancreatitis he would have been sicker for longer and would have been vomiting for a few days leading up to the day he passed away. She did say he could have had peritonitis though. She said that when a dog goes off thyroid medication they get a really swollen face like they have been stung by a bee and they go into a coma from not enough thyroid hormone. She said Mack was in a coma at the end, but I’m guessing that was because his organs were shutting down. She said he could have had a stroke that caused a blood clot to travel to his heart like deep vein thrombosis. She said he could have had a twisted stomach too. She also said that when his stomach started getting bigger it may have pushed on his organs causing something to rupture. She said he probably had an adrenal gland tumour rather than a pituitary gland tumour and that could have ruptured.
I was also asking why he appeared to have his hackles up about 5 mins before he vomited and she wasn’t sure why. Any one have any ideas?
She also said there was nothing in the T4 test that the other vet had done that showed he might have Cushing's. She said his liver enzyme’s looked good, but when I spoke to her before Mack passed away she said that doesn’t always mean he doesn’t have an adrenal gland tumour.
She also wasn’t sure why he was pooing more since she put him on antibiotics, but he was. He had really sloppy poo before going on them, which stopped on the antibiotics but there seemed to be more of it.
She said another reason could be that he had stomach ulcers and the high coritzol level caused them to rupture which sent him into septic shock.

[loveMyDaisy]

So very sorry to hear that your baby has passed. I just lost one of my babies on the 24th of May. It is so hard and you do question yourself, because the only voice they have is us. But you did all you could and were doing what was best. Sometimes it is just out of our control. I keep reminding myself of all the good times we had. I allow myself to feel the sadness, but also try to allow yourself to feel the joy he brought into your life. It will get better.

[goldengirl88]

So sorry to hear of your Mack's passing. God Bless you and your baby in heaven.
Patti

[maria]

I am really sorry for your loss. God has a wonderful little Pittie in Heaven. You will be together again.

Maria

[Tania]

Hi,

It's been 4 weeks on Friday since Mack passed away suddenly and I just had a question for people who have more experience with Cushings than me.

When Mack had a T4 test the vet said his liver enzymes were good and said he had an under active tyroid, but then when he had a ACTH test the vet said he had Cushings.
Could this have been true though if his liver enzymes were good?

[labblab]

Welcome back to us! I am sending you many hugs on this first month's anniversary of Mack's passing. I know how hard each and every milestone can feel.

As far as the liver enzymes, it is true that the majority of Cushpups do exhibit elevations but a small percentage do not have abnormalities. One of our other Administrators has explained this dynamic to us in the past, but I'm afraid I do not recall the specifics. I'll try to find the reference, though, and come back and post it for you.

In the meantime, Please do stay with us and let us know how you are doing.

Marianne

[addy]

Hi Tania,

I cant explain the abnormalities either but I do know that endocrinologist, Dr. Petersen explained to me some dogs dont have them as my Zoe did not at the time of diagnosis.

Sometimes, we just dont know what is all going on internally with our pups. I know that does not make it an easier for you, I'm sorry.

Love and hugs and prayers. Please come back to talk when you need to. We are always here to listen.

[Tania]

Thank you all for your help :)