Not treating cushings?

[Buddy76]

Hi there,

My dog Buddy was recently diagnosed with Cushings earlier this month. He has been on Trilostane for 12 days now with no side effects; however I woke up this morning to find bloody poop outside. It wasn't completely diarrhea but was much looser than normal and had a significant amount of bright red blood with it. I am stopping the medication immediately (had not yet given him his pill this morning) and he seems fine otherwise, but since its Sunday morning, I just don't know if I should bring him into the emergency vet. Any thoughts on if this can wait until tomorrow (Monday) morning? I've left a message with his vet, but again with it being Sunday morning I haven't heard back yet.

This is very overwhelming and any help to navigate through this disease will be very appreciated!

[Squirt's Mom]

Hi and welcome to you and your baby! :)

You done good, REAL good, to stop the med for now. One of the good things about Trilo is that it is out of the system fairly quickly - in 2-12 hours - so if the med is the cause you should see improvement soon.

Colitis will cause a bloody stool. You might want to withhold food (NOT water) the rest of the day, too. If the stool gets watery or more bloody, she may need to be seen today but it can probably wait until tomorrow.

Can you tell us how much your baby weighs and what dose of Trilo she is on and how often she takes it?

Hang in there! Some of our Trilo parents will be along soon to talk with you. We are a Lysodren house so I leave Trilo to those who use it for the most part. I'm glad you found us and look forward to learning more as time passes. You and your baby boy are family now and we will be with you all the way.

Hugs,
Leslie and the gang

[frijole]

Hello. I had this happen once and the vet asked if it was dark brown/black or bright red. As per the attached you can see what the different answers indicate.

Many possible reasons - hope this is helpful. And as Leslie said if it continues and is worse go to any ER if your vet is not responding. It always happens on weekends! Kim

http://www.k911.biz/Petsafety/BloodinStool.htm

[addy]

Hi and Welcome,

Does your pup have a history of colitis type issues? Has your pup ever had problems with loose stools for any reason?

I'm glad you stopped the Trilostane as when in doubt, always withhold the medication.

Loose stools can be a side effect of the drug, it could be unmasking a problem your pup already had but was self medicating with higher cortisol, it can also be a sign of a problem with the cortisol going too low.

When I started my dog on a very low dose of Trilostane her on going colitis flared for 3 weeks but in her case, those first days, her cortisol dropped like a ton of bricks. She continued to flare for about 3 weeks when we started treatment but she had a history of colitis which was eventually diagnosed as inflammatory bowel disease..

You will need to sort this out with your vet. I know it is scary.

[maria]

When my dogs have had diarrhea, I have seen blood it it. It usually goes away in a couple of days. Boiled chicken breast and white rice is good to put them on when they have diarrhea.

[Buddy76]

Thank you for all your suggestions. It turned out that he was allergic to the antibiotic he was on for a bladder infection. Once I stopped the antibiotic, his stool returned to normal. I just dropped him off for his first re-check since being on Trilostane. He'll also be getting another urinalysis to see if he was on the antibiotic long enough to get rid of the infection. My poor guy has been through a lot in the last year :(

[addy]

Let us know the results. Hoping for good numbers :)

[Budsters Mom]

Hello and welcome from me too. :)
I have a Buddy also. A great name, huh? 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. It looks like you re off to a great start and are in excellent hands. So again welcome to you and Buddy.:)

Hugs,
Kathy and Buddy:cool:

[molly muffin]

So glad that the reason for the blood was discovered. Hope the infection is completely gone.

Sharlene and Molly Muffin

[Buddy76]

Hi there, so I've been treating my dog Buddy for his Cushings for a little over 3 months now. He is a 9-10 year old shepherd mix and is currently on 60 mg of Trilostane.

Prior to being diagnosed, he had chronic allergic bronchitis which caused him to cough up phlegm on a daily basis. He had surgery on his spine for a disc that was pressing on his spinal cord (August 2012) About 2 months after his surgery, which he recovered well from, he had a spinal cord stroke and was paralyzed. After a month of rehab he was able to walk again and get up on his own and continued to do well. Ever since he has been on trilostane for his cushings (3 months ago) it seems like he has progressively gotten worse with regards to his coordination. Three weeks ago he fell down and wasn't able to get up on his own. Since then he has progressively gotten worse. He can't get up on his own and when walking he is very unstable, weak and can't stand for long without falling. His allergy problems are also coming back (coughing at night, sneezing, and licking paws).

I've taken him back to the neurologist twice since he started having a real problem getting up and walking again. First they prescribed an anti inflammatory (75mg Deramaxx) which seemed to help at first but then he just got worse so I took him back. They then prescribed a med for pain (100mg Gabapentin). He's been on the anti inflammatory for 3 weeks and the pain med for 2 days. The pain med makes him very drowsy and he still can't walk well and falls and can't get up on his own.

I'm not sure how long I should give the meds before I decide they aren't working and I'm now wondering if treating the cushings has caused all of this to happen. I knew his allergies may return with the Cushings being treated but I'm wondering if all his walking problems were also being masked by the excess steroids in his body from the cushings.

Does anyone have any experience with this? I wonder if he'd be better off not treating his cushings and maybe it would resolve all these other issues.....

[Jan W.]

I wish I could help you with Buddy's problems. I can't imagine what you are going through. I am new to this site and have a dog that we are currently running tests to see if she has Cushings. She also has problems with her hind legs. My vet recommended that she be seen by a neurologist for a possible pinched nerve. I see a lot of expense and rehab if surgery is needed. But I thought there was more to her story than he was seeing. I decided to rule out Cushings first since Cushings symptoms are hind leg weakness.
I would be curious as to how you arrived at the Cushing's syndrome. And what type of Cushings Buddy has. I hope someone in the "know" is up reading this late. I know the Gabapentin can cause some neurological problems, but you started that after he already had symptoms.
I don't even know what the side effects are with cushing's medication, but I would be a little interested in that area
I'm sure someone will be along soon to help you. Jan W.

[Jan W.]

ps---- I forgot, have you had any ACTH stim test done to see if you are overdosing Buddy?? Jan. W.

[spdd]

Just want to welcome you to the forum. I have been treating my dog now for about 3 months and it's been up and down.

I am not schooled well enough on these issues, but it has been a wealth of information here for me.

Good luck with Buddy, we do love our pups on here tremendously.

Judi & Keesh

[goldengirl88]

Hi:
I just wanted to welcome you to the forum. Yes high cortisol can mask other problems as it acts as an anti inflammatory . Shepherds usually get arthritis etc. in old age don't they? Maybe he had this going on and the Cortisol masked it. What are the tests he has had done to confirm Cushings, and could you put the numbers on here so we can see them? What is his weight? Has he had any vomiting or diarrhea? Are you watching for signs of Addisons? Do you have prednisone if needed? I understand the falling etc. could be frightening so we need to see what the problem is here and help get him straightened out. Again please post all results form all testing done. Blessings
Patti

[Squirt's Mom]

Hi and welcome to you and Buddy! :)

We don't use Trilo (Vetoryl) in our house, we use Lyso, so I will let the Trilo folk talk to you about things.

However, for now stop the med and see if that helps him regain his leg use. It may be the dose is too high.

How is his appetite? his stools? any nausea or vomiting?

How much does he weigh?

What dose (mg) of Trilo is he taking and how often (once or twice a day)?

When did he have the last ACTH and would you mind posting the results here?

Was he fasted for the ACTH?

Was he given his med before the ACTH?

Was the ACTH given within 6 hours of the dose?

Hang in there! We are here to help in any way we can. I'm glad you found us!
Hugs,
Leslie and the gang

[Buddy76]

Buddy was drinking excessive amounts of water and peeing a ton. He also began to pee in the house which he never did before. It was like he couldn't hold it. He also became obsessed with food and would take your hand off if you weren't careful when before he was the gentlest dog when taking treats from you. When he had spinal surgery the hair on his back was shaved and it never grew back. That was the final sign that I was pretty sure he had Cushings and I took him in to be tested.

He weighs 60lbs. He's had several ACTH tests every few weeks since his diagnosis and had his most ACTH test a month ago. He was slightly high so my vet reduced the dose and said I wouldn't need to recheck him for 3 months (I don't have his medical records with me but will be asking my vet on Monday to send them to me).

I'm planning on taking him to the vet tomorrow to discuss all these things with my vet. It's been several days on the anti inflammatory and pain meds and they don't seem to be helping at all. My other dog has been sick as well with stomach ulcers and just yesterday I had to rush her to the emergency and she ended up having bloat and a twisted stomach. She had emergency surgery and is in the hospital now. I'm so stressed out and just don't know how I'm going to afford all of this....I have pet insurance but it only covers so much. I just want my babies pain free and comfortable :(

[Jan W.]

I am so so very sorry for your critters' illnesses!!!! I am sending you many prayers and I know that God and everyone on this site will wrap their arms around you and your fur kids. They give us a lot of love and happiness and we just want to return that to them. Keep us posted. Jan W.

[Junior's Mom]

I'm so sorry to hear of all your troubles. I hope your other dog recovers well from the surgery. If at the last acth test, your dogs cortisol was still high, the vet should have increased the dose, not reduced it. Any time a dose is changed, an acth test needs to be done 10-14 days later. It could be dangerous to wait 3 months.
Did he start on 60mg and it never changed?

[doxiesrock912]

From what you're describing, it sounds like Buddy is likely getting too high of a dose of Trilo.

Weakness and lethargy are top signs that the meds might be too high. If he's been this way for a time, he also could move into Addisons which is the opposite of Cushings and is life threatening. For these reasons, I'm going to suggest that you find an IMS (small animal internal medicine vet) to treat Buddy. Cushings is tricky and every dog responds differently. Your current vet is waiting much too long to retest. Especially considering that Buddy obviously isn't stabilized.

We went through three vets before we learned about IMS specialists and changing has made all of the difference for our dog Daisy Mae. They are a little more expensive but they can do many tests right there and the money that you save by getting Cushings treated correctly is HUGE.

For assistance with vet bills, there is a credit card called Care Credit. You can apply online.

I hope that your other furbaby recovers nicely! Bloat and a twisted stomach. That is incredibly frightening!

[molly muffin]

Hello and welcome to the forum.

Oh my, you are in the midst of several pretty severe issues with your dogs. I'm so sorry to hear this and I hope the one that just went through surgery makes a good speedy recovery.

Leslie has asked all the pertinent questions, so that is covered. The ACTH tests in particular we would be interested to seeing the results of.

It is completely possible that with the cortisol lowered, especially if it has gone really low, then yea, he would be showing back leg problems. Cortisol can mask many issues and make them feel better, namely joint issues.
It is possible that you might need to tweak the trilostane so that you are at a point, where his joints aren't bothering him and yet you still have some symptom control. In that case, it might not be the Perfect numbers that we like to see, but what is going to work best for Buddy.

Sharlene and Molly Muffin

[Buddy76]

Thank you. I took Buddy back to his neurologist today and they suggested taking him off the pain meds since he doesn't appear to be in pain and see if there is any improvement. The pain meds do make him very sedate. My next step is to take him back to his regular vet and have his blood tested. He was initially prescribed 70 mg of trilostane and every test after that (he had it checked every 2-3 weeks from the initiation of meds given) showed he was the same and levels were stable. His last test was a little over a month ago and it appeared he was slightly over medicated so the vet lowered the trilostane dose to 65 mg and said to have him rechecked in 3 months. The neurologist brought up that I might take him off the trilostane and see if his neurologic issue gets any better because some dogs don't respond to NSAIDs but he might be better off the the steroids in his system.

[Budsters Mom]

Hi,
My Buddy displayed signs of neurological issues before his Cushings diagnosis was confirmed. He had a neuro consult (with a neurosurgeon) to verify that he was stable enough for Cushings testing. His Cushings was later tested and controlled successfully. Unfortunately, he's neuro symptoms were caused by an active/growing Pituitary macro-tumor. Has your neurologist given you any indication of what might be causing Buddy's symptoms?

[Budsters Mom]

Sorry, I just read back and realized that your buddy has had spinal surgery. That definitely could be the cause of his neuro symptoms. What kinds of neuro symptoms is Buddy experiencing? Have they escalated since he's been on Trilostane?

[Harley PoMMom]

His last test was a little over a month ago and it appeared he was slightly over medicated so the vet lowered the trilostane dose to 65 mg and said to have him rechecked in 3 months.

I am a bit concerned about Buddy, when a dog's cortisol goes too low from Trilostane, the Trilostane should be stopped and when clinical signs return the Trilostane should be restarted at a lower dose. An ACTH stimulation test should be performed in two weeks after any dosage adjustment. I strongly urge you to have an ACTH stimulation test done in two weeks instead of 3 months.

Love and hugs, Lori

[doxiesrock912]

Three months is too long to wait. Our IMS vet suggests testing at 6 weeks after the dosage has been adjusted.

[Buddy76]

Hi everyone, its been a while since Ive been on here. My Buddy is a shepherd mix who was diagnosed with Cushings 2 years ago. I'm not sure on his exact age because I found him on the streets but we think hes around 11-12. His cushings is under control, he just had a recent ACTH test 2 weeks ago and I don't have the numbers in front of me, but they were within normal limits so my vet said he was stable. He's currently on 65mg of Trilostane. In the last 2-3 months his mobility has dramatically declined. He no longer is getting up on his own and when he walks he is very unstable, weak and falls constantly. I was doing physical therapy with him but he became very intolerant of it and the therapist they didn't think was benefiting from it any longer. I also do laser therapy on his spine to help with inflamation from disc disease and arthritis which seemed to help for a while but doesn't seem to be doing anything now. He also has a quad wheelchair that helps but he can't be left in it for extended periods of time because he gets it stuck and then just barks and barks. Just recently he developed a bad skin infection and his skin is basically peeling off...taking all his hair with it. He's been on antibiotics for 3 weeks with little results so we had a culture done, skin scrape, etc. The culture is showing 3 different bacteria so the vet said he might have an additional auto immune issue going on. I feel terrible for him and just want to keep him comfortable. I don't want him in pain but he just looks at me like he's depressed most of the time. He is also not eating well and has lost over 10 lbs.

I'm wondering if treating the Cushings was a mistake and if I stop, his arthritis and disc problems would get better and his appetite would come back etc.

Any advice on this would be greatly appreciated. I'll do anything to help him feel better if possible...I just don't want to be prolonging any suffuering. Up until the last month or 2 he's been hanging in there but the last couple of months his health has drastically gone downhill. I don't want to give up on him, but don't want him to suffer ...

[goldengirl88]

Sorry your baby is having trouble. My Tipper has laser therapy and I do know that you must keep up with the maintenance or it stops working. The mobility issues are probably related to arthritis which can become worse once the cortisol is controlled. High cortisol actually masks the pain of arthritis, just like a person would get a shot of steroids for pain, and feel better after the shot. Dogs with arthritis are sometimes not diagnosed with it because it is being controlled by the high cortisol. Cushing's does cause muscle loss and weakening in the legs. You said your vet told you the numbers were good, but unfortunately we need you to post them to make sure. Many vets read the normal scale on the results as being for a Cushing's dog and they are not, they are only for normal dogs, therefore could be misleading if read wrong. Please get a copy and get those numbers up so we could see them. Lastly you said your dog lost 10 lbs which is not normal for Cush dogs as they gain weight. Has your dog been tested for diabetes or thyroid problems. They will lose weight with diabetes, and with an over active thyroid. I would start first by getting the results, then ask the vet for a full blood panel, thyroid panel, and diabetes test. Sheperds are notorious for arthritis have you thought about Adequan shots? They have helped my dog a great deal, and I can tell when hers is starting to wear off. What were the symptoms the dog was presenting with that made you get him tested for Cushing's? Were any of these health issues you stated present when your dog was tested for Cushings? If so it can make a false positive by skewing the numbers. Did you dog have an LDDS, ACTH, Urine, Ultra Sound and any blood work? If so please get copies of all and post the abnormal results and the reference guide form the lab as they are all different. Blessings
Patti