New to the group and new to Cushings (11 y/o Boston Terrier)

[nancywoodbury]

Good Morning - My 11 yr. old Boston Terrier named Vinny was just diagnosed with Cushings this week. It would be bad enough if this was the only thing he had but my poor Vinny has a laundry list of ailments. He has had idiopathic epilepsy since the age of 4 and also recently had testicular cancer. Want to quickly add that he would have been neutered when a baby but he also has a redundant membrane in his throat making him an extremely high risk candidate for anesthesia. Boston's normally do the reverse sneezing, but with this extra membrane, Vinny's reverse sneezing can completely cut off his airway and send him into respiratory distress very quickly. So, he was never neutered until recently when my vet was positive that his testicles were full of cancer and she was right. The surgery went well, but as all anticipated, he had severe respirator distress afterwards and it was touch-and-go for several hours until his BP and breathing stabilized. He had 2 forms of rare cancer in the testicles and also some in one of his lymph vessels, so we have to watch very closely for any signs of it spreading. Also over the past 6 months (same time cancer was growing), we noticed some changes in his body shape with his tummy getting larger, hair thinning, and more panting than usual. He is very thirsty and always hungry, but really doesn't urinate any more than normal. So, once the drama of the neutering was over, we proceeded with the Cushings testing. To be honest, my vet was not convinced of the Cushings diagnosis, so sent his lab results to our oncologist who works with an internist. Both of them felt the results were conclusive for Cushings. Vet wants to now start on low dose of Vitoryl and I am very nervous about this drug after reading about it. He has also developed high blood pressure and is on meds for that. I know the Cushings can elevate the BP. He's also on Phenobarbital for the epilepsy. I'm concerned that this is too many medications for him. My vet isn't sure about the contraindication of all of these meds, but said "she will check" and she's only starting him on a low dose so is sure it will be fine. I'm not so sure and would really appreciate hearing from you guys. I have been on a canine epilepsy list for years now and know from experience there that the docs definitely don't have all of the answers. I trust the information from other people living with these animals who know what's right and wrong. Thank you!

[Harley PoMMom]

Hi Nancy,

Welcome to you and Vinny!

I am so glad you and Vinny have joined our family. In order to give you the best possible feedback about Vinny's situation, can you tell us more about the diagnostic tests that determined that Vinny has Cushing's? Was a chemistry/CBC blood panel done recently, and if so could you post those results. We only need to see the abnormal values along with the reference ranges and units of measurement.e.g...ALT 150 U/L (5-55)...Thanks!

To further complicate things, the symptoms of Cushing's can also be the side effects of phenobarbital. Increased drinking/urinating, change in appetite, and elevated liver values are some of signs that can be attributed to Cushing's or phenobarbital use.

Could you also tell us how much Vinny weighs and the dose of Vetoryl that the vet prescribed?

Getting a confirmed diagnosis of Cushing's can be difficult because there's not one test that is 100% accurate at diagnosing it and other non-adrenal illnesses can create false positive results from all tests for Cushing's. In the meantime I am including links to information regarding Cushing's and the treatment protocols. ;)


Links to Cushings Websites (especially helpful for new members!) (http://www.k9cushings.com/forum/showthread.php?t=180)


Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

Hugs, Lori

[nancywoodbury]

I don't have a copy of the numbers from the ACTH test but will get them. He's on such a low dose of Pb that it's below the therapeutic range, so they don't think the symptoms are from the Pb. It's just enough to keep his seizures under control though, so I have not increased it. Will post the numbers when I get them on Monday and thank you!!!

Do most of you see your normal vet for Cushings maintenance or do you see an Internist?

[Harley PoMMom]

Having a vet that is knowledgeable about Cushing's along with the treatment protocols and that has experience with the disease plus is willing to be a team player is important. :eek:

Not many GP's fall in that range and when there are other health issues that run concurrent with Cushing's is when the expertise of an IMS is needed. Often times the IMS can work the side lines (be the secondary) and have the GP being the primary doctor.

[nancywoodbury]

I will definitely look into getting a specialist to work with my vet.

I don't have the numbers from the ACTH test, but I do have the latest blood work and after looking at some of the other numbers posted by others, Vinny's blood work numbers don't look bad at all?

ALT 130 U/L Ref. 5-107
ALKP 140 U/L Ref. 10-150
U CREA was 166.7 mg/dl Ref. 100-500

Vinny weighs 16.8 lbs.
Don't know dose of Vitoryl yet as I haven't picked up. Due to his throat anomaly, we must have meds compounded. I just read something on this site about compounding Vitoryl and how FDA has not approved so added concern.

[Harley PoMMom]

I don't have the numbers from the ACTH test, but I do have the latest blood work and after looking at some of the other numbers posted by others, Vinny's blood work numbers don't look bad at all?

ALT 130
ALKP 140
U CREA was 166.7

Could you do us a favor and edit your post to add the reference ranges plus the units of measurement for the values listed...Thanks!! As an example; ALT 150 U/L (5-50).

[grapey]

Hi Nancy,
I'm new here too and also have a wonderful Boston. I haven't started medication yet (will start loading on lysodren in two weeks) but just wanted to wish the best for your Vinny.

[mytil]

Hi Nancy,

Welcome and glad you and Vinny are here.

Looks like Lori started things off with our usual questions.

Here is a link to assist in finding a specialist - http://www.k9cushings.com/forum/showthread.php?t=182.

Keep us posted
Terry

[nancywoodbury]

Vinny's ACTH Stim tests were:

3.0 ug/dl PRE-ACTH
27.2 ug/dl Post-ACTH

Vet has prescribed 10 mg. 1x per day of Vitoryl

Thank you for your comments.

[BostonLover]

Welcome! I also have a Boston who is currently on Lysodren (about 8 weeks now). She was on Trilostane for over a year, and it didn't help, and caused more problems. The Lysodren has been a miracle for my Bells.

Wishing you all the best.

[nancywoodbury]

Thanks for the welcome, Boston Moms! Seems that every single Boston Terrier I know, has either Atypical Cushings or full blown Cushings.

[BostonLover]

Thanks for the welcome, Boston Moms! Seems that every single Boston Terrier I know, has either Atypical Cushings or full blown Cushings.

I know, I'm starting to hear more and more about it. Growing up my grandma always had two Boston's and none of them EVER had any health problems, and always passed of old age. I lost my Tyson on Christmas Eve to a brain tumor (horrible seizures) and now my Bells has Cushing's. I'm hoping my other Boston, Kaya, is completely healthy, of course I scrutinize everything she does and in the back of my mind I wonder about Cushing's and brain tumors. :(

[lulusmom]

Thanks for the welcome, Boston Moms! Seems that every single Boston Terrier I know, has either Atypical Cushings or full blown Cushings.

I would have to agree. Most reference material I've read over the years have a short list of breeds that seem to be over represented and BT's are on few of those lists. In all the years I've been here, I would have to say that in the last year, BT's moved to the very top of my own list based on data I've accumulated from the thousands of threads on this site. I'd also have to put them on the top of the list of breeds that experience growth of a macrotumor quite soon after initiating treatment. As a rescuer, I know that BT's are a hugely popular breed. In California, if a BT were to be unfortunate enough to find themselves in a shelter, they don't stay there long as there is always a waiting list for them. That's one breed that I don't have to worry about being killed in a shelter. I've never rescued one so I have no knowledge of the breed. Would love to hear more about them from our many Bost Terrier lovers.

Glynda

[molly muffin]

Hello and welcome to the you and Vinny. Oh Vinny, he has sure been through a lot in his life.
Your liver numbers really don't look bad at all. In fact, I'd take them in a heart beat! LOL So, it is really good to know that it looks like his liver is good.

Did they give a normal range on the ACTH test? I agree the post does look high to me.
Another question, have you had an ultrasound done to see what the adrenal glands look like? It might be included on any ultrasound done to see if there had been any spread of the original cancer.

So glad you found us. We have a wonderful supportive group and a lot of BT mums. :)

hugs,
Sharlene and Molly Muffin

[nancywoodbury]

We did have an ultrasound and it showed "slightly enlarged" adrenal glands at .07 that merited watching. We are on a 3 mo. schedule with the ultrasounds and the oncologist to make sure the cancer is still in check. He did have some in the lymph vessel, so cancer is always in the back of my mind.

[molly muffin]

If both adrenal glands are enlarged then they are probably both secreting cortisol. Whether this is due to cushings or due to the cancer it is hard to say. Cortisol will be risen usually for any illness and the more sever, the more secreted. So that would probably rule out an adrenal tumor causing cushings too.

Sharlene and Molly Muffin

[nancywoodbury]

Saw the internist today and she wants us to treat with Melatonin and check with her again in 3 mos. She felt that with so much going on and the drugs being so strong, she did not want to treat for Cushings now.

[Boriss McCall]

Hi!
I am also a BT mom. Makes me sad to see so many on here. well I guess any dog for that matter. :(
Your picture of Vinny is adorable. He is really cute!
I would say your boy has been thru a lot. My guy has been completely healthy until he was diagnosed last year with cushings. He is 9. I guess I should feel lucky. I hope things are starting to be on the upswing for Vinny.
I would say waiting is probably the best thing. I will cross my fingers that you can check Cushings off the list for Vinny & he won't have it.
Please keep us posted on how things are going on the Melatonin.

[Squirt's Mom]

May I ask what the IMS said the melatonin would do for Vinny? I use it myself for various things, but most have to do with calming or helping to sleep and I'm curious the purpose the IMS feels it will serve for Vinny.

[nancywoodbury]

Amy - I always tell him that he has the sweetest soul I have ever known; animal or human.

Not sure what they feel the Melatonin does but our grand-dog, Hubble, who was also a BT, was prescribed Melatonin and Lignans with Flaxseed for his atypical Cushings.

[Squirt's Mom]

Yeah, that combination is the treatment for Atyical but either one alone won't help Cushing's of any form. It does have the ability to lower the cortisol but only a tiny bit and can't do much in the face of the massive amount being produced in true Cushing's.

But, like I said, I am just curious if your IMS knows of another purpose for melatonin that might help your sweet boy in some way. Always wanting to learn more about the things I use. ;)