Adopted possible Cushing's dog, Holistic care

[Bandicoon]

Hello-I am new on the forum and have a new (to me) dog named Magnus who likely has Cushing's. He is a 13 year old Aussie mix whose owner has given him into our care since her job requires her to travel too much to give him the care he needs, and we were willing to take him since he gets along with our dogs and our friend will pay for his upkeep.

He was tested for Cushing's a couple of years ago and it was negative... But I still think he has Cushing's or something that looks just like it. His symptoms when he first came to stay with us a couple of weeks ago were:

Constant heavy panting
Pot belly
Large firm lumps on torso -biggest is almost as big as a tennis ball, on chest
No muscle especially in hind legs, shoulders and neck
Head looks gaunt
Weak-difficulty standing and lying down
Frequent drinking and needing to go out
Dilute urine
Strong appetite
Loss of hair on either side of spine in lumbar region
Droopy skin
Lethargic

Other symptoms:
Cloudy eyes (cataracts?)
Skin on top of nose crusty and cracked
Elbow calluses cracked and crusty
Frequent kicking while asleep

Magnus is not currently on any medications and had been fed a "premium" kibble. I put him on a raw home made diet (the same one our three dogs have been eating for over a decade, with a couple of modifications due to his condition) and supplements. Within a few days the panting and excessive thirst cleared up, the skin on his nose has mostly healed and his energy level improved quite a bit. He also stopped kicking so much in his sleep.

His owner and I have discussed care and agree that-considering the early improvements in his condition- the best course for now is to keep him on holistic care. Beside the raw (prey model type) diet I have started him on curcumin, boswellia, hyaluronic acid, l-glutamine and ashwaganda. I'm also looking into IP6, flax lignans and melatonin. The diet includes raw bone-in chicken, pork, bone broth with vinegar, green tripe (raw not canned), fermented vegetables and enough butter, cheese or hotdog to get the pills in. Looking forward to hearing from others who are have personal experience with holistic care.

[Squirt's Mom]

Hi Bandicoon and welcome to you and Magnus! :)

The signs you listed are certainly consistent with Cushing's but the same signs will also be displayed due to conditions other than Cushing's. The lumps are a bit concerning to me and I would want those checked out to see if they were cancerous. That would certainly cause cortisol to rise, resulting cush signs, yet not be Cushing's. ;)

If Magnus has not had blood work, a senior wellness panel for example, that is something I would have done for sure asap.

Chaste Tree Berry, Rehmannia, Si Miao San, Siberian Ginsing, Ginko Biloba, and Burdock root are some other herbs you can look into that are used to help with Cushing's. Avoid ALL herbs and supplements that are adrenal stimulants like licorice and the snake oils out there like Cushex and Adrenal Gold.

Please understand - it is not the norm that alternative approaches can address the cortisol levels. They often simply address the signs while the cortisol continues to do its damage quietly. Most folk who take this route never test - not to find out what is actually wrong nor to find out if their approach is having any effect other than anecdotal. I do know folks who used herbs, diet and supplements exclusively and who kept up the testing to see how those things were affecting the cortisol - but they are very few and very far between. Their babies did well, even those who were put on traditional treatment when the "natural" approaches proved ineffective, but most who were not diagnosed and monitored did not do well and did not live as long nor as well as pups on a traditional treatment.

If you wish to take this approach, I strongly recommend you find a Holistic vet to work with and not wing it unless you have training in herbalism. Herbs are drugs in their own right and deserve as much respect as pharmaceuticals as a result. ;)

As for the diet, I don't do nor recommend raw unless it is a last resort, especially in a pup who's health is already compromised. HOWEVER, I do understand that you feel the change has been beneficial for Mangus and what works best for him is all that matters. So I will let our raw proponents talk to you about this. I would also recommend you use the Holistic vet to make sure this diet is balanced so it doesn't cause further problems.

I'm glad you found us and look forward to learning more and watching Magnus' progress as time passes. Just so you know - I am a HUGE supporter of herbal treatments, a student of Herbalism and Canine Nutrition. So I do support the use of herbs and the neutriceutical approach but I also know we often have to use traditional meds as well. A combined approach is often very beneficial for many issues, both human and animal.

You are an angel to give Magnus a caring home when he needed one and I have no doubt he is in good hands.
Hugs,
Leslie and the gang

[Bandicoon]

Thanks for the welcome!

The signs you listed are certainly consistent with Cushing's but the same signs will also be displayed due to conditions other than Cushing's. The lumps are a bit concerning to me and I would want those checked out to see if they were cancerous. That would certainly cause cortisol to rise, resulting cush signs, yet not be Cushing's. ;)

If Magnus has not had blood work, a senior wellness panel for example, that is something I would have done for sure asap.Magnus had a check-up at his owner's vet last week and was given a "clean bill of health" (according to his owner) which I took to mean that he is not currently having a life-threatening medical emergency, considering his obvious poor state of health. This was after a few days on the raw diet and according to his owner he was not re-tested for Cushing's at that time because the vet believed he was already in better condition than he had been on his previous checkup.

Chaste Tree Berry, Rehmannia, Si Miao San, Siberian Ginsing, Ginko Biloba, and Burdock root are some other herbs you can look into that are used to help with Cushing's. Avoid ALL herbs and supplements that are adrenal stimulants like licorice and the snake oils out there like Cushex and Adrenal Gold.The only direct cortisol-lowering supplement he is getting at this time is the ashwaganda. I will look for studies on the herbs you mention. I'm interested in supplements that support metabolic healing, endocrine balance, and immune support, rather than direct symptom relief. Good point on the "snake oil". If a compound has good ingredients I would consider it but I avoid pet grade supplements and feed products because the labeling and quality is less controlled than human grade. The only product I use that's an exception to that is green tripe, which is not available in human grade (yuk!), but since its a raw by-product of the beef industry there's not much incentive or opportunity for adulteration.

Please understand - it is not the norm that alternative approaches can address the cortisol levels. They often simply address the signs while the cortisol continues to do its damage quietly. It appears that allopathic Cushing's drugs often fail to control the disease, or do so only at the price of severe side effects that are worse than the Cushing's itself, and/or bankrupting the animal's owner. Until I know more, and have exhausted less invasive methods, I would prefer to err on the side of not doing further harm.

Most folk who take this route never test - not to find out what is actually wrong nor to find out if their approach is having any effect other than anecdotal.This makes sense to me. The testing is expensive and it seems to me only of academic interest, unless you are dosing the animal with a toxic substance which needs to be tightly controlled. I will surely test if we end up going with a protocol that demands it to minimize the toxic effects of the drug, but meanwhile, if someone wants to give me free testing in the name of science for the non-toxic approach we are using, I'll be happy to take it!

I do know folks who used herbs, diet and supplements exclusively and who kept up the testing to see how those things were affecting the cortisol - but they are very few and very far between. Their babies did well, even those who were put on traditional treatment when the "natural" approaches proved ineffective, but most who were not diagnosed and monitored did not do well and did not live as long nor as well as pups on a traditional treatment.Indeed! Lots of anecdotal information both ways. And "natural" encompasses a huge range of practices. Are there any good, well designed, conflict of interest-free studies comparing holistic vs allopathic treatments?

As for the diet, I don't do nor recommend raw unless it is a last resort, especially in a pup who's health is already compromised. HOWEVER, I do understand that you feel the change has been beneficial for Mangus and what works best for him is all that matters. So I will let our raw proponents talk to you about this. I would also recommend you use the Holistic vet to make sure this diet is balanced so it doesn't cause further problems.Thanks, I'm always happy to discuss raw diets. I think some people believe you can just toss a dog a factory-farmed chicken leg week after week (which IMO seems likely to eventually cause deficiencies, though I haven't tried it), but feeding dogs a "balanced" diet is not much more complicated than that, and certainly less complicated than feeding humans - actually much easier because you don't have to worry about taste or presentation, you have total control over their diet and don't have to worry about balancing crappy school lunches or boozy social events. Of course the dog food industry doesn't want people to know that! If in doubt, I agree talking to a holistic vet could be helpful, as long as they really have studied nutrition - I have talked to some who are fat phobic and want to feed our carnivorous friends heaps of veggies :rolleyes: or, gods help me, grains of any kind. Even holistic vets can have some pretty strange ideas about nutrition thanks to heavy funding from the pet food industry in vet school. There are lots of good resources for people interested in raw/prey model/BARF/RMB - forums and books.

[molly muffin]

Hello and welcome to the forum.

We do have some who feed a raw diet and support it, so I'm sure they will pop in when they get a chance.

Over all I am happy though that Magnus has a home where he can be cared for and kudos to his owner for recognizing that he needs more than she has the time to provide right now. More kudos to you for providing that home. Even better, it is good to hear that the changes you have made have had a good over all effect on Magnus.

Welcome to the forum!
Sharlene and Molly Muffin

[Bandicoon]

Here is Magnus's photo album:
http://www.k9cushings.com/forum/album.php?albumid=740

He had a badly cracked nose when he first came to us about 10 days ago:
http://www.k9cushings.com/forum/picture.php?albumid=740&pictureid=5498

At the time I put coconut oil on it which is what the white is.

Same nose today:
http://www.k9cushings.com/forum/picture.php?albumid=740&pictureid=5500

I doubt it was the topical coconut oil (thought that was probably soothing at the time) because Magnus didn't like it and we only put it on him twice. My guess is the change in diet is what cleared it up.

* not sure why the images aren't showing up in the post, but the links should work.

[lulusmom]

Thanks for the welcome!
Magnus had a check-up at his owner's vet last week and was given a "clean bill of health" (according to his owner) which I took to mean that he is not currently having a life-threatening medical emergency, considering his obvious poor state of health. This was after a few days on the raw diet and according to his owner he was not re-tested for Cushing's at that time because the vet believed he was already in better condition than he had been on his previous checkup.
This plus the fact you mentioned that the panting and excessive thirst resolved is fairly substantial evidence that excessive amounts of cortisol or other adrenal hormones may not be the culprit in causing Magnus' symptoms. Good call on the vet’s part and good for you for getting Magnus on a healthy diet. While excellent nutrition doesn’t normalize cortisol in a dog with any form of cushing’s, it does support the immune sytem and does aid in internal organ function.


The only direct cortisol-lowering supplement he is getting at this time is the ashwaganda. I will look for studies on the herbs you mention. I'm interested in supplements that support metabolic healing, endocrine balance, and immune support, rather than direct symptom relief. Good point on the "snake oil". If a compound has good ingredients I would consider it but I avoid pet grade supplements and feed products because the labeling and quality is less controlled than human grade. The only product I use that's an exception to that is green tripe, which is not available in human grade (yuk!), but since its a raw by-product of the beef industry there's not much incentive or opportunity for adulteration.
I have been immersing myself in all things hyperadrenocorticism since my first dog was diagnosed in 2005 and I have never been able to find any scientific based evidence that ashwaganda or any other supplement is effective in lowering circulating cortisol levels enough to resolve symptoms and mitigate chronic adverse impact on the immune system and internal organs. I’m sure I’m not the only member who has been searching high and low for an alternative to Lysodren (Mitotane) or Vetoryl (Trilostane) so I’d really appreciate it if you could provide a citation to studies proving the cortisol lowering properties of ashwaganda by way of appropriate tests such as LDDS, urine cortisol:creatinine ratio and acth stimulation tests.


It appears that allopathic Cushing's drugs often fail to control the disease, or do so only at the price of severe side effects that are worse than the Cushing's itself, and/or bankrupting the animal's owner. Until I know more, and have exhausted less invasive methods, I would prefer to err on the side of not doing further harm.

Actually, aside from the expense factor, which can be mitigated if you have an experienced vet and do your homework, your statements are not completely accurate. There are at least four allopathic drugs used to treat canine cushing’s, two of which have fallen out of favor due to their low rate of efficacy. Those are Ketoconazole and Anipryl. Ketoconazole his effective in less than 65% of dogs due to lack of absorption into the GI tract, plus it can have a profound effect on the liver. Anipryl is effective in less than 30% of dogs and even when a dog does show improvements, it’s usually short lived. Conversely, Lysodren (Mitotane) and Vetoryl (Trilostane) are actually quite effective in lowering cortisol and an educated pet owner and an experienced vet are equally effective in facilitating safe and efficacious treatment with few to no side effects. Each thread on this site represents a case study, and we have more on this site and a predecessor site, that most vets will ever see in their lifetime, whether allopathic or holistic. Those case studies have clearly shown the efficacy of these drugs and a good many of those case studies involving dogs suffering more serious side effects usually have a trail leading back to an ignorant vet and a pet owner who placed blind faith in that ignorant vet. Education is key with this disease. Sadly, in all the years I’ve been monitoring this board, I have yet to find a member who has successfully treated a dog with a confirmed diagnosis with human or pet grade supplements. By successful, I mean not masking symptoms but rather remedying them by lowering cortisol levels to therapeutic levels that can be substantiated by appropriate testing.

This makes sense to me. The testing is expensive and it seems to me only of academic interest, unless you are dosing the animal with a toxic substance which needs to be tightly controlled. I will surely test if we end up going with a protocol that demands it to minimize the toxic effects of the drug, but meanwhile, if someone wants to give me free testing in the name of science for the non-toxic approach we are using, I'll be happy to take it!
If you haven’t lived with canine cushing’s and I mean eat, sleep and breath it, I can see where you might think testing is merely academic but I assure you, academia is overrated when you are dealing with cushing’s because most of our dogs have never read the book. If Magnus had a confirmed cushing’s diagnosis and you continued to see resolution of all of his symptoms, I’d almost be willing to take up a collection to pay for those tests, in the name of science, to validate your claims. Believe me, it would be a first.

Indeed! Lots of anecdotal information both ways. And "natural" encompasses a huge range of practices. Are there any good, well designed, conflict of interest-free studies comparing holistic vs allopathic treatments?
No there are no studies comparing the two because you would be comparing apples to oranges. Science based evidence abounds proving the efficacy of at least two allopathic treatments whereas none exists for natural/holistic/supplements, etc. Actually I have never been able to find much in the way of anecdotal evidence for the latter. I’m a geek about this stuff and would love to see anything you may have found in the way of anecdotal evidence supporting the efficacy of alternative treatments. I love citations and know how to use them. :D


Thanks, I'm always happy to discuss raw diets. I think some people believe you can just toss a dog a factory-farmed chicken leg week after week (which IMO seems likely to eventually cause deficiencies, though I haven't tried it), but feeding dogs a "balanced" diet is not much more complicated than that, and certainly less complicated than feeding humans - actually much easier because you don't have to worry about taste or presentation, you have total control over their diet and don't have to worry about balancing crappy school lunches or boozy social events. Of course the dog food industry doesn't want people to know that! If in doubt, I agree talking to a holistic vet could be helpful, as long as they really have studied nutrition - I have talked to some who are fat phobic and want to feed our carnivorous friends heaps of veggies :rolleyes: or, gods help me, grains of any kind. Even holistic vets can have some pretty strange ideas about nutrition thanks to heavy funding from the pet food industry in vet school. There are lots of good resources for people interested in raw/prey model/BARF/RMB - forums and books.
I dare say that few people will agree on what is the best diet for dogs but I wanted to weigh in and say that I am a huge fan of raw feeding. I am a special needs and senior small dog rescuer so most of my rescues walk through my door with broken legs, compromised immune systems and mental anguish from being dumped in a hell hole. The first thing I do is get them on a commercially prepared raw diet that has been tried and true for me for several years. Puppies with the worst cases of mange and accompanying bacterial and yeast infections improve much faster on raw diets as do those recovering from amputations, life saving surgeries and GI problems. Just like case studies here, it’s all anecdotal but I’ve lived it and know it to be true. I’m a show me person and I pooh poohed my friends who hounded me to try it for two years before I did. One is a life-long special needs Yorkie rescuer who is hugely into holistic treatments, including raw diet. She shared some amazing before and after pictures which convinced me to give it a try. She became my mentor on diet and I became her sounding board on endocrine disorders, as holistic treatments are limited for most. Anyway, my own four dogs, two of which were cushingoid, were my guinnea pigs and their health improved dramatically as did their activity levels after switching to raw. Allergies disappeared, chronic colitis disappeared, extra weight disappeared and no recurrence of oxalate bladder stones. Unfortunately for us raw diet supporters, very few, if any, credible studies have been done to lend us credibility when debating the subject. Actually the only studies available have been done by the beyond disgusting commercial pet food giants who have great influence over the veterinary community. Money talks in any industry. To my knowledge, there have been no sanctioned studies in support of raw diet but I have also been unable to find any sanctioned studies showing that feeding raw diet is detrimental to a dog's health. If anybody is aware of any, please share.

I will be anxiously awaiting your updates on Magnus (very cool name by the way) and will be keeping fingers and paws crossed that his health continues to improve under your excellent care.

Glynda

P.S. One of my cushdogs had a really crusty nose before starting treatment. It was so dry, it would crack and bleed. The before and after of Magnus' nose is pretty amazing, plus he's really cute. Good job!

[molly muffin]

Is Magnus filling out more on that the raw diet. He looks so skinny. Was he exhibiting any diarrhea with his old diet? I wonder about Irritable Bowel Syndrome, and if he wasn't getting enough nutrients or something.

I just want to give him a hug and a belly rub.
Sharlene and Molly Muffin

[LtlBtyRam]

Here is Magnus's photo album:
He had a badly cracked nose when he first came to us about 10 days ago:
http://www.k9cushings.com/forum/picture.php?albumid=740&pictureid=5498

At the time I put coconut oil on it which is what the white is.

Same nose today:
http://www.k9cushings.com/forum/picture.php?albumid=740&pictureid=5500

I doubt it was the topical coconut oil (thought that was probably soothing at the time) because Magnus didn't like it and we only put it on him twice. My guess is the change in diet is what cleared it up.

* not sure why the images aren't showing up in the post, but the links should work.

My cush pup has a really dry nose. It isn't cracking, yet, and her pads are also really dry. I'm interested in what you think was the fix for Magnus' nose. I'd really like to see an improvement in my baby's nose and pads. Welcome to the forums.
Angela

[Bandicoon]

Is Magnus filling out more on that the raw diet. He looks so skinny. Was he exhibiting any diarrhea with his old diet? I wonder about Irritable Bowel Syndrome, and if he wasn't getting enough nutrients or something.

I just want to give him a hug and a belly rub.
Sharlene and Molly Muffinyeah, he's really cute. His owner didn't say he had any signs of IBS and I didn't see any signs of it, but I didn't check his poop until he'd been on prey model for a few days and by then it was the same chalky solid poop as our boys. His owner came to visit last week and thought he was looking much better. He's certainly acting better. Spends much less time lying down and more time running! (Albeit stiffly) up and down the fence line barking at whatever our GSD has deemed bark worthy. I think his skin has tightened up a bit too, and shoulders seem a little more muscular, but he has a long way to go.

Nutrient absorption can be an issue with or without Cushings. His owner was impressed enough with his improvements that she has switched her other 2 dogs over to a raw diet and giving the older one (an arthritic 13 yo border collie) the same supplements Magnus is on, minus the ashwaganda.

[Bandicoon]

My cush pup has a really dry nose. It isn't cracking, yet, and her pads are also really dry. I'm interested in what you think was the fix for Magnus' nose. I'd really like to see an improvement in my baby's nose and pads. Welcome to the forums.
Angelai can't say for sure, but my best guess is that we have replaced the poor quality damaged fats from the premium kibble with fresh, undamaged fats in fresh meat, and considerably increased the amount of fat in the diet while eliminating carbs. The other change that could explain it is the broth. Home made bone broth is loaded with glycine (gelatin) which is very helpful for healing the gut, connective tissue and skin. We're also supplementing him with hyaluronic acid which is great for both joints and skin. So.. I'm not doing a scientific study! Just throwing everything I can at him that might help :)

[labblab]

Regarding raw diets, I am not personally advocating one way or the other and leave it to owners to make that choice. But in 2012, both the American Veterinary Medical Association (AVMA) and also the American Animal Hospital Association (AAHA) published policy statements discouraging the feeding of raw or uncooked animal protein to dogs and cats. The U.S. Centers for Disease Control (CDC) and American College of Veterinary Nutritionists (ACVN) have also issued similar warning statements. Since I don't feed raw meat myself, I have not ventured into the associated research studies. But for anybody who's more interested in assessing the research for themselves, here are links to the policy statements and the study citations upon which the policy statements were based:

Here is the AVMA policy itself:

https://www.avma.org/KB/Policies/Pages/Raw-or-Undercooked-Animal-Source-Protein-in-Cat-and-Dog-Diets.aspx

And here is an extensive set of related "FAQs":

https://www.avma.org/KB/Resources/FAQs/Pages/Raw-Pet-Foods-and-the-AVMA-Policy-FAQ.aspx

Here is the The American Animal Hospital Association (AAHA) policy statement:

https://www.aahanet.org/Library/Raw_Food_Diet.aspx

In addition to posing a risk to the animals themselves, here's an excerpt from the AAHA policy statement that summarizes the risk to humans that they believe to be associated with raw feeding (with the risk being greatest for young children, older adults, or anyone with a compromised immune system):


Homemade raw food diets are unsafe because retail meats for human consumption can be contaminated with pathogens. Studies that have been done on both commercially available and homemade raw protein diets have found a high percentage (30–50%) of them contaminated with pathogenic organisms, and up to 30% of the dogs fed such diets may shed pathogenic organisms in their stool. Many of the pathogens found in raw protein diets can be transmitted to the human population by contact with the food itself, pet or environmental surfaces. A disturbing number of these organisms have also been shown to be resistant to multiple antimicrobials.

Raw protein diets are now demonstrated to be a health risk for several groups, including:
•The pets consuming the diet
•Other animals in contact with these pets or their feces
•Human family members
•The public

To give equal time to the risks of salmonella associated with processed food and treats, I found a link to another article by the AVMA that was also updated around the same time:

https://www.avma.org/KB/Resources/FAQs/Pages/Dry-Pet-Foods-and-Salmonella-FAQs.aspx

As I was expecting, though, even though all the recent recalls make it clear that contamination issues exist with commercial dry/canned food, too, the likelihood of exposure is perceived to be higher with raw meat:


No pet food is immune from the possibility of Salmonella contamination. There is evidence, however, that feeding raw foods, such as raw meat and eggs, increases the risk of Salmonella infection and shedding of the bacteria (leading to possible infection of other animals and of people).2-9 Regardless of the type of food you choose to feed your pet, proper precautions should be taken to protect your family's health.

If I am correctly understanding the AVMA's policy re: raw feeding, a component of the increased risk, historically, has been that raw meat pet foods have not been regulated in the same manner as commercially prepared dry and canned foods. However, future implementation of regulations associated with the Food Safety & Modernization Act of 2011 will seemingly standardize commercial pet food manufacturing safety requirements. This may mean that the greater risk of contamination will be associated with raw "human-grade" protein bought directly from the market.


Scientific studies have confirmed that pets fed raw diets contaminated with Salmonella can become Salmonella carriers...

...It’s common knowledge that raw meat is likely to be contaminated with bacteria; it’s not sterile by any means. Even USDA-inspected, “human grade” meat is not free of bacterial contamination...

...Bacteria are expected to be present in raw meat, so the presence of Salmonella or other bacteria in raw diets does not trigger the same regulatory process that applies to commercially made canned or kibble pet foods...

...Unlike with raw pet foods, the detection of Salmonella or other bacteria in a commercially processed pet food triggers a cascade of events at the state and federal level that lead to a voluntary recall by the pet food manufacturer. The pet food is considered adulterated and not fit for distribution or sale.

Marianne

[Bandicoon]

We are on a "paleo" style diet which means daily of home-cooked meals from scratch, almost no processed ingredients and lots of meat. You know, the way people used to eat, before TV. I do not buy into the paranoia promoted by the processed food industry regarding raw ingredients. Choose ingredients from reputable, local, preferably organic sources, avoid the big processors like Tyson and you'll be better off. Vegetable and fruit products are a bigger worry than meats anyway.

[Bandicoon]

Also, keep in ind that the AVMA is heavily funded by the commercial pet feed companies. Follow the money.

[labblab]

From the AVMA's FAQs:


Q: What influence did the pet food industry have on the AVMA’s policy?
A: None. Neither commercial nor raw diet manufacturers were contacted during development of this policy because it was based on public health risk, and not on nutritional comparisons, health benefits, or economic factors. None of the pet food companies were aware that a policy was being developed.

Q: What is your response to allegations that the AVMA is “in the pockets” of the pet food industry?
A: These allegations are false. We are a science-based organization, and this policy is based on scientific research. Veterinarians are pet owners too. We love our animals and have the experience and training to make educated decisions about what to feed our own pets. Veterinarians choose and recommend diets based on what is best for the animal – e.g., it is medically appropriate and nutritionally balanced to meet that pet’s need. Many veterinarians feed commercial diets, and veterinarians are free to make their own choices when it comes to feeding their pets.

Contrary to the internet rumors that have been propagated, none of our Executive Board or House of Delegates members are employed by pet food companies. AVMA Convention Sponsorship provides financial support for programs and activities that are designed to enhance the attendees’ overall experience through unique educational programs, networking events and entertainment options. AVMA Convention Sponsorship provides visibility and engagement with attendees for the sponsor, as well as an opportunity to support important educational initiatives. AVMA Convention attendees are invited to attend and participate in sponsored events without any obligation to promote, purchase or sell the sponsor’s product or services.

The development of AVMA policy is independent of sponsorship. This is critically important to us because we are expected to be objective, science-based experts on animal health and welfare topics. Sponsorship is necessary to allow us to provide experiences for our members, but we do not allow sponsorships or sponsors to drive AVMA policy.

Veterinarians are independent thinkers, and are free to promote and sell the products they feel will serve their patients’ and clients’ needs. We encourage you to have an open discussion with your veterinarian about your pet’s nutritional needs, and work with them to find the optimal diet for your pet.

Please note that the warnings come from multiple groups including the CDC (which is unlikely to have any interest in, or connection with, pet food companies). Here is the CDC's statement:


CDC recommends against feeding raw food to dogs and cats because of the risk of illness to the pet as well as to people living in the household. Do not feed your pet a raw diet. Here is why:
• Raw diets consist of foods such as meat, poultry, milk, and eggs that have not been cooked or treated to remove harmful germs.
• These food items can carry harmful bacteria including Salmonella and Campylobacter.

I am posting this info in response to Glynda's earlier reply in which she asked for documentation relating to possible harm associated with raw feeding. Regardless, of course you are absolutely free to make the feeding decision that you believe is best for your own dogs.

Marianne

[labblab]

Just wanted to add that contamination issues/warnings are different for fruits and vegetables than they are for raw meat. Fruits and many vegetables are expected to be eaten raw, and therefore a finding of contamination is a source of concern and recall from the marketplace. Raw meat, on the other hand, is known to have the potential for contamination and that is what accounts for the abundant package warnings about proper handling and cooking prior to consumption. If all pathogen-containing meat was removed from the marketplace, the meatcases probably would be pretty bare. :o

However, I didn't intend for this meat discussion to divert our attention away from Magnus and his specific situation. So I'm backing up a couple of steps to offer you both my belated "Welcome!!" and to tell you that I will be very anxious to hear how things proceed for him from this point onward.

Marianne

[Bandicoon]

When vet schools stop allowing pet food companies (and big pharma) to provide or underwrite the curriculum, and vets stop selling commercial pet food in their practices, their claim to not be influenced might have more credibility for me.

As for pathogens on meat, pathogens are on everything. The solution is to eat a species-appropriate diet that supports strong stomach acid, healthy gut flora and a strong immune system, not to try to live in a bubble. I've been preparing and eating raw meat and eggs daily for decades and have yet to get sick from it, if (by "sick" we mean having to take the day off work). What makes me sick is gluten and sugar so I avoid those. Our dogs certainly don't get sick, even on meat that has gotten a bit "high" after a week in the fridge, and no doubt crawling with pathogens. One thing I can say for sure, the food I give our dogs has never been recalled!

[Bandicoon]

This plus the fact you mentioned that the panting and excessive thirst resolved is fairly substantial evidence that excessive amounts of cortisol or other adrenal hormones may not be the culprit in causing Magnus' symptoms.

Why is this evidence that excessive cortisol isn't the problem? Not trying to argue about it, I am interested in the mechanism that causes these particular symptoms. I assumed the panting and thirst were due to co-morbid diabetes. If it's not that, what is it?

While excellent nutrition doesn’t normalize cortisol in a dog with any form of cushing’s
Not to be contrary but people keep saying this like there is strong scientific evidence that diet can't help - What diets have been studied and found to be unhelpful?

I have been immersing myself in all things hyperadrenocorticism since my first dog was diagnosed in 2005 and I have never been able to find any scientific based evidence that ashwaganda or any other supplement is effective in lowering circulating cortisol levels
There isn't a lot out there but I did find these (human studies):
http://www.ncbi.nlm.nih.gov/pubmed/22987912
http://www.ijpm.info/article.asp?issn=0253-7176;year=2012;volume=34;issue=3;spage=255;epage=2 62;aulast=Chandrasekhar


If you haven’t lived with canine cushing’s and I mean eat, sleep and breath it, I can see where you might think testing is merely academic
It's academic in my case because it won't affect the diet and probably not the supps I am giving him. Yes, I am curious, but the diet and supps won't hurt Magnus either way... The worst that can happen is that they will fail to control the primary disease in the long run. In the short run, they do seem to be helping with his overall health presentation. His body composition would be the big indicator that the underlying pathology is being addressed. If that big belly reduces and he starts gaining muscle I think we can safely assume the catabolic state which is due to chronic excess cortisol (Cushing's or otherwise) is being corrected. Please note I have NOT ruled out using drugs, but I do feel that they are a last resort. I want to give this a chance, and at worst it will reduce comorbidities and prepare him to better withstand the stress of the drug treatment.

If Magnus had a confirmed cushing’s diagnosis and you continued to see resolution of all of his symptoms, I’d almost be willing to take up a collection to pay for those tests, in the name of science, to validate your claims. Believe me, it would be a first.
This is actually an interesting idea. Maybe for a kickstarter. Design a test protocol, design a study, then find a good holistic vet or vets to provide oversight. I'm tracking this pretty closely and may do some tweaks as I learn more about helpful nutrient therapies so that might be a good basis for a protocol. Know a holistic vet who would be interested in this?

[labblab]

All of us hate giving our pups such heavy duty drugs. If there was something effective and safer, we'd all be using it. xxxxx


I don't think we can assume that there isn't something safer and as or more effective. There is zero science behind that assumption, and our dogs did not get sick because they have a Trilostane deficiency. It's actually very common for people to believe that the pharmaceutical solution is the only one, thanks to the power of marketing (often disguised as science and designed to play on your hope, guilt and fear) behind the drugs. Millions of dollars for popular drugs, far more money spent on marketing than research.

Diabetes is an obvious example of a disease that people believe can't be cured or controlled without drugs, yet most cases can be controlled without drugs or greatly improved by simple dietary modification, but many people choose to follow the advice of big pharma which is designed to keep them dependent on exogenous insulin, glucose testing supplies and other drugs, thus continuing to pour money into the marketing/drug-dependency cycle.
Bandicoon, I saw that you had posted this reply to Budster's Mom in another member's thread, and I decided it best to move the entire conversation here. I suspect your comments may generate some additional replies, and this way it will be easier for you to address them directly here on your own thread.

Marianne

[molly muffin]

No, they don't get sick from having trilostane deficiency they get sick from either having too much cortisol, or they die from not having enough.

So, until we have some ACTH testing to show cortisol prior and possibly an ultrasound to show that liver and adrenal glands are enlarged from too much cortisol production, then have someone follow an all natural holistic method only, including food of whatever choice and then follow up ACTH test that show cortisol has been lowered and is no longer causing liver damage and adrenal enlargement. We can't say that a pure holistic method works to do those two things, lower the cortisol and mitigate internal damage.
That is why we don't say that.

On the other hand, we do have follow up ACTH testing and ultrasounds showing cortisol reduction and adrenals and liver returning to normal size. So, based on that, alone, outside of the experts testing and opinions, that is why we recommend what we do on here.

Making a mistake is not something that we take lightly as the risk is too enormous and the potential heart ache overwhelming to lose one. It is why we as a forum even exist, because the drugs can be damaging, if given incorrectly, wrong dosage and if proper testing protocols are not followed.

If symptoms are fine on a certain diet and someone doesn't want to pursue the drug use, that is up to them and we will still support them and their decisions, but we won't say that the cortisol is being lowered, until we have what I said above and that is proof. We just can't risk it.

I'm Super happy that Magnus is doing well on his diet and that his symptoms have cleared up and I hope that continues and he remains doing well. That is great news.
It doesn't mean anything in relation to whether cortisol was high or not previous to diet, or what it is afterwards, without appropriate testing.

No one likes to feed the big pharma's, but there are times, when their drugs can be life saving, for people and for animals. I would never want anyone to feel that trying to save their animals and give them a good quality of life was a wrong thing to do, whatever their choice may be.

Okay, that was my bandwagon. :)
Sharlene and Molly Muffin

[molly muffin]

Ooopsie, turns out I'm done yet. :o

I don't want you to think that I/we are against trying holistic methods. We have another member who is trying holistic and having very good symptom control using her methods and we support her in that effort.

She doesn't want to risk an ACTH, as she has a very good balance going for now and doesn't want to upset that apple cart, which I totally understand and "get". So I can say that her methods have shown good control of symptoms with her dog. I just can't say that the cortisol is controlled, which neither her nor we know if it is or not, but symptoms are good so far.

okay now I swear I am done. Really. Well, until next time. :D

Sharlene and Molly Muffin -> whom I am not treating with drugs Yet course we don't know if she has cushings or not Yet. It's only been a couple years after all. :) Nothing easy with this disease

[Bandicoon]

I do get that, if there's a lack of clinical evidence you can't say that diet definitely helps with Cushing's, and I agree with you ... more studies would be helpful. But that's not what people are saying. People are saying that diet doesn't help or can't help when they don't actually have any evidence of this. It's just hearsay that's been repeated enough that people assume its the truth, when in fact the truth is not known. And that's damaging too.

[molly muffin]

I think most people are very interested in diet and what they feed when dealing with anything involving their animals. We certainly spend quite a bit of time talking about it on the this forum, so I think people are interested in it. Not to the exclusion of medical support in addition though, unless they have opted to go a purely holistic route and that usually has involved other supplements in addition to diet, whether it be chinese herbal or other supplements.
Acupuncture, hydrotherapy, laser treatments have been shown to have some beneficial effects on muscular issues associated with cushings.
But we haven't in over 2000 members seen diet alone control confirmed diagnosed cushings damage to internal organs but we do see it help, in addition usually to other treatments.
That is just the sad and by sad I mean very sad situation that exists today.

Sharlene and Molly Muffin

[Squirt's Mom]

Another perspective on food and canine Cushing's for your perusal -


Food-dependent Cushing’s (print copy)
http://www.2ndchance.info/cushingskooistra2010.pdf

HYPERCORTISOLISM DUE TO ECTOPIC ACTH SECRETION

Ectopic ACTH hypersecretion has been documented in an 8-year-old German shepherd dog. (1) The UCCRs and plasma ACTH concentrations were very high and not suppressible with dexamethasone. These findings were initially interpreted as being consistent with PDH. However, histologic examination of the tissue removed by transsphenoidal hypophysectomy didot confirm the presence of an adenoma. Within 2 weeks after hypophysectomy the clinical manifestations were exacerbated and both
the UCCR and plasma ACTH concentration were further increased. CT of the abdomen revealed a tumor in the region of the pancreas. Laparotomy revealed a 5-mm nodule in the pancreas, a 3-cm metastasis in an adjacent lymph node, and metastases in the liver. Partial pancreatectomy and excision of the lymph node were performed, and a neuroendocrine tumor with metastasis in the lymph node was diagnosed by histopathology. Based on this report, ectopic ACTH secretion should be considered in cases of severe hypercortisolism in which plasma ACTH concentrations are very high and are not suppressible with high doses of dexamethasone, and in which diagnostic imaging does not reveal a pituitary tumor. In patients body weight results in a significant increase in plasma concentrations of ACTH and cortisol; but in patients with ectopic ACTH secretion CRH per kg does not increase these plasma hormone concentrations. (1) The neuroendocrine tumor causing the ectopic ACTH syndrome may be detected by a whole-body scan, but in human patients with ectopic ACTH syndrome the tumors are frequently small and often not found. Based on reports of individual cases in which ectopic ACTH secretion may have caused hypercortisolism, the condition may not be extremely rare in dogs. (29,30)

HYPERCORTISOLISM DUE TO ECTOPIC OR HYPERACTIVE EUTOPIC
ADRENOCORTICAL RECEPTORS

In addition to autonomous cortisol secretion by an AT, ACTH-independent hypercortisolism can also be caused by aberrant adrenal expression of either ectopic or overexpressed eutopic hormone receptors. (2,3) Most of these hormone receptors belong to the superfamily of G protein-coupled receptors. (31) In humans, various adrenocortical membrane-bound receptors functionally coupled to steroidogenesis have been reported, including glucose-dependent insulinotropic polypeptide (GIP), catecholamine, vasopressin, serotonin, and luteinizing hormone receptors.

In a recently published case report of a dog with food-dependent hypercortisolism, the ACTH-independent hypercortisolism was most likely due to aberrant adrenocortical expression of GIP receptors. (4) The hormone GIP is secreted in the gastrointestinal tract in response to a meal and normally serves to enhance postprandial insulin secretion. In human patients with aberrant adrenocortical expression of GIP receptors, a meal not only results in augmented insulin secretion but also in increased steroidogenesis. The dog described in the case report had clinical manifestations of hypercortisolism and slightly elevated UCCRs. Basal and CRH-stimulated plasma ACTH concentrations were low, but diagnostic imaging did not reveal an adrenocortical tumor. Ingestion of a meal resulted in significant increases in plasma cortisol concentration and UCCR. Consistent with the diagnostic criteria for food-dependent hypercortisolism in humans, (2,32) IV administration of 3 mg octreotide per kg body weight completely prevented the meal-induced hypercortisolemia. The dog had a good clinical response to medical treatment with trilostane, administered shortly before the main meal.

Thus, a distinct increase in UCCR and plasma cortisol concentration after ingestion of a meal, (4) low or undetectable plasma ACTH concentrations, and prevention of a meal-induced rise in plasma cortisol concentration by octreotide administration strongly suggest food-dependent hypercortisolism.

SUMMARY
The recognition of new causes of hypercortisolism, such as ectopic ACTH secretion and food-dependent hypercortisolism, and changes in technology, such as advances in imaging procedures, have reshaped the diagnostic scenario. An array of tests is available for the diagnosis of Cushing’s syndrome, but once the diagnosis of hypercortisolism is made considerable expertise is still required to determine its cause, to allow selection of the best treatment, and to avoid misdiagnosis.
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http://www.sciencedirect.com/science...90023307001517
The Veterinary Journal
Volume 177, Issue 1, July 2008, Pages 141-143
doi:10.1016/j.tvjl.2007.04.008 | How to Cite or Link Using DOI
Cited By in Scopus (8)
Short Communication
ACTH-independent hyperadrenocorticism due to food-dependent hypercortisolemia in a dog: A case report
S. Galaca, Corresponding Author Contact Information, E-mail The Corresponding Author, V.J. Karsa, G. Voorhoutb, J.A. Mola, H.S. Kooistraa
a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 8, P.O. Box 80.154, 3508 TD Utrecht, The Netherlands
b Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 8, P.O. Box 80.154, 3508 TD Utrecht, The Netherlands
Accepted 4 April 2007. Available online 14 June 2007.
Abstract
In addition to adrenocortical tumours, aberrant expression of functional hormone receptors in the adrenal cortex may cause adrenocorticotrophic hormone (ACTH)-independent hyperadrenocorticism. Here we report on a 6 year old Vizsla dog in which ACTH-independent hyperadrenocorticism was associated with meal-induced hypercortisolemia. Diagnosis was based on history, physical findings, biochemical changes, and elevation of the urinary corticoid/creatinine ratio (UCCR) on two consecutive days (11 and 8.3 × 10−6, reference range <8.3 × 10−6). Basal plasma ACTH concentration was found by repeated measurements to be suppressed (<1 ng/L, reference range 5–85 ng/L) and administration of corticotrophin releasing hormone (CRH) resulted in a minor increase (to 6 ng/L), consistent with ACTH-independent hyperadrenocorticism. Ultrasonography and computed tomography revealed two uniformly enlarged adrenal glands. Magnetic resonance imaging of the pituitary area showed a non-enlarged, normally enhancing pituitary gland. Based on these results, expression of functional aberrant adrenocortical receptors was suspected and the possibility of food-dependent hyperadrenocorticism was explored.
The UCCR on two separate occasions rose from 11 and 8 × 10−6 before a meal to 25 and 23 × 10−6 at 3 h after ingestion of a meal, respectively. There was a corresponding increase in plasma cortisol concentration (from 90 to 150 nmol/L), while plasma ACTH concentration remained low or undetectable. Consistent with the diagnostic criteria for food-dependent hyperadrenocorticism in humans, administration of octreotide completely prevented meal-induced hypercortisolemia. The dog was treated successfully with the cortisol-synthesis-inhibitor trilostane (2 h before meal), and at 26 months after the final diagnosis the dog is still in good condition.
The combination of (1) low plasma ACTH concentration in the absence of an adrenocortical tumour, (2) an increase of >100% in UCCR after ingestion of a meal, (3) prevention of the meal-induced increase in plasma cortisol concentration by octreotide, and (4) reversal of signs of hypercortisolism by administration of trilostane a few hours before the meal led to the diagnosis of food-dependent hyperadrenocorticism in this dog.

Fig. 1. - Basal plasma concentrations of cortisol and ACTH before and after ingestion of a protein-rich meal (at time 0 min) in a 6 year old male Vizsla dog with ACTH-independent hyperadrenocorticism without (day 1) and with pre-treatment with octreotide (day 2) at a subcutaneous dose of 3 μg/kg body weight (at time −30 min).
Table 1. Urinary corticoid/creatinine ratio (UCCR) immediately before and 3 and 6 h after ingestion of a meal on two consecutive days in a 6 year old male Vizsla dog with ACTH-independent hyperadrenocorticism
View table in article At 08.00 h only bread was given, while at 16.00 h a protein-rich meal was fed.
Corresponding Author Contact InformationCorresponding author. Tel.: +31 30 2539411; fax: +31 30 2518126.
Alert
This article is not included in your organization's subscription. However, you may be able to access this article under your organization's agreement with Elsevier.
Copyright © 2007 Elsevier Ltd. All rights reserved.
The Veterinary Journal
Volume 177, Issue 1, July 2008, Pages 141-143
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http://igitur-archive.library.uu.nl/dissertations/2010-0610-200141/UUindex.html
Recent developments in canine Cushing`s syndrome - Galac, S.
source Diergeneeskunde proefschriften (2010)
publisher Utrecht University
document type Dissertation
version Publisher version
disciplines Diergeneeskunde
Abstract
Cushing`s syndrome or hypercortisolism is one of the most common endocrinopathies in dogs. Besides the ACTH or pituitary-dependent and adrenal or ACTH-independent hypercortisolism, ectopic ACTH secretion and food-dependent hypercortisolism are described in the dog for the very first time. Ectopic ACTH secretion has been diagnosed in a dog in which initially pituitary microadenoma was diagnosed and since the hypophysectomy was not curative, further diagnostic has been performed. CRH stimulation test revealed no respons of plasma ACTH and cortisol concentrations, which was strongly indicative of ectopic ACTH secretion syndrome. Total body CT scan revealed a mass in the pancreas and during the celiotomy, also some nodular changes in the liver were noted. Pathohistological examination confirmed pancreatic neuroendocrine tumor, which is a common origin of the ectopic ACTH secretion syndrome in men. Food-dependent hypercortisolism has been diagnosed in a dog with mild clinical signs of hypercortisolism, suppressed plasma ACTH concentrations and bilateral enlarged adrenal glands. UCCR increased after ingestion of the meal. Treatment with ocreotide, which suppresses release of gastric-inhibitory polypeptide (GIP), blocked cortisol secretion, while plasma ACTH concentration remained suppressed. Treatment with trilostane was successful only when trilostane was administered before ingestion of the meal, which provided an additional information for food-dependent hypercortisolism in this dog. The differentiation between ACTH-dependent and ACTH-independent hypercortisolism can be done by the measurements of the urinary corticoid:creatinine ratio (UCCR) combined with the high dose dexamethasone suppression test. The generally-accepted criterion of 50% suppression of plasma cortisol concentration in the differentiation between pituitary or adrenal hypercortisolism is also applicable to the UCCR. Although the UCCR is very reliable in the diagnostics of hypercortisolism, it cannot be used to detect the optimal dose of trilostane. However, the measurement of the UCCR could be useful to detect dogs at risk of developing hypocortisolism. Similar holds true for the basal ACTH concentration, which significantly increased in dogs which received trilostane overdose when compared to dogs receiving the optimal dose. There was no overlap in plasma ACTH concentration in dogs on the optimal dose when compared to dogs which received an overdose. Obviously, trilostane affected the pituitary-adrenal axis. In addition, also an effect at renin-aldosterone system has been detected, since the aldosterone:renin ratio significantly decreased during treatment with trilostane. The pathogenesis of the adrenocortical tumors in dogs is poorly understood. In humans, cortisol-secreting adenomas could be initiated by the aberrant expression of hormonal receptors. In the dog, the overexpression of the genes coding for luteinizing hormone receptor (LHR), gastric-inhibitory polypeptide receptor (GIPR) and three vasopressine receptors (V1aR, V1bR and V2R) was not responsible for the hypersecretion of cortisol by the adrenocortical tumor. However, ectopic expression of GIPR and V2R protein, and eutopic expression of LHR protein in tumorous ZF tissue, may play a role in the pathogenesis of canine cortisol-secreting ATs. Hypercortisolemia in dogs with cortisol-secreting ATs cannot be ascribed to upregulation of the genes encoding for steroidogenic enzymes. In adrenocortical carcinomas, there was a significant downregulation of ACTH-R, which may contribute to the malignant character of cortisol-secreting carcinomas.
keywords Cushing, dog, adrenal, receptors, ACTH, ectopic, trilostane
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http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&Category=7889&PID=52354&O=Generic
Genetic Alterations in Cortisol-Secreting Adrenal Tumors
By Sara Galac
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands

Adrenal or ACTH-independent hypercortisolism results from autonomic glucocorticoid hypersecretion by an adrenocortical lesion. The mechanisms by which cortisol is produced in ACTH-independent hypercortisolism are classified as autonomous so far. However, recent research in humans indicates that some ACTH-independent macronodular adrenal hyperplasias (AIMAH) and cortisol-producing unilateral adenomas are regulated by aberrant adrenal expression of either ectopic or overactive eutopic receptors. The presence of these receptors places adrenal cells under stimulation of a hormone that escapes the cortisol-mediated feedback system and leads to increased function and possibly to hyperplasia and proliferative advantage. In the dog, the suspicion of the existence of functional gastric inhibitory polypeptide (GIP) receptor has been raised in a patient diagnosed with food-dependent hypercortisolism (Galac et al. 2007). In addition, the presence of vasopressin receptors on adrenocortical tumors (ATs) has been indirectly postulated by the finding of non-ACTH-mediated cortisol responses to systemic lysine vasopressin (LVP) in dogs with adrenal hypercortisolism (Maaskant-Van Wijk et al. 1994).
We studied the presence and expression of vasopressin receptors (V1aR, V1bR, V2R), luteinizing hormone (LH) receptor and GIP receptor in canine cortisol-secreting ATs and normal adrenals. The messenger RNA (mRNA) was present in normal adrenals and ATs, although the expression level of the V1b receptor was very low. The mRNA expression levels for the GIP and V2 receptors were significantly decreased in adenomas compared with the normal adrenals (P<0.05). Also in carcinomas, GIP and V2 receptors are down-regulated, but the difference was not significant. For the V1a, V1b and LH receptor no difference was found between the expression in ATs compared to normal adrenals. The normal adrenal gland was immunopositive for the LH and GIP receptor and immunonegative for the V2 and V1b receptor. The V1a receptor antibody utilized did not stain control tissues nor normal or neoplastic AT tissue. The AT tissue stained positive for the LH receptor and in the majority of the adenomas and carcinomas also for the V2 receptor, although only a small percentage of cells was labeled. The staining for the GIP and V1b receptors was negative in ATs. These findings indicate that in the classical canine cortisol-secreting ATs expression of investigated receptors is not causative for adrenal hypercortisolism (Galac et al. 2009).
Another explanation for the overproduction of steroid hormones in cortisol-secreting ATs may be disordered expression of steroidogenic enzymes. We performed QPCR analysis of enzymes encoded by CYP11A1, CYP11B1, CYP-17, CYP21 and 3β-HSD genes in canine cortisol-secreting ATs and compared it to normal adrenals. All above mentioned steroidogenic enzymes showed a trend of down regulation in cortisol-secreting ATs compared to normal adrenals, which is in contrast to results of similar studies in man (Bassett et al. 2005). The trend of down-regulation of the target genes is in line with the fact that the major transcription stimulator of these genes, ACTH, is down-regulated through negative feedback in dogs with hypercortisolism. A consequence of down-regulation of the steroidogenic genes is the reduced cortisol synthesis per individual adrenocortical cell. At the same time, however, an increase in the number of functionally cortisol producing cells in tumorous adrenals must occur, otherwise hypercortisolism in dogs with an AT cannot be explained.
The actions of ACTH, the major regulatory hormone of steroid synthesis and adrenal cell growth, are mediated by its specific membrane receptor (ACTH-R). Due to the suppressed endogenous ACTH levels in patients with adrenal-dependent hypercortisolism, the expression of the ACTH-R gene might be suppressed as well. However, in vivo and in vitro studies in humans have demonstrated that cortisol-secreting adenomas are responsive to ACTH, suggesting the expression of functional ACTH-Rs. In accordance with this, QPCR analysis demonstrated that ACTH-R mRNA was up-regulated in adrenocortical adenomas, while in carcinomas the ACTH-R mRNA levels were low or even non-detectable (Reincke et al. 1998). Similar studies in dogs are running, but the results are not known yet.
Research in humans has also demonstrated loss of the heterozygosity of the ACTH-R in highly malignant ATs. The deletion of the ACTH-R gene seems to be involved in tumor dedifferentiation, which also suggests, that the ACTH-R may act as tumor-suppressor gene (Zwerman et al. 2004). Additionally, it is important to mention that the human ACTH-R gene has been recently cloned, allowing systematic determination of its sequence, expression and function in adrenal tumorigenesis. Direct sequencing of the entire coding region of the ACTH-R gene did not reveal any constitutive mutations, indicating that this mechanism is not frequent in human adrenocortical tumorigenesis (Beuschlein et al. 2001).
Among growth controlling factors, the insulin-like growth factors I and II (IGF-I and IGF-II) and their binding proteins (IGFBPs) have been linked to abnormal adrenocortical cell growth and proliferation in both cancer and hyperplasia. In humans with cortisol-secreting ATs, the IGF-II mRNA expression is significantly up-regulated in carcinomas versus adenomas and normal adrenals. Together with an increased expression of IGF-I receptors, this represents an autocrine stimulatory loop for the AT cell, which results in a significant growth advantage and thus contribute to the highly malignant phenotype of this tumor. Additionally, IGF-independent effects of IGFBP-2 via so far unknown mechanisms, could further promote malignant transformation and facilitate metastatic disease (Fottner et al. 2004). In dogs, IGF-I, IGF-II and IGFBP mRNA was detected in normal adrenals and ATs. However, there were no significant differences in the expression of any investigated genes. Unexpectedly, the expression of IGF-II mRNA in carcinomas was down-regulated when compared to normal adrenals. These results suggest that in the dog the IGF system does not seem to play a significant role in adrenocortical growth control and carcinogenesis.
One of the characteristics of ATs is extensive and invasive growth and the development of metastasis. For tumor growth beyond a certain size, the formation of blood vessels within the tumor is needed to provide the tumor cells with oxygen and energy necessary for growth. Angiogenesis is also involved in facilitating metastasis. The two major groups of genes crucial for angiogenesis are the VEGF family (VEGF-A and VEGF receptor 1 and 2) and the Angiopoietin (Ang) family (Ang 1 and 2 and its receptor Tie-2). QPCR analysis in canine cortisol-secreting ATs demonstrated no significant differences in expression levels of Ang 1, Tie-2 and VEGFR 2 and only minor changes in the expression levels of VEGF-A and VEGFR-1. Interestingly, Ang 2 was significantly up-regulated in the tumor group when compared to normal adrenals, which was confirmed also at the protein level by Western blot analysis. In addition, the presence of Ang 2 splice variant Ang-2443 was demonstrated in both normal adrenals and ATs with significant up-regulation in the tumor group. Higher levels of Ang-2443 were detected in carcinomas when compared to adenomas. This indicates a role of Ang 2 in the pathogenesis of canine ATs, whereas for the other genes of the Ang and VEGF family such a role could not be confirmed (Galac et al. unpublished data).
In conclusion, the genetic alterations of canine cortisol-secreting ATs are unique as the results of the research performed so far demonstrated a lot of discrepancy with the situation in humans. The research performed so far (expression of aberrant receptors, steroidogenic enzymes, IGF system and genes involved in angiogenesis) did not provide an explanation for the pathogenesis of ATs. In the near future, the research in canine cortisol-secreting ATs should focus on expression of gene-specific transcription factors and other growth regulators. Elucidating the genetic alterations, a predictor sets of genes might be identified, whose up- or down-regulation could differentiate between malignant versus benign tumors. Or even more revolutionary, future research might offer the potential for novel pharmacological therapies.
References
1. Lacroix A, N'Diaye N, Tremblay J, Hamet P. Ectopic and abnormal hormone receptors in adrenal Cushing's syndrome. Endocr Rev 2001;22:75-110.
2. Galac S, Kars VJ, Voorhout G, Mol JA, Kooistra HS. ACTH-independent hyperadrenocorticism due to food-dependent hypercortisolemia in a dog: a case report. Veterinary Journal 2008;177:141-43.
3. Maaskant-vanWijk PA, Rijnberk A, Croughs RJM, Wolfswinkel J, Selman PJ, Mol JA. Responsiveness to corticotropin-releasing hormone and vasopressin in canine Cushing's syndrome. Eur J Endocrinol 1994;130:410-6.
4. Bassett MH, Mayhew B, Rehman K, White PC, Mantero F, Arnaldi G, Stewart PM, Bujalska I, Rainey WE. Expression profiles for steroidogenic enzymes in adrenocortical disease. J Clin Endocrinol Metab 2005;90:5446-55.
5. Reincke M, Beuschlein F, Menig G, Hofmockel G, Arlt W, Lehman R, Karl M, Allolio B. Localization and expression of adrenocorticotropic hormone receptor mRNA in normal and neoplastic human adrenal cortex. J Endocrinol. 1998;156:415-23.
6. Zwerman O, Beuschlein F, Klink A, Stahl M, Reincke M. The role of the ACTH receptor in adrenal tumors: identification of a novel microsatellite marker. Horm Metab Res 2004;36:406-10.
7. Beuschlein F, Fassnacht M, Klink A, Allolio B, Reincke M. ACTH-receptor expression, regulation and role in adrenocortical tumor formation. Eur J Endocrinol. 2001;144:199-206.
8. Fottner C, Hoeflich A, Wolf E, Weber MM. Role of IGF-System in adrenal tumorigenesis. Horm Metab Res 2004;36:397-405.

Sara Galac
Dept. of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine
Utrecht University
Utrecht, The Netherlands
Copyright 1991-2011, WSAVA 2002 Congress

[Squirt's Mom]

This is actually an interesting idea. Maybe for a kickstarter. Design a test protocol, design a study, then find a good holistic vet or vets to provide oversight. I'm tracking this pretty closely and may do some tweaks as I learn more about helpful nutrient therapies so that might be a good basis for a protocol. Know a holistic vet who would be interested in this?

Dr. Susan G. Wynne
Dr. Steven Marsden
Dr. Sean Messonnier

All practicing Holistic vets who have written text books on Holistic veterinary practices and approaches. The last I read from these docs, they all recommend and use a combined approach of traditional pharmaceutical drugs plus herbal support to treat canine Cushing's but you might be able to change their minds....or they yours. ;)

[labblab]

Since Magnus' diet is probably your main treatment focus right now and it sounds as though you are aiming at high-protein and high-fat, I want to add a cautionary note. There is some reason to believe that dogs suffering from Cushing's are more vulnerable to pancreatitis and there is a possibility that high-fat diets may help trigger episodes in susceptible dogs. For that reason, we often recommend that owners avoid feeding Cushpups diets with highly elevated fat content. Also, for dogs recovering from pancreatitis, a moderate-protein/low-fat/high-carb diet may initially be best because digestion of carbs causes the least amount of pancreatic stimulation. So there are situations with Cushpups when carbs can be helpful and desirable dietary components.

Also, I am worried that readers may misinterpret your earlier comments suggesting that a diabetic's need for insulin is somehow a myth manufactured by the pharmaceutical industry. In terms of solely controlling diabetes via dietary changes, I must assume you are referring to "Type 2" diabetes mellitus. For patients suffering from "Type 1" diabetes (chronic condition in which the pancreas produces little or no insulin), supplemental insulin ultimately becomes necessary to maintain life. If you have evidence to the contrary, please provide us with the documentation. We do have several dogs here who suffer from both Cushings and diabetes requiring insulin, so this is a very important clarification.

And lastly, I am not sure you are understanding the difference between the regulatory framework that governs recalls of raw meat/poultry vs. processed pet food. The following statement seems to imply that you are thinking your raw meat is safer because it has not been recalled.


"One thing I can say for sure, the food I give our dogs has never been recalled!"

It's true that it's unlikely your raw food has been recalled, but this is not because the meat is free from contamination but instead because it is legal in the U.S. for raw meat to be sold containing contaminants such as salmonella. It is the regulatory expectation that raw meat will be thoroughly cooked prior to consumption and thus the danger of illness lessened or eliminated. Salmonella is not permitted in ready-to-eat food sold for humans or pets, so that is why the discovery of such contamination triggers removal of the product from the shelf. So even though there may be other totally valid reasons why people prefer raw feeding, the fact that raw meat has not been recalled should not lull people into thinking it is somehow safer from contamination than is kibble/canned food. Here's a recent article from Consumer Reports that details the amount of contamination they found in raw ground turkey samples :eek::

http://www.consumerreports.org/cro/magazine/2013/06/consumer-reports-investigation-talking-turkey/index.htm

Marianne

[Squirt's Mom]

A list of small animal nutritionists -

Linda Case, MS
Daniel P. Carey, DVM
Diane A. Hirakawa, PhD
Leighann Daristotle, DVM, PhD
Donald Rl. Strombeck, DVM, PhD
Michael S. Hand, DVM, PhD
Craig D. Thatcher, DVM, MS, PhD
Rebecca L. Remillard, PhD, DVM
Philip Roudebush, DVM
Mark Morris, Jr., DVM, PhD
Bruce J. Novotny, DVM

I'm sure any of these good folk would be happy to discuss your theories and provide the studies you seek.

[Bandicoon]

But we haven't in over 2000 members seen diet alone control confirmed diagnosed cushings damage to internal organs but we do see it help, in addition usually to other treatments. Of those 2000 members, how many have actually tried a good raw/prey model diet, and stuck with it long enough to give it a chance? Reading the posts here, it seems that most people go straight from diagnosis to drugs with no attempt to fix the diet - most dogs are eating the same processed product they were when they developed the disease. Or the owner switches their dog from Attaboy to a "premium" or "prescription" kibble product, and maybe throws in a supplement. So I wouldn't say that the lack of success (on this forum) is meaningful evidence that holistic methods don't work.

[Squirt's Mom]

I would be VERY interested in seeing the proof you have to offer that diet, especially a raw diet, will have any effect whatsoever on elevated cortisol and the associated hormones of Cushing's. By proof, I am asking for the same thing you are - double-blind, peer-reviewed studies. Those we can supply for the traditional treatments for Cushing's but one has to be open-minded enough to read them and try to learn, not simply argue because they don't support their own thoughts on the matter. ;)

[Bandicoon]

I would be VERY interested in seeing the proof you have to offer that diet, especially a raw diet, will have any effect whatsoever on elevated cortisol and the associated hormones of Cushing's. By proof, I am asking for the same thing you are - double-blind, peer-reviewed studies. Those we can supply for the traditional treatments for Cushing's but one has to be open-minded enough to read them and try to learn, not simply argue because they don't support their own thoughts on the matter. ;)
Why do I need to prove anything? I haven't made any claims. I have a theory that it might help, so I'm trying it. I do have an issue with people claiming that it can't help, without offering any evidence to support their claims. They are making claims, I am not. Do you see the difference?

[labblab]

You don't need to prove anything at all if the only thing you want to accomplish is to see whether, in your own opinion, Magnus looks and behaves better to you on a raw prey diet. However, if you want to convince people that a raw prey diet is an effective treatment for Cushing's, you have to go a whole lot further.

This is the thing -- I personally cannot think of any physiological reason why feeding a dog a raw meat/poultry diet (as opposed to any other type of diet) will have any effect on the excess cortisol produced by a pituitary or adrenal tumor associated with Cushing's. So to me, switching to a raw diet is simply a random action. No different than deciding to pick a different kibble or adding a different exercise regimen or changing to a different type of fish oil supplement. But I am neither a vet nor a scientist. You can certainly try a raw diet, but just reporting back to us that Magnus looks better to you personally is not going to convince me that you have clinically changed anything that actually relates to Cushing's nor lead me to recommend raw feeding to others. That kind of proof requires documented, measurable, controlled experimentation.

The other big variable here is that we don't even know whether or not Magnus even suffers from Cushing's. If you decide to proceed with further testing, that would give us more information in that regard. But in the absence of a diagnosis, telling us that Magnus is doing better on a raw prey diet really means nothing right now in terms of Cushing's treatment.

You are certainly welcome to remain with us and to continue reporting on how Magnus is doing. As Sharlene has already indicated, she is one of several members who are either not actively treating or who remain uncertain of a diagnosis themselves. So you are not alone in that regard. But if you are hoping members here will embrace a raw prey diet as an effective Cushing's treatment, I am afraid you are going to be disappointed in the absence of documented physiological and clinical information that supports that theory.

Marianne

[Harley PoMMom]

My boy, Harley, had Cushing's but was also diagnosed with kidney issues which prevented the use of the traditional therapies such as Trilostane/Vetoryl and Mitotane/Lysodren.

He was fed Primal, which is a raw food. Harley passed away because the elevated cortisol took a toll on his liver, heart, and pancreas.

Wishing you and Magnus the best of luck.

Hugs, Lori

[Bandicoon]

Sorry about your Harley! I researched Primal and it looks pretty good for a commercial feed, but it does have a couple of problems. It looks a bit high in protein for a dog with kidney problems, and I would avoid cruciferous veggies for dogs with any kind of endocrine problem, as they are goitrogens. But still, way better than most kibbles out there. I'm surprised Harley got Cushings if he was on that diet from puppyhood. Just goes to show even a good diet can't make your dog immortal.

[Squirt's Mom]

I'm surprised Harley got Cushings if he was on that diet from puppyhood.

If you are going to make statements such as this which implies that diet will prevent Cushing's please provide documented support from a credible source such as the AVMA or a recognized small animal endocrine specialist.

There is NO KNOWN cause for Cushing's at this time - unless you are privy to information we are not. If so, please do share so we will all be enlightened. ;)

[Bandicoon]

Since Magnus' diet is probably your main treatment focus right now and it sounds as though you are aiming at high-protein and high-fat, I want to add a cautionary note. There is some reason to believe that dogs suffering from Cushing's are more vulnerable to pancreatitis and there is a possibility that high-fat diets may help trigger episodes in susceptible dogs. For that reason, we often recommend that owners avoid feeding Cushpups diets with highly elevated fat content.
I'm trying to make Magnus's diet as low stress as possible, especially for the pancreas. It's a bit of a balancing act as he is coming off a free-fed kibble (typically low fat) diet, which means he probably has a gall bladder full of stones. With protein and carbs low, he has to get more calories from fat, but the fat needs to be increased gradually to avoid a gallstone attack. I've been using butter and coconut oil which may be easier to digest and adding them in small amounts away from the meal.

Also, for dogs recovering from pancreatitis, a moderate-protein/low-fat/high-carb diet may initially be best because digestion of carbs causes the least amount of pancreatic stimulation. So there are situations with Cushpups when carbs can be helpful and desirable dietary components.carbs are the biggest endocrine pancreatic stressor as they raise blood sugar which forces the pancreas to secrete insulin. This is actually the cause of IDDM- a pancreas that becomes exhausted from chronic overproduction of insulin due to high blood sugar combined with systemic insulin resistance. Exocrine function is really only "stressful" if the duct becomes blocked which can trigger acute pancreatitis due to bile and enzymes backing up into the pancreas. That blockage is caused by gallstones. Gallstone formation is more likely if a dog is kept free-fed (constant grazing) and/or on a low fat diet, with insufficient dietary fat to keep the bile flowing as it should. A high fat meal can then trigger blockage as the gallbladder ejects stones into the duct. A regular high fat diet is therefore the best way to prevent acute pancreatitis, because it prevents gallstone formation in the first place. As I mentioned above, I am taking steps to prevent a large bile dump in case Magnus has preexisting gallstones from his previous diet.

Also, I am worried that readers may misinterpret your earlier comments suggesting that a diabetic's need for insulin is somehow a myth manufactured by the pharmaceutical industry.as I said, many cases not all. And most cases are in fact type 2. However there is increasing evidence that even type 1 has dietary causes as it is well established that most type 1 is autoimmune. Gluten is a big culprit. Many studies! Have to catch it early however. If the beta cells are gone obviously you'll need exogenous insulin at least until they have regenerated. Even in these cases insulin needs can be greatly reduced by eating a very low carb diet however. Many many case histories out there. Also I am a type 2 diagnosed over a decade ago totally controlled with diet.

And lastly, I am not sure you are understanding the difference between the regulatory framework that governs recalls of raw meat/poultry vs. processed pet food. The following statement seems to imply that you are thinking your raw meat is safer because it has not been recalled.
My raw meat is safer because I know I need to wash my hands after preparing it. Food safety is not rocket science, and the AVMA has no business discouraging people from feeding our pets (and families) food made from fresh raw ingredients based on the assumption that we are just too stupid to wash up after preparing it. It's so ridiculous there can't be anything behind that recommendation but commercial interests.

[labblab]

Also, for dogs recovering from pancreatitis, a moderate-protein/low-fat/high-carb diet may initially be best because digestion of carbs causes the least amount of pancreatic stimulation. So there are situations with Cushpups when carbs can be helpful and desirable dietary components.
If you will go back and re-read my paragraph above, you will see that I was referencing the desirability of carbs for a dog in the specific situation of recovery from an attack of pancreatitis (to lessen stimulation of pancreatic enzymes). I was not making a statement re: long-term feeding for normal dogs. I was merely trying to illustrate that "one diet does not fit all" -- and that different types of nutrients or dietary components may be desirable in different situations. Here are a series of quotes substantiating my comment about higher carb meals during recovery from pancreatitis:


The goal in the beginning is to feed a diet with low fat, moderate protein, and high carbohydrates, as carbs cause the least amount of pancreatic stimulation. An easy diet to start with is overcooked white rice made with extra water, combined with a low-fat protein source, such as cooked skinless chicken breast, low-fat cottage cheese, or boiled hamburger (boiling removes most of the fat).

http://dogaware.com/articles/wdjpancreatitis.html


...Depending upon the dog's response, food intake can be started again after a day or more. The dog is generally fed small meals of a bland, easily digestible, high-carbohydrate, low-fat food. In some cases, it may be necessary to use tube feeding to provide proper nutrition.

http://www.peteducation.com/article.cfm?c=2+2103&aid=335


When food is resumed, bland, low fat, high carbohydrate, easily digestible food will be recommended until the condition has cleared thoroughly.

http://www.petmd.com/dog/conditions/endocrine/c_multi_pancreatitis?page=2

If you'd like even more citations, they are very easy to find if you conduct an internet search.


My raw meat is safer because I know I need to wash my hands after preparing it. Food safety is not rocket science, and the AVMA has no business discouraging people from feeding our pets (and families) food made from fresh raw ingredients based on the assumption that we are just too stupid to wash up after preparing it. It's so ridiculous there can't be anything behind that recommendation but commercial interests.
I have to assume you haven't taken the time to read the AVMA citations that I provided for you, because owner hand-washing after food preparation is really not the basis for the central warning for humans (even though, of course, not using safe food prep techniques would also be an issue). It is the fact that dogs can shed salmonella and other pathogens in their stool. This can contaminate any area in which the dog defecates, the dog's anal area, and consequently the surrounding fur and the dog's mouth if the dog licks around its anal area. Unless you also wear rubber gloves whenever you pet your dog and never allow your dog to lick you, then hand-washing after food prep alone is not going to protect you if your dog is shedding salmonella in his/her stool. If you wish to be critical of the AVMA's advisories, it would be helpful if you first read them.


Also be aware that pets may be infected with Salmonella but may not appear to be sick. Salmonella bacteria can be shed in your pet’s stool for 4 to 6 weeks, and possibly longer, after infection. If you suspect your pet is ill, contact your veterinarian.

If your pet is infected with Salmonella and is shedding the bacteria in their stool, it’s also possible for people to become infected by contact with their infected pet’s fur, mouth, or feet – as well as anything that can come in contact with your pet’s stool. You can find Salmonella essentially anywhere the animal has been. Salmonella can survive for weeks or even years given the right environmental conditions (temperature, pH, humidity).

Marianne

[Harley PoMMom]

carbs are the biggest endocrine pancreatic stressor as they raise blood sugar which forces the pancreas to secrete insulin. This is actually the cause of IDDM- a pancreas that becomes exhausted from chronic overproduction of insulin due to high blood sugar combined with systemic insulin resistance.

Insulin Dependent Diabetes Mellitus (IDDM) is an autoimmune disease.
There isn't an absolute known cause of IDDM but it is believed to be triggered by an illness/virus.
http://www.diabeteshealthsupport.com/diabetes-mellitus/diabetes-mellitus-insulin-dependent-diabetes-mellitus.html


A regular high fat diet is therefore the best way to prevent acute pancreatitis, because it prevents gallstone formation in the first place.

I totally disagree, low fat diets are very important when dealing with pancreatitis, dietary management has proven to be an aid when dealing with either chronic or acute pancreatitis.

I have researched pancreatitis in great depth and have had a dog that was diagnosed with it. A low fat diet was vital in controlling the pancreatitis.

Hyperlipidemia and hypertriglycemia are known risk factors for pancreatitis.

Excellent articles: Diagnosing and treating pancreatitis (http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/education/diagnosing-treating-pancreatitis-roundtable.pdf)

Lipid metabolism and hyperlipidemia in dogs (http://www.fcv.unl.edu.ar/archivos/posgrado/especializaciones/espsaludanimal/informacion/material/250411/ENDOCRINOLOGIA%202010/lipidmetabolismdog.pdf)

[Squirt's Mom]

My raw meat is safer because I know I need to wash my hands after preparing it. Food safety is not rocket science, and the AVMA has no business discouraging people from feeding our pets (and families) food made from fresh raw ingredients based on the assumption that we are just too stupid to wash up after preparing it. It's so ridiculous there can't be anything behind that recommendation but commercial interests.

Let me share my experience with you concerning washing hands after handing raw meat. I contracted salmonella from chicken. No one got sick who ate it, only me, the only one to handle the raw meat. And I was not "just too stupid to wash up after preparing it" - I even used hand sanitizer and still got violently sick. (Both my parents worked in the medical field so I grew up learning basic care. ;))

When I told the doc that I had washed and used the sanitizer he told me it makes no difference what you do AFTER touching the raw meat - the pathogens are already present on the skin and if there is the least little opening, they enter the bloodstream. I had no visible scratches on my hands or fingers when preparing this meal but contracted the infection regardless. The fact that you are aware of the dangers of handling raw meat is good yet don't fool yourself by thinking anything you do after handling it will stop the pathogens if they have any opportunity to invade your system.

I now use surgical glove to handle any meat raw even in the grocery store when picking up the packages. BTW - so does my butcher for the very same reason. ;)

[Squirt's Mom]

From another mom who has dealt with Pancreatitis, I second every word Lori had to say. Fats TRIGGER pancreatic attacks. LOW fat diets are recommended for cush pups precisely because they are prone to pancreatitis. ;)

[Bandicoon]

If you are going to make statements such as this which implies that diet will prevent Cushing's please provide documented support from a credible source such as the AVMA or a recognized small animal endocrine specialist.OK, let me go on record here that everything I say is my opinion (those are allowed here right? ;) ), unless it's a link, in which case it's someone else's opinion. I have formed my opinion over many years of reading and web research and I don't have time to go back and find supporting links for everything I write, but if I write something that you believe is wrong feel free to point it out (and please give a specific reason why so we can have a useful discussion about it ;) ).

There is NO KNOWN cause for Cushing's at this time - unless you are privy to information we are not. If so, please do share so we will all be enlightened. ;)I'd say the causes of Cushings are well known, its all over this forum... what am I missing? Overmedication by vets, tumors of the pituitary or adrenals, are these not the primary causes? And lots known about the causes and cofactors of these tumors. Chronically elevated insulin and IGF-1 for a start (go back and read those studies you posted, it's in there), systemic inflammation, autoimmune factors all of which are certainly influenced by diet. There are heaps of studies documenting the relationship between various diets, nutrients and tumors in general, see Pubmed.

[Squirt's Mom]

OK, let me go on record here that everything I say is my opinion (those are allowed here right? ), unless it's a link, in which case it's someone else's opinion. I have formed my opinion over many years of reading and web research and I don't have time to go back and find supporting links for everything I write, but if I write something that you believe is wrong feel free to point it out (and please give a specific reason why so we can have a useful discussion about it ).

No, we are not a group based on nor in the business of presenting our personal opinions as fact. When we have pointed out the errors of your posts, you simply argue back, still based on your opinions, and pooh-pooh the science presented because it is in opposition to your opinions. If you have the credentials worthy to ignore those who have decades of training, education and experience under their belts, please present them here.

As for the "why" - because we are here to save lives period. Opinions do NOT save lives tho they can lead us to research further - if one is of a mind to learn something beyond their own opinions. Your statement that a high fat diet prevents pancreatits is a prime example, as that little opinion could result in the painful, completely avoidable death of one of our members. So no, opinions are NOT acceptable when presented as fact, never.


I'd say the causes of Cushings are well known, its all over this forum... what am I missing? Overmedication by vets, tumors of the pituitary or adrenals, are these not the primary causes? And lots known about the causes and cofactors of these tumors. Chronically elevated insulin and IGF-1 for a start (go back and read those studies you posted, it's in there), systemic inflammation, autoimmune factors all of which are certainly influenced by diet. There are heaps of studies documenting the relationship between various diets, nutrients and tumors in general, see Pubmed.

Please post the link(s) to Pubmed where you find the cause(es) of canine Cushing's given.

As for the cause(es) being "all over this forum" you obviously are not comprehending what you are reading on the threads. " Overmedication by vets, tumors of the pituitary or adrenals" are NOT causes of canine Cushing's. What caused the tumors on the adrenals or pituitary? The tumors did not CAUSE the disease but are a manifestation of the disease. Over-medication does not CAUSE the disease, it is instead a result of mishandling the drug, a misdiagnosis, or a pup who simply cannot handle that drug - the drug, used correctly or not, did not CAUSE the disease.

Again, PLEASE support what you are claiming here with studies and links from credible sources. I would love to see the portions of the studies we have offered you that state what you claim they do, because if that info was present, trust me, we would be shouting from the rooftops that a definitive cause or causes are now known for canine Cushing's. Please don't keep this wonderful news to yourself. There are cush parents and researchers and vets all over the world awaiting your knowledge. Once the cause(es) are known, we can start to focus on prevention instead of treatment after the fact. ;)

[Bandicoon]

If you will go back and re-read my paragraph above, you will see that I was referencing the desirability of carbs for a dog in the specific situation of recovery from an attack of pancreatitis (to lessen stimulation of pancreatic sure... But whatever. Magnus does not have acute pancreatitis, and I am feeding him to prevent it, not treat it. That same article has this to say about it:

Causes of pancreatitis

Pancreatitis is often blamed on high-fat diets, though there is little scientific evidence to support this. Active, working dogs, such as sled dogs, can eat as much as 60 percent fat in their diets without developing pancreatitis, but too much fat may cause trouble for middle-aged, overweight, relatively inactive dogs, who are the ones most commonly affected by pancreatitis. Too much fat can also cause problems for some dogs with chronic pancreatitis.
Dietary indiscretion, such as eating rancid fatty scraps from the garbage, can also lead to pancreatitis, particularly when a dog accustomed to a low- or normal-fat diet ingests high-fat foods. That’s why pancreatitis incidents are thought to increase after Thanksgiving, when people may feed their dogs a meal of turkey skin and drippings.




I have to assume you haven't taken the time to read the AVMA citations that I provided for you, because owner hand-washing after food preparation is really not the basis for the central warning for humans (even though, of course, not using safe food prep techniques would also be an issue). It is the fact that dogs shed salmonella and other pathogens in their stool. This can contaminate any area in which the dog defecates, the dog's anal area, and consequently the surrounding fur and the dog's mouth if the dog licks around its anal area. Unless you also wear rubber gloves whenever you pet your dog and never allow your dog to lick you, then hand-washing after food prep alone is not going to protect you if your dog is shedding salmonella in his/her stool. If you wish to be critical of the AVMA's advisories, it would be helpful if you first read them.
My apologies, I didn't follow all the links you posted. Once I saw the AVMA statement that their policy wasn't based on any actual health data, only on speculation that feeding raw *might* increase risk of illness in household members, that was pretty much all I needed to know about it.

Consider this: dogs who have healthy levels of stomach acid and healthy gut flora (from eating a healthy, species-appropriate diet) are unlikely to have large pathogen load. On the one end, strong stomach acid and digestive enzymes kills pathogens in food, in fact that's one of its main functions (in humans too). On the other end, healthy gut flora and strong immune system create an inhospitable environment for pathogens entering by the anus. So pathogens on food are far less of an issue if the food they are on supports healthy stomach and gut function and immune system. Pathogens on your typical heat processed, grain based kibble...yes, that is something to worry about. Pathogens in the occasional raw treat in an otherwise unhealthy diet? Yes, I can see that being a problem too.

[labblab]

My apologies, I didn't follow all the links you posted. Once I saw the AVMA statement that their policy wasn't based on any actual health data, only on speculation that feeding raw *might* increase risk of illness in household members, that was pretty much all I needed to know about it.
Hmmmm...perhaps that's a research strategy that you may wish to rethink. Unless you read studies and articles in their entirety, you're pretty much destined to come away with incomplete and even erroneous conclusions. Unless you are only looking for information that supports positions you already hold, then it seems you'd be better served to keep an open mind and consider information as it is intended to be read and considered.

Marianne

[labblab]

By the way, just to add once again, it is not only the AVMA which has issued warnings about raw feeding, but also the American Animal Hospital Association, the American College of Veterinary Nutritionists, the U.S. Centers for Disease Control and Prevention, and the FDA. Perhaps you may wish to read all their combined warnings in their entirety before you dismiss them out-of-hand.

[Bandicoon]

Hmmmm...perhaps that's a research strategy that you may wish to rethink. Unless you read studies and articles in their entirety, you're pretty much destined to come away with incomplete and even erroneous conclusions. Unless you are only looking for information that supports positions you already hold, then it seems you'd be better served to keep an open mind and consider information as it is intended to be read and considered.

MarianneThere is so much info out there, I have to be selective. Even if it were my full time job to read science journals, i couldnt begin to scratch the surface. I've found statements from health industry associations like the AVMA to be low quality in general. Too much conflict of interest. So forgive me if I skim.

[labblab]

Interesting that your decision to be "selective" means you choose to ignore all these professional/governmental organizations that are specifically focused on animal and human health. Can you give us examples of journals/organizations that meet your personal standards?

[Bandicoon]

Interesting that your decision to be "selective" means you choose to ignore all these professional/governmental organizations that are specifically focused on animal and human health. Can you give us examples of journals/organizations that meet your personal standards?Any peer reviewed science journal entry especially if its open access and you can read not just the abstract (which can be misleading) but the methods and data. Industry organizations are commercial in nature and their focus is actually the profit of their sponsors. Government organizations... Really?

[labblab]

I just find it interesting that after five pages and 46 replies in your thead, you are basically dissing all the citations/resources that others have cited but you have provided actual citations to only two articles of your own (both related to Ashwagandha Root). You ask us for "proof," but offer none of your own. You want us to provide research citations, but list none that support your opinions/beliefs/claims/facts.

For me, the bottom line is that I think it is wonderful that you have decided to take Magnus into your care. I truly hope that the decisons you are making for him will grant him a long and healthy life. But I'm guessing that your choices might have greater impact on more people here if you choose to take the time to actually provide references and resources for us to evaluate and consider. As I said earlier, if your primary goal is solely to experiment with Magnus and let us know how things go, then no additional info is necessary. But if you want to engage in discussion as to the "whys" and "hows," it'd sure be helpful to see some concrete resource citations that support the direction in which you're heading.

[Bandicoon]

Hi folks, just wanted to post a final status on Magnus. As it turned out I was given his vet records by his owner and he had been tested for Cushing's because he displayed many of the classic signs. He was given an ACTH which was borderline on the 2nd reading and high on the 3rd, and liver enzymes were very high (1400+). For some reason they chose not to treat. In retrospect I think his owner felt that at his age it would be pointless. I offered to foster him while she moved across the country and settled into her new home, feeling that I might be able improve his health enough that he could safely be shipped to her, but it's now clear that she left him with me to die and did not expect to see him again.

However, after 3 months on a prey model raw diet and a few supplements he is very much improved. He could barely walk and now he runs and plays with our other dogs. He actually established himself as dominant over our 6 yo GSD. The calcium deposits in his skin are gone, and the lipomas are much reduced. Excess panting is gone. Polydipsia is also much reduced and he is no longer incontinent. His coat has regrown on the bald patch on his back.

Last night I put him on a flight back to his owner who is overjoyed to have him back. She has switched her other dogs to prey model raw and is seeing lots of improvement so hopefully Magnus will continue to improve.

I wish all here best of luck with their dogs, and farewell as I will no long be participating on this forum.