Asia, 8½ Yr. Old Greyhound - Atypical - Getting Better...

[Greyhound mom]

My 8 1/2 year old greyhound has had several contradictory test results for Cushings. These include two negative Urine Creatnine ratio tests, one positive Low Dose Dexamethasone Suppression Test, and one equivical ATCH stimulation test. She has had an ultra sound which showed totally normally adrenals along with everything else. We just last week sent off the other version of the ATCH to Tennesse to test for atypical Cushings.

My main question is does anyone know of any other greyhound with Cushings in any form? Greyhounds have quite a few differences in their regular blood chemistrys but I haven't been able to find anything about Cushings in greyhounds. I would appreciate any information. Thanks, Kim

[gpgscott]

Welcome Kim,

Sorry you have to be here and I hope we can help you understand.

Certain breeds are more susceptible than others but I do not thinks greyhounds fall into this group.

I am glad you are having what sounds like the full adrenal panel from UTK, I will place a link to information about it from our resources section of this website. I really wish more people would have this as the first ACTH because of the additional information it gives. There are a total of 6 adrenal hormones, the one most comonly associated with Cushing's is cortisol but one or a combination of the others which are not assayed on the typical ACTH can both cause Cushing's symptoms and require modification of treatment to acheive relief from the symptoms.

It is a good idea to keep copies of all the testwork, it is not uncommon to have more than one Dr. involved and this will help you ensure the Drs. are all working on the same page.

If you have them would you please post the results of the tests already done. Just the ACTH and the LDDS, a negative UC:CR is generally unambiguous and is a rule out for cortisol induced Cushing's, I hope the UTK panel gives you a clear outcome.

Welcome again, what is your pup's name? Scott

http://www.k9cushings.com/forum/showthread.php?t=198

[lulusmom]

Hi Kim and welcome,

In addition to the information Scott has requested, can you please tell us what lead your vet to suspect cushing's, like physical symptoms, bloodwork? I do know that interpreting bloodwork for Greyhounds is vastly different than most breeds. I am not sure if you've researched any sites regarding this issue but I found a few that I found interesting.

http://www.animalmedicalcentreofmedina.com/library/Greyhound%20Labwork.pdf
http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=174493&pageID=1&sk=&date=
http://www.greyhound-data.com/dir/99/Vet's_Notes_-_Effect_of_Stress.pdf

We'll all be looking forward to hearing a lot more about your dog.

Glynda

[Greyhound mom]

Thanks for the information so far. My greyhound, Asia, is a retired racer, as are most greyhounds, at least the ones I know! She ran 96 races and won 16 in her 18 month carreer--she retired at about 3/12 and she picked me out to be her mom a few months later. She's a big (80 pounds!) beautiful red fawn and has been totally healthy until recently.

The first symptom I took her to the vet for was panting. The vet rant the curantine ratio and it was normal. The next week Asia developed a UTI, and I noticed her increase in water intake. A week of antibiotics knocked out the UTI, but a few days after she had UTI symptons again, and another culture showed a returned bacterial infection. After 2 more weeks of antibiotics and another culture which came back clean, the vet tested again for diabetes as well as leptospirosis as there was a rodent problem in my building ( I live in a rehabbed 1920 building in Chicago). All that was fine.

We decided to run the Low Dose Dexamethasone Suppression Test which came back positive. So we did the ACTH to confirm which was equivical. Another creantine ratio was negative. My vet sent me to an internist for a ultrasound for Asia, which all looked normal. The second vet is the one who suggested atypical cushings and suggested the broader hormone panel.

Anyway, I'm glad I found this group because I have a feeling you will all be very helpful. I don't know the exact numbers for any of the test results, however. But I hope I answered your other questions.
Thanks again, Kim

[gpgscott]

Hi Kim,

Yes it looks like your Drs. are following a logical path.

The next big step is the results from the extended adrenal panel.

Please let us know.

Best to you both. Scott

[Wylie's Mom]

Hi Kim & Welcome,

Could you also tell us if your vet has ruled out hypothyroid & diabetes (assuming Cushing's was suspected due to symptoms)?

-Susy

[Greyhound mom]

Glynda,

Also, I have done a lot of research regarding greyhounds, as well as the vets who treat them, so have that info, but thanks! Regarding stress, Asia is the least stressed out greyhound in the world. She is very outgoing and friendly, and although she greets me (or whoever walks in my door) ecstatically when I come home, she has no seperation anxiety. She basically loves the vet so I don't think she's stressed out there.
All that being said I am the one who kep pushing the Cushing's diagnosis because her symptoms kept getting worse--she now drinks over a gallon of water a day, pants CONSTANTLY, has no endurance, and I don't think I mentioned her blood pressure is up to 190/ 160. We started her on Enalapril-5 mg 2x a day just last week.

Anyway, thanks again, I'm always grateful for any input or insight.
Kim

[Greyhound mom]

Susy,
Yes both were ruled out...
Kim

[gpgscott]

Hi Kim,

We would all like to see Asia, you can place an avatar, which is a small picture that appears with your post and you also have an album for larger photos.

You access them all from your usercp.

Please let us know if you need help, we would like to see pictures.

Scott

[MiniSchnauzerMom]

Hi Kim,

Just dropped in to see how you and Asia are doing. I'm glad to hear that you will be getting the UTK adrenal panel for her. When is she scheduled for the test? The Enalapril should help with her BP. Is she on any other meds or supplements?

Besides being a 16 race winner, Asia is one smart dog as she picked you out to be her Mom!! Hope you will post some pictures of her. Oops, see that Scott and I were posting at the same time and asking for the same thing....pictures.

Louise

[Greyhound mom]

Been crazy busy and just got a chance to check back. I posted an avitar of Asia, will do a few photos in an album when I get a chance.
FYI they other panel was done on Asia last Tuesday-8 days ago. The vet said to expect results in 10-14 days, so possibly as soon as this Friday.
I am just hoping most for a definitive result so I can start treatment on her and she'll begin to feel better.
Thanks for all the support,
Kim

[ChristyA]

Hi Kim & Asia,
Welcome to you both. Asia is really pretty! I think greyhound's are so graceful. I've met a lady in our local park that has 4. They are always so well behaved.

I am looking forward to hearing what the test results say on Friday.

Christy

[Greyhound mom]

While on a walk last night my greyhound, Asia, (who's still waiting for her test results from Tennessee) sort of fell over--she seemed to lose all the strength in one of her hind legs. After a few moments (maybe 10 secs?) she seemed alright.

Is that a sign of the muscle weakness I read about as a sympton?

I appreciate any input...thanks!
Kim

[Squirt's Mom]

Hi Kim,

It very well could be associated with the Cushing's and if it is, you should see some improvement once treatment has started. There could be other reasons, too, so if it seems to get worse, take her to the vet and have them check Asia for any spinal issues, hip, knees, etc.

You will want to watch her and not let her over-do. These pups don't always know what is good for them and they can tear ligaments quite easily. So limit her jumping up and down, running wildly, etc. Exercise is good, but don't let her push it; when she seems ready to turn for home, let her.

I know it's tough waiting for test results and to start treatment as called for, but it's worth it to be sure of what you are dealing with. Keep up the good work and I'm sure you will see an improvement in Asia on down the road.

Hugs,
Leslie and the girls

[Greyhound mom]

Merged Asia test results into Asia's original thread to keep all of Asia's information in one thread for ease of reference.

Got the test results from University of Tennessee. Her Androstenedione and Estradiol are pretty elevated...I'll send specifics when I have more time.
They are reccommending Melatonin and Flaxseed hull (lignans). Start the melatonin at 3mg 2 x day and increase to 6 for a couple weeks before adding the flax.

From what I've read sounds typical.
Any thoughts on side effects? Should I stay home with her for a couple days?
Kim

[Squirt's Mom]

Hi Kim,

The treatments for Atypical don't require quite as much watching as Lyso or Trilo. They are relatively safe when used a prescribed. The melatonin may make Asia a bit more sleepy, especially when she goes up to the 6mg dose. I use purified lignans in a capsule, so I can't really comment on the flax hulls. As long as Asia tolerates flax alright, it should be fine, too.

One of the moderators will merge this thread with your original one so we can keep all your sweet baby's info in one place.

You're doing a good job so just hang in there!
Leslie and the girls

[Greyhound mom]

I've been emailing a vet in Florida about Asia, since he's treated a lot of greyhounds. He agrees with everything my vets are saying, except he told me he's never seen a dog (greyhound or otherwise) where the melatonin/flaxseed treatment actually helped.

Does anyone know any satistics on this? If it doesn't work, the internist told me that we can't use the trilostane because it increases the hormones that she has elevated (estradiol and androstenedione) and since her cortisol is normal we can't use the lysodren.

If this is all true, is there no other treatment? If she doesn't respond to the melatonin can her Atypical Cushings be fatal?
Thanks for your support.
Kim

[Greyhound mom]

I said I'd post Asia's results, here they are:

CortisolBaseline-12.1 Nor: 2.1-58.8 postACTH 70.5 Nor: 65.0-174.6

Androstenedione B-1.13 N-0.05-0.57 Post 5.69 N-0.27-3.97

Estradiol B-102.9 N-30.8-69.9 Post 111 N-27.9

Progesterone B- 11 N- 0.03-0.49 Post 0.58 N- 0.40-1.62

17 OH Progesterone B-0.08 N-0.08-0.77 Post 0.58 N- 0.40-1.62

Aldosterone B-<11 N-11-139.9 Post 140.9 N-72.9-398-5

They marked the Androstenedione & Estadiol as elevated and that "these results incidate presence of increased adrenal activity (mild).

I'd appreciate any thoughts...also am still curious as to how often the melatonin/flaxseed hull treatment has been successful?
Thanks again, Kim (Asia's mom)

[gpgscott]

Hi Kim,

Thanks for posting the results.

Along with the results the Dr. receives a treatment recommendation, it does not sound like you have been given this.

I would really like to hear what the experts at UTK say before commenting further. I can tell you there are many here who are treating pups with similar labs with good results.

There are meds specifically for hyperestrinisim, but I cannot think of a single member here who has had to resort to them.

It is a very good thing for Asia that the cortisol is in normal ranges.

Scott

[Squirt's Mom]

Hi Kim,

The good news is the cortisol isn't elevated! :D So you are dealing with simple Atypical Cushing's...YEAH!!! Much simpler and less stressful!

As for the vet in Fla you have been talking with...tell him to contact Dr Oliver at UTK for information that will support what he hasn't seen yet on the effectiveness of the treatments for Atypical. This is something that is fairly new in the vet med world and not many vets have actual experience in the area of Atypical so don't let his words upset you or worry you. My Squirt has been on this treatment only since last Aug and she just had another UTK panel done today. So in about 2 weeks, I should know if it is helping her or not. By her signs, I have to say it is.

No treatment is effective on all dogs, but that doesn't mean it won't work on Asia. I understand that the Greyhound's make-up is a bit different but if that was a concern, I feel that Dr O would have mentioned it in his results. He is the world premier in this area. And a really nice man to boot! :)

Hang in there! You and Asia will be just fine, and we will be here to help you.

Hugs,
Leslie and the girls

[Greyhound mom]

I WAS given a treatment reccommendation--melatonin starting with 3mg 2 times a day increasing to 6 mgs 2 times a day, then adding the flaxseed hull after a couple weeks.

Asia was also put on a med for hypertension a couple weeks ago. We went to the vet yesterday -- she hasn't responded to it so we changed to something else--you're going to ask me what and I don't remember but the new pill is VERY tiny and only one a day.

Anyway, the vet said she's seen good results with the melatonin so I'm trying to stay optomistic.

I've been measuring Asia's water intake daily for the last week so I have something to track it against in the coming weeks. (FYI the most she drank is one day was 142 oz--the least was 118).
Hopefully I'll see that start to come down after a month or so....

Kim

[Squirt's Mom]

Hi Kim,

Patience is the key with these treatments for Atypical. We don't get to see the immediate improvement some see with Lyso or Trilo so it is easy to lose hope sometimes. It's been my experience that changes come slowly but surely. Then a WHAMMY comes along and I'm right back where I was at the first...a basket-case once again. :eek::p But Squirt and I are not the typical cush family...she is not a poster pup for Cushing's and I'm just nuts. :D

Sounds like your vet is working hard to help Asia and I know you are, so things will start to look up soon, I'm sure. And you all have Dr O on your side...a great team! :cool:

Keep up the good work and let us know how things are going.
Hugs,
Leslie and the girls

[gpgscott]

I WAS given a treatment reccommendation--melatonin starting with 3mg 2 times a day increasing to 6 mgs 2 times a day, then adding the flaxseed hull after a couple weeks.



Kim, I would skip this and go straight to the most agressive treatment in this range which is melatonin 3mg twice daily and 40mg flaxseed lignans once daily. I cannot see a reason to wait for the melatonin alone to work as the lignans do not have a downside.

You can get lignans at vitacost.com 40mg in a capsule, the mfg is NSI. The melaontin should not be a timed release version.

Scott

[Wylie's Mom]

Hi Kim,

Just wanted to say... I agree with Scott about going ahead with the lignans;).

-Susy

[SachiMom]

Kim, Scott & Susy,
There may be a reason to hold off since a greyhound is "different" and the treatment plan came from UTK.

Got the test results from University of Tennessee. Her Androstenedione and Estradiol are pretty elevated...I'll send specifics when I have more time.
They are reccommending Melatonin and Flaxseed hull (lignans). Start the melatonin at 3mg 2 x day and increase to 6 for a couple weeks before adding the flax.

Just a thought.
~Mary Ann

[gpgscott]

You may be right Mary Ann, what I should have said is to ask the Dr. why it is necessary to wait to add the flax. In most cases this treatment can take a few months to show improvment in lab results.

Scott

[Greyhound mom]

The reason for the slow increases in the doses IS about the fact she is a greyhound--they are extremely sensitive to meds. On only just a couple days of the low dose of melatonin Asia has diarrhea--it's not too bad but I will give her system a little time to adjust to it before we start adding more stuff.
I imagine the flaxseed hulls will add more fiber, so again, taking it slow is a good idea for my girl.
Beleive me, I'd like to get her up to full dosages as fast as possible, but also don't want to add to her distress....
Kim

[MiniSchnauzerMom]

Hi Kim,

Just wanted to drop by and see how Asia is doing. Hope she adjusts to her new melatonin soon and the diarrhea will subside. I don't have a Greyhound but I have a dog who is very sensitive and it surely can make treatments a challenge sometimes!

Give Asia some extra petting from me.

Take care,
Louise

[Greyhound mom]

I've been reading other discussions and and must wondering...can someone please tell me why it is generally recomended to get the concentrated lignans from the "vita" place web page rather than the flaxseeds.com place recommended by UTK?
Thanks,
Kim

[Squirt's Mom]

Hi Kim,

The use of the hulls is a new development in the treatment. Most of us were already using the purified form in a capsule when this option was made known and have just continued to do so. For a while it was the FSO w/lignans (flax seed oil) but the dose and concentration were a bit questionable so many of us changed to the purified form. Some of us have also started using the hulls, or plan to when the caps run out.

As for whether the hulls or the purified form is the best...I can't say as I have only used the cap form. I can imagine that the hulls could add roughage, tho.

Keep up the good work! and ask away!

Hugs,
Leslie and the girls

[gpgscott]

Kim,

I use the purified lignans as it is a dose. I shake it from the bottle and down it goes.

I do understand there is contention concerning oxidation and freshness.

I like the idea of seeing a pill go down her fuzzy gullet.

She is better with the treatment, another treatment may be even better, but this one is working.

Scott

[Greyhound mom]

Asia is up to her full dose of melatonin and I gave her her first flaxseed hulls this morning on her food and she gobbled it right up. Yea! We're finally on the way to her full treatment. She adjusted to the melatonin quickly-the diareha subsided after a couple days. I can't tell if she's sleepier than normal--greyhounds normally sleep nearly about 18 hours a day anyway. I told the vet if she sleeps any more than that she'll be a cat!

After re-reading the stuff I got from UTK they say there is a higher concentration of lignens in the hulls than you can get in the oil. That may be why they switched their reccommendation.

Kim

[Squirt's Mom]

Hi Kim,

Glad that Asia has adjusted to the melatonin and hope she doesn't have any troubles with the lignans. You're right about the oil VS the hulls.

I am surprised to learn that Greyhounds normally sleep that much! The ones I have met have all been calm and gentle but I had no idea they were that laid back.

Keep up the good work,
Hugs,
Leslie and the girls

[Harley PoMMom]

Hi Kim,

So glad too that Asia is adjusting to her melatonin so well, and I hope she does well on the hulls too.

My Harley is on the pressed flax hulls, now a month, no adverse reactions. The only problem I see with using the pressed hulls is when I mix them into his food, sometimes, when Harley is done with his food I see some of them left behind, (they kinda look like ground pepper). I guess I need to mix them into his food better.

Did you get your pressed hulls from flaxhull.com? Thats where I got mine from.

As far as the melatonin goes, for Harley it didn't make him sleepier, just calmer. But all furbabies are different :eek::D

Take care and I wish you the best of luck with Asia.
Lori

[Greyhound mom]

Yes, I got the flaxhulls from that web page--Asia gets a small amount of canned food mixed in with her dry, so I mixed the flaxhulls into that first, then mix it in to the dry food. She licks the bowl to get every last bit of the wet food, so I know she's getting it all.

Kim

[Roxee's Dad]

Hey Kim,
How Is Miss Asia doing? Is she at full dose yet and accepting it well?

[Greyhound mom]

After 8 weeks of melatonin and lignuns I am finally starting to see a slight improvement in Asia, my almost 9 year old greyhound with Atypical Cushings.
My question is, can I expect this improvement to accelorate? Will she continue to improve this slowly? Will she ever stop panting altogether?
Just not really sure how much improvement I can expect.
Thanks, Kim
Asia's Mom

[lulusmom]

Hi Kim,

I only have a minute but all dogs are different so I'm not sure that any of us can give you a magic number or the speed with which you are going to see complete resolution of symptoms. I hope that other members with atypical pups will weigh in and share their experience.

Glynda

[jrepac]

it's my understanding that it can take 3-4 months to see real improvement via melatonin & flaxseed treatment....I'm just past 2 months...have not seen a huge difference just yet, but will stay the course for another 8 weeks for sure...

Jeff

[Wylie's Mom]

I'm sorry, since Wylie also has regular Cushing's & I'm treating both, it's hard for me to tell how well the Atypical treatment is working. But as Jeff said it does take some time. Could the panting be from her actually just being hot? I keep my house between 68-70 degrees to keep him from panting, but Wylie has a much thicker coat (well, maybe not... it's thinned out considerably due to Cushing's:rolleyes:), but he probably also has more fat than Asia.

-Susy

[Greyhound mom]

So it's been over 3 months on the atypical treatment and I can't help but feel disappointed in Asia's improvement.
Her water consumption IS about normal, which of course is great. But she is still panting constantly--with a very rare occasion when she is inside, laying down when she won't pant for a minute or so, but that's it. Also, her energy level, though improved somewhat, is no where near it was when this all started 6-7 months ago.

Is this as good as it is going to get? Can I expect her to continue to improve, or do these symptons never really go away?

I just this week increased both melatonin and flaxseed by 50%. The dosage they recommend is for dogs over 30lbs...she is 80 lbs and I think this makes sense. I emailed the doc in Knoxville but haven't heard back.

Also, about amonth ago she started showing symptons of arthritis. The vet has her on anti-inflamatories to which she is responding very well.

I remember reading that the cortison in regular Cushings can mask symptons of other issues such as arthirits. Does anyone know if the same goes for Atypical?

BTW, Asia turns 9 tomorrow!

Thanks as always for your input.
Kim
Asia's mom

[StarDeb55]

Kim, I went back & quickly reviewed Asia's thread. Her UTK panel showed only an elevated estradiol & androstenedione, neither of these hormones would have any anti-inflammatory effect on arthritis that I am aware of. The elevated cortisol involved in regular Cushing's is what is treating the arthritis in our pups, that when it is lowered can unmask the arthritis. It very well may be Asia is just showing signs of arthritis. What meds did your vet put her on? I ask because certain meds to treat arthritis in our Cushpups can increase the risk of GI bleeding. A lot of members are using Adequan injections to treat with good success.

Could you refresh our memories as to the exact dose of melatonin & flax hulls that you are currently giving Asia? The elevated estradiol can be extremely difficult to get under control because there are non-adrenal sources of estradiol that can contribute to the elevation.

Debbie

[Greyhound mom]

The anti inflamatory is Metacam, which my vet chose because it is so gentle.

I finally heard from Dr. O and he agreed with my increase in her meds, so that's good. He also said it was possible that the increased sex hormons could have been acting to mask the arthritis, but no one knows for sure. It doesn't really matter, I was just curious.

However, he, and no else that I can find, seems to be willing to answer the question about results. Has anyone ever had their dog become symptom free with the melatonin/flaxhull treatment?

I just want to know if my expectations are too high...
Kim

[Greyhound mom]

It's been 6 months and Asia got her 2nd hormone panel results back today. All her levels are normal with the exception of her Estradiol which is :
Baseline 98.4 Post 127.4

Symptomatically she is MUCH improved, although she still pants more than she should although that is greatly reduced and the rest of her symptoms have subsided. The vet is very pleased and she talked to Dr. O who said it often takes up to a year for the treatment to bring down the Estradiol.

Anyway, I've been asking for months if anyone has had success with the flaxseedhull/melatonin treatment for Atypical Cushings...if you're wondering that, the answer is YES!

[Greyhound mom]

By the way, thanks to everyone, and Happy Holidays!

[jrepac]

Sounds like good news!;)

I think it is sometimes hard to correct ALL of the symptoms from atypical or "regular" Cushings, frankly! Some of us are luckier than others!

My Aussie has Cushings w/the other atypical hormones elevated as well. I have been using the melatonin & flax/lignans for 9 months now in tandem w/anipryl...have not checked all the hormones recently, but latest cortisol reading came back as "low", which was an improvement vs. her last tests in the summer. So, there is likely truth in needing to allow sufficient time for the treatment to have an effect.

Symptom wise, sometimes I see a "spike"...meaning there may be days where she is more hungry/thirsty than usual, but those are not common place, just from time to time. As there are more good days than "off" days, I am happy for that and try not to worry too much.

Jeff

[lulusmom]

Hi Kim,

I am glad to hear that Asia's symptoms have improved so much. I just went back in your thread and saw that the original UTK panel showed elevations in androstenedione and estradiol. According to Dr. Oliver, estradiol is the worst sex hormone to deal with and is the one that usually causes the same symptoms and blood abnormalities as you would find with elevated cortisol. In Asia's case, her androstenedione has returned to normal but both her pre and post estradiol have increased in the last six months so I am quite surprised that you have seen such great improvements in her symptoms. This is great news!!! Aside from telling you that treatment often takes up to a year, did Dr. O have anything else to say about the increasing estradiol?

Just out of curiosity, does Asia have any fatty tumors? I ask because I had a long conversation with my old internal medicine specialist and he is intimately familiar with atypical cushings. One of his patients had elevated estradiol, a rather sizable Lipoma (fatty tumor) and presented with a lot of the symptoms associated with cushings. He surgically removed the Lipoma, symptoms abated and estradiol returned to normal. I was blown away by this but when you think about it, it makes perfect sense because estradiol is the only sex hormone that can be found in tissues other than the adrenals.

Glynda

[Bichonluver3]

What brand/type of melatonin do ypou suggest (or Tennessee suggest)? I have been giving Chloe Barleans Flax Oil (not flaxseed oil) with highest lignans. I see you use flax hulls.:confused:
Carrol

[jrepac]

What brand/type of melatonin do ypou suggest (or Tennessee suggest)? I have been giving Chloe Barleans Flax Oil (not flaxseed oil) with highest lignans. I see you use flax hulls.:confused:
Carrol

It's really best to avoid the flax oil entirely...the hull or capsules are better...the oil can cause other issues. I use Source Naturals Lignan Extract (70 mg capsules)....re: melatonin, just use "plain" ordinary melatonin w/out any additives and NOT time release or sustained release. Can be capsules or tabs.

[Bichonluver3]

Thanks for the quick reply! I had just ordered flax hull powder from flaxhulls.com so was glad to hear from you.