Maltese: epilepsy; diabetes; negative for Cushing's (Sydney has passed)

[starfish]

Hi all! So happy I found this site & am able to offer any info and/or find info. My Maltese has had idiopathic epilepsy since he was 4 yrs. old and has been treated with phenobarbital for 8 yrs. now (we held off starting him on meds as long as we could). When the seizures 1st started, he would seek me out (being scared) and lean up against me & all I could do was go to the floor, hold him & keep telling him he was going to be alright. When he has a seizure he is awake, his eyes look as though he is blind & he shakes. The seizures would last for about 1-2mins. but it feels like forever. The meds have been adjusted over the years & now (just recently) he is up to 1.5 pills 2x's per day. He has been diagnosed with diabetes in July 2012 & get insulin (levemir) 2x's per day. The insulin has been adjusted 3x's since diag. Last week he had his 1st ear infection (he is 12yrs. old) & I brought him into the vet. They gave me an ear wash & a med. to use for 5days. They also did a senior blood panel as he was due on Oct. 20th. I got a call that his liver enzymes are extremely high. They have been high but now higher. The vet last yr. said we will hold off testing for Cushing's until we get the diabetes under control (btw this is a new vet as the last one almost caused me to loose my little boy). I have read & have the info on Cushing's but it would be great to hear from anyone who is knowledgeable managing all 3 diseases. I hope I was able to offer some insight on the seizures.

[labblab]

Hello and welcome!

I noticed you had posted this reply on another member's thread who has not been active now for several months. I have taken the liberty of moving your reply so as to start a new, active thread that is your very own. This way, it will be much easier for our members to reply to you directly.

Once again, welcome to you both!
Marianne

[Harley PoMMom]

Hi and welcome to you and your boy!

So glad you found us and we will help in any way we can.

Elevated liver enzymes, along with increased drinking/urinating are very common when a dog is on phenobarbital, and diabetes can also cause elevations in the liver values.

Our sister site deals with canine diabetes and I do urge you to join there too, here's the link: http://www.k9diabetes.com/forum/ The wonderful people at the k9diabetes forum can get you up to speed on the diabetes.

Your vet is correct that until the diabetes is under control the diagnosis for Cushing's needs to be put on the back burner.

Please keep us posted and do not hesitate to ask any and all questions.

Hugs, Lori

[molly muffin]

Hi I just want to welcome you to the forum also and second the suggestion to join our sister site for diabetes. We have some members, who are managing both cushings and diabetes. It is sometimes hard to get that definite cushings diagnosis though with diabetes, causing the same sort of symptoms and needed to be controlled too.

Welcome again
Sharlene and Molly Muffin

[starfish]

Hi lablab, Harley Pommom & Molly Muffin! Thank you so much for your responses & in welcoming Sydney & me! I will def. check out the diabetes site! I dropped Sydney off this morning at the vet for his 1st ACTH test, the vet said this is the best one for a diabetes patient. He has had elevated levels since July 2012, but recently went even higher....same as Molly. Sorry they haven't figured out what is going on with Molly, I really hope they are able to help her soon!! I will keep you posted.

[molly muffin]

Aww, thank you. Molly is doing fine.

Do post the ACTH numbers when you get them back from the vet. We'll be interested to see what it shows.

Sharlene and Molly Muffin

[starfish]

It has been awhile since I have returned after joining & I apologize. I wish to thank you all for the welcome, and regret to inform you that my boy Sydney is gone. I am having a very difficult time dealing with this loss but I also try to be strong for my other 2 boys because they too have been sad.

We did receive a negative diagnosis after the Cushing’s test was done and thought we were out of the woods. But it was only 2 months later when we lost him to HS (hepatocultaneous syndrome). Without alarming anyone, I would like everyone on this site to be aware of this disease, mostly because it is associated with high liver enzymes, and the more information we have the better we can protect our babies.

On October 3, I brought Sydney into the vet for his 1st ever ear infection. On Oct 9, when we went into the vet for his Cushings test, I pointed out a little, tiny, pimple sized thing on the top part of his back near his shoulder. The vet scratched it off & said it was nothing (I point out these 2 symptoms because they may have been the beginning).

In December I noticed that his behind was turning darker in color (from pinkish to very dark), but when I researched this I found that this is common for older Maltese’s. Some Maltese’s get this darkening of the skin all over their belly in addition to the behind.

By the end of December his behind started to get scabby. I also found 2 additional scabs (small, not thick) on his back & shoulder. I made an appointment with the vet for 1/11 and in the meantime I treated them with an all natural organic cream (which I ordered on 12/30) and the back & shoulder ones went away. With treating Sydney’s behind with this cream, it seemed to have helped in the beginning but by the time that we went to the vet (on1/11, less than 2 weeks), it really wasn’t helping anymore.

When we went to the vet on 1/11, he also had 2 small pink/reddish pimple looking things on the inside of his right rear leg. The vet said they were nothing. The vet gave us a different cream to apply, said the cream I bought had too many oils and instead to apply this new one with Aloe. In less than a week, he began to have terrible pain and so bad that I couldn’t apply the cream anymore. We went back to the vet (on 1/17); they looked at his behind, cleaned it, gave him an antibiotic (since applying cream was not an option anymore) & pain medicine. On 1/20 I went back in for more pain medicine.

I then suggested a culture to find out what the cause of this problem is (a more knowledgeable individual told me depending on what the cause is determined the treatment administered: autoimmune, bacterial, fugal or viral). On 1/22 we went back in to do the culture. Besides doing the culture, the vet spoke about putting him on a steroid because she felt that would be the only thing to help him at this point. I was hesitant because of Sydney’s high liver enzymes, but the vet assured me that the dosage would be extremely low, so I agreed to try it. The following day (1/23) after having just 1 dose of the steroid, Sydney seemed to be doing better.

Then the horrible morning of 1/25, only 9 days after his 13th birthday, I had to rush Sydney to a hospital because he was having trouble breathing (he was fine the night before). They put him into an oxygen tank & only 8 hours later (after a sonogram was done of his liver) I was told that he has HS and that his liver looked like a honey comb.

The vet told me that in her over 30 yrs of practice, she has only seen 1 other case. Afterwards, I found the strength to read about HS and learned how aggressive it is, & the life expectancy with this disease is 6 months at best.

I can tell you that although I have lost loved ones throughout my life, including a 22 yr old brother, it is extremely difficult dealing with Sydney’s passing. I have never in my life lost one & the pain & loss is very difficult. I thank God for my mom, who has been my biggest support, understanding completely & in speaking with me about what she went through.

I thank you again & pray for you and your little ones to live a full & happy life, no matter how long.

[goldengirl88]

I am so sorry for the loss of your dear Sydney. I can imagine how you are feeling. Would you mind terribly if I asked what Sydney's enzyme numbers were, since you offered the information to help others on here, they will probably be wanting to know. Others on here have dogs with high liver values also so I think this will help others to be aware this can happen. This is the first time I have ever heard of this. I am so glad your mother is helping you through this. Not a lot of people understand someone's grief over a pet, so that is great mom understands. A few of our members who have recently lost their babies have encountered very uncaring people in their work places. People do not realize this can affect you more than the passing of a human relative. I hope the hole in your heart soon mends. Blessings
Patti

[doxiesrock912]

Please, I would like those numbers as well since Daisy's symptoms are resolving nicely but her numbers don't seem to be going down as quickly.

My sincere condolences on the loss of your furbabies, but I thank you so much for providing this information! I know that it must be difficult to discuss it.

[labblab]

I am so very sorry about your loss of Sydney. It was very brave of you to return to tell us what happened. I can honestly say this is the very first that I have heard of Hepatocutaneous Syndrome. Now that I have quickly Googled it, I see that it is a very rare problem, but one that is indeed linked with disorders that affect the liver such as diabetes or Cushing's, or tumors of the liver or pancreas. I've quickly scanned a few articles and haven't yet had the time to absorb the actual mechanism by which liver damage causes these diagnostic skin changes. But you've done us a service here by alerting us to the disorder, and highlighting for us once again the importance of diagnostically exploring the nature of any strange or unusual skin growths/changes in our dogs who suffer from endocrinological/metabolic disturbances. For the benefit of our other members, I hope you don't mind my taking just a moment here to add a link to an article that discusses the sydrome in greater detail:

http://veterinarynews.dvm360.com/dvm/Dermatology/Hepatocutaneous-syndrome-When-liver-dysfunction-af/ArticleStandard/Article/detail/18429

Having done that, I want to return to your own loss, and tell you again how sorry I am. We hope it may bring you a bit of comfort to know that Sydney has now been added to our special memorial thread of honor:

http://www.k9cushings.com/forum/showthread.php?t=5973

Even though it turned out that he did not have Cushing's, he is still a very special member of our family, and we will always join you in celebrating his spirit and your memories of your lives together. Please do feel free to return to us at any time, either to share more information about Sydney's diagnosis or simply to share stories about your sweet boy.

Sending you many hugs,
Marianne

[molly muffin]

I am so very sorry to hear of your loss of your precious Sydney. I too hadn't heard of this disease, but I did read the same as Marianne that it can be associated with diabetes or cushings, other endoctrinal disorders. :(

How very sad to lose Sydney so swiftly too. I am sure that your heart is broken and we have found that the animals left behind grief just as we do.

my sincere condolences
Sharlene and molly muffin

[lulusmom]

Thank you for coming back to let us know about Sydney's passing and for being so selfless in sharing your experience in the hopes of helping others. My heart goes out to you and your family.

I also did some researching and aside from the causative factors Marianne has already listed, chronic phenobarbital therapy can also cause Hepatocutaneous Syndrome so Sydney had a few things that can have a profound effect on the liver.