Boston Terrier-hypothyroid-calcinosis cutis (Cosmo has passed)

[thecoz]

Thought I'd do a short intro post on the forum tonight. I have an 11 year old Boston boy, Cosmo. He was diagnosed low thyroid in late August of this year. He's had thinning hair, wrinkly skin, loss of muscle tone, drinking a lot, extra hungry and generally looking/acting older. In September, he started having hardened patches of skin. A biopsy concluded calcinosis cutis. That diagnosis along with an LDDS test (done in October) confirmed he has cushings. We began Vetoryl on November 6th. He weighs about 20lbs and we started with a low dose of 10mg, once per day.

I've been reading here on this forum for a couple of months now and have learned a lot!

KJ & Cosmo

[Arizona Boston]

I'll be the first to say hi (although I'm not the expert).

Our Lucy is 11...but we've always thought she looked older...maybe that's a "pre-clinical" sign.

Good Luck on your journey. The advise on this forum is amazing!

Shelly and Lucy

[thecoz]

Hi Shelly! Thank you! That picture of Cosmo is from a few years ago. He does indeed look older now. I have a few pics of him now with that awful calcinosis cutis that I may upload on an album here.

[lulusmom]

Hi, KJ, and welcome to you and Cosmo.

So you are giving Cosmo his Vetoryl with food and know that Cosmo needs to have an acth stimulation test no later than 14 days after initiating treatment, right? Make sure you give him his Vetoryl with food the morning of the acth stim test and have him to the vet within 3 to 4 hours after dosing. If you've been skimming threads you probably already know that we will be asking you to post the results of those tests. We are relentless about that. :D

I'm really sorry for the reasons that brought you here but I'm glad you found us. Calcinosis Cutis is a booger to deal with and I'm hoping with treatment, Cosmo can find some relief.

Glynda

[thecoz]

Glynda, Thank you and yes, he's getting his meds with food. ACTH scheduled for this Tuesday. The vet seems on top of things, so far, in regards to everything I've been reading here on this forum.

[lulusmom]

I forgot to mention that it's very possible that Cosmo didn't have primary hypothyroidism but instead something called Sick Euthyroid Syndrome. 50% of cushdogs have low T-4 at diagnosis but this is a transient abnormality caused by excess circulating cortisol and the T-4 normalizes with treatment. If Cushing's was responsible for the Cosmo's low thyroid and he is still getting thyroid supplementation, you should make sure your vet checks the T-4 level as Cosmo could go from hypothyroid to hyperthyroid, and you'll never see resolution of the excess drinking and peeing.

Glynda

[thecoz]

I am wanting to have them specifically check on his thyroid again very soon.

[goldengirl88]

Hoping all goes well for Cozmo's testing. I never dealt with the CC but from reading all the posts know it is a hard issue to deal with. Good luck. Blessings
Patti

[thecoz]

thank you Patti. I have no guess as to what to expect for results for his first testing since starting the meds. It's a seemingly low dose (which both the vet and I wanted to start with) so I'm not expecting too much too soon.

[BostonLover]

Welcome! You've come to the right place!!! Again, I am so sad to see all the Boston's on here. :( Of course, I hate that any dog has to go thru this AWFUL disease. It's not fair.

[goldengirl88]

Great job starting low on the meds, you baby will surely continue to do well. You are doing a great job. Blessings
Patti

[molly muffin]

I'm really happy to hear though that he is doing well. Starting low, seems to improve the chances of his body accepting the drug and getting a good level with no crashes. It's a real pain in the tush though until they get to that level.
You're doing great though!
hugs,
sharlene and molly muffin

[thecoz]

Thanks everyone!

Crystal: I know, it's sad to see many Bostons on here...but it's unfortunately pretty common with our breed.

Part of why I wanted an extra low starting dose of Vetoryl is because he's been through so much lately. Besides the calcinosis & cushings, he recently had a bad GI problem (was at the vets for 4 nights because of that) and an ulcer on the eye that was pretty bad but is finally healing. He was such a sad, mess!

KJ & Cosmo

[goldengirl88]

KJ:
You know it isn't even just the Bostons there are so many Terriers with this, even Jack Russells having a high incidence of this. It's a shame this cannot be cured, it has ruined so many peoples lives. Hope your baby is doing well. Blessings
Patti

[Boriss McCall]

Hi KJ & Cosmo,
Welcome to the group. So many people have helped me get thru hard times on this forum. This is the best place you could have found.
Sorry to here about all the problems Cosmo has been thru. I haven't experienced the cal cutis I know that is a hard thing to get under control.
We are all here for you & Cosmo's journey. ;)

[thecoz]

Thank you, Amy. To me, the CC makes this all twice as bad. But I know a lot of people here have pups with all kinds of additional problems too. It's sad/hard for everyone.

[goldengirl88]

KJ:
How is the baby doing today? I don't know if I could handle the CC problem on top off all Tipper has going on. I pray she never has to go thru that. My heart goes out to you, I know that has to be most difficult to manage. Blessings
Patti

[thecoz]

Cosmo is doing okay. He acts like he's feeling a bit better since starting the meds. Some parts of the CC looks to be healing...yet it's still spreading in other areas. This will definitely be a long road.

I should be getting the results of his ACTH test in an hour or two. He had that done 2 days ago.

[thecoz]

Cosmo's ACTH results:

pre - 5.2 reference range: 2 - 6
post - 12.2 reference range: 6 - 18


LDDS (from October 31 report)

pre dexamethasone - 6.4 reference range: 1.0 - 6.0 ug/dL

[molly muffin]

Okay, just so you know, the range of 6 - 18 post, is for a dog that is not being treated with vetroyl. Once they are on treatment, the range is different. Dechra said the post can be up to 9.0 if symptoms are controlled, if not controlled then down to below 5.0.
So, on the post ACTH he still needs to come down some. How are the symptoms?
Also, the cc, I think you are going to want the post to come down some more to help with that. The cortisol being too high is what causes it, so coming down usually helps with that eventually.

hugs,
Sharlene and Molly Muffin

[thecoz]

Sharlene: thanks for explaining about the post-range to me. His symptoms are all pretty much the same still.

[molly muffin]

Happy Thanksgiving KJ and Cosmo!
I hope that things are going well.

hugs,
Sharlene and Molly Muffin

[thecoz]

Thanks Sharlene, and same to you!

Cosmo has improved a little bit now since starting on the Vetoryl. So hopefully that will continue.

[goldengirl88]

Hope you and Cosmo had a great day yesterday. Blessings
Patti

[molly muffin]

Great to hear that Cosmo is improving a bit! Every bit helps!

hugs,
Sharlene and Molly Muffin

[goldengirl88]

I second that every miniscule improvement is a celebrated here.

[thecoz]

Cosmo's CC has been improving. I posted a couple more pics in my album. Drinking/peeing diminished a bit, though still getting up in the middle of the night to drink/pee.

My big concern at the moment: his eye ulcer will not heal. He is now blind in that eye. Vet recommends removal of the eye and we're scheduled to have that done this Tuesday.

[frijole]

Ah so sorry to hear that. Please know that we have several members who have dogs with an eye loss or that have gone totally blind and it is truly amazing how they adapt.

Glad the cushings is more under control. When was the last acth test and what were the results? (trying to figure out how much further you have to go in lessening the cortisol levels) Thanks, Kim

[thecoz]

Cosmo's ACTH results:

pre - 5.2 reference range: 2 - 6
post - 12.2 reference range: 6 - 18

His next ACTH test is December 19th.
He's about 20lbs and is on 10mgs of Vetoryl once a day.

[Squirt's Mom]

Cosmo's ACTH results:

pre - 5.2 reference range: 2 - 6
post - 12.2 reference range: 6 - 18

Just a reminder that that normal range is not correct for a treated cush pup on Vetoryl (Trilostane). The normal range for a Trilo pup is between 1.45 and 9.1 IF all signs are controlled. The optimal post is around 5.1. ;) So with a post of 12.2, Coz is not controlled yet. Hopefully you will start to see better control of signs before the 19th. If not and that post is more than 9.1, an increase may be needed.

[thecoz]

Yes, even though we're taking the start low/go slow approach, I expect that his post number after the Dec. 19th test will not have dropped by much...and the vet will suggest an increase in the medication. I don't think I want to bump up to 30mg per day from 10mg though. I'm wondering if we could maybe do 10mg twice a day?

[Freckles#3/Louise]

Just a reminder that that normal range is not correct for a treated cush pup on Vetoryl (Trilostane). The normal range for a Trilo pup is between 1.45 and 9.1 IF all signs are controlled. The optimal post is around 5.1. ;) So with a post of 12.2, Coz is not controlled yet. Hopefully you will start to see better control of signs before the 19th. If not and that post is more than 9.1, an increase may be needed.

Leslie,
Thanks very much for this explanation, as I was puzzled as to why the IMS doubled Freckles's vetoryl from 10 mg to 20 mg daily when the results of her 3rd week ACTH were 8.6. The Dr said that she wanted 4.5.
Louise

[thecoz]

Louise: have you started 10mgs twice per day? How is that working out?

[frijole]

You can do 10 mgs twice a day or 2 10 mg capsules in the morning. I suspect you will need to increase the dosage as it is low and 12 is still high. It is wise however to give it some time before increasing because sometimes it just takes a while. Kim

[Freckles#3/Louise]

Freckles is off Vetoryl for the month and will restart at 1 x 10mg daily on Jan 5th. I need to get her food situation settled and stomach calm again before adding Vetoryl, as it causes stomach upset. I think the 2 x 10 mg daily may have been too much.
Her priority medication is her Piroxicam to keep the baldder cancer in remission. She is handling that well so far.

[molly muffin]

Hi, I just want to check in on you and Cosmo. Did they do the eye removal surgery yesterday? How is he doing?

I thought his skin actually looked better in recent pictures compared to November.

It takes forever for any infection or problem to heal with cushings unfortunately.

I hope that everything is okay. Just the worry wart here.

hugs,
Sharlene and Molly Muffin

[thecoz]

Sharlene: thanks for asking. Surgery was on Tuesday and he did great. He came home that same afternoon and is doing well.

[goldengirl88]

I also wanted to know how the eye surgery went. Hope Cosmo is doing well and continues to improve every day. Blessings
Patti

[Squirt's Mom]

It may sound odd, actually I KNOW it sounds odd - but if I could afford it, I would have both Brick's and Grace's eyes removed. They are useless for vision and their presence is nothing more than a source for injury and disease. I spend a great deal of time making sure there is nothing at head level for them that could poke an eye as I fear an injury. Sophie is blind in one eye from an injury but she can see where she is going and is not near as apt to injure herself as Brick and Grace are.

I hope Coz heals quickly and with no complications. I'm quite sure he will adjust to his visual changes quite well.

Hugs,
Leslie and the gang

[Renee]

Hey KJ, I just read through your thread, and it sounds like you are a few months ahead of me in this journey. My girl's ACTH and LDDS test are scheduled for next week, but since she has CC, a cushings diagnosis is already expected. My vet and I discussed starting a very low dose of vetoryl too.

I'm sorry your guy lost his eye, but much better to remove a bad eye than to keep it. Like Leslie was saying... those bad eyes just become targets for injuries.

[thecoz]

Cosmo is still doing very well since the eye surgery. He's on some meds for pain. He's feeling better and is eating again and acting normal. Also, his cc is really looking better too!

[thecoz]

Renee: yes, we seem to be a couple months ahead of you! Cosmo will be having his 2nd ACTH test done on Dec. 19th. Like you, we had started treatment with prednisone when the vet first saw his cc (not knowing yet what it was). So, once that biopsy showed it to be cc, and we thought cushings, we began weaning him off the pred. We waited 30 days before doing the test to confirm cushings. I felt like that was one month wasted...but we got through it.

[Renee]

Renee: yes, we seem to be a couple months ahead of you! Cosmo will be having his 2nd ACTH test done on Dec. 19th. Like you, we had started treatment with prednisone when the vet first saw his cc (not knowing yet what it was). So, once that biopsy showed it to be cc, and we thought cushings, we began weaning him off the pred. We waited 30 days before doing the test to confirm cushings. I felt like that was one month wasted...but we got through it.

That's interesting that you went through the same experience, including the pred. I am so very glad we did a biopsy on the lesions before waiting too long. A lot more time could have been wasted.

Does Cosmo have the elevated liver function? The lack of this is what really tripped up my vet.

We aren't waiting 30 days to do the testing. I'm too impatient, and Tobey is suffering from too many symptoms. We are testing a week after weening off.

[molly muffin]

Glad to hear that Coz is doing well after the surgery and that his cc is looking so much better. :) yay Cozmo. :)

I'll check in next week, as I'm away for the weekend. Stay out of trouble!
hugs,
sharlene and molly muffin

[thecoz]

I don't think too much was "off" on his latest bloodwork. I can check on that and let you know tomorrow.

I was pretty impatient waiting too but Cosmo wasn't really too horrible. Plus, that DMSO seemed to be helping a tad.

[thecoz]

Thanks, Sharlene. We'll try very hard to stay out of trouble for awhile, lol.

[Squirt's Mom]

Thanks, Sharlene. We'll try very hard to stay out of trouble for awhile, lol.

Weellll, some might but I make no promises! :p

[goldengirl88]

Renee:
Glad to hear Cosmo is doing well. I am going to research that drug you told me about. The nuitritionist said absolutely not to yams. Too much sugar and not enough nutrients. I am exhausted today from running around yesterday to get the sweet potatoes, and taking Tipper to laser therapy, and cooking all nite, then getting up at 5am as Tipper had to go potty. I am half sick today from all this, but this too shall pass. Blessings
patti

[thecoz]

What would show liver function on the blood test? His ALT was normal back in August's results.

[frijole]

liver enzymes are alk phos and alt. the one that is the most elevated in cush dogs is the alk phos. Kim

[thecoz]

thank you !!!

[thecoz]

Cosmo's alk phos was on the lower end of "high"

[goldengirl88]

Renee:
Thank you for all the helpful hints. I am hoping Coz is still improving. If he has high ALT and ALK Phos have you ever tried any milk thistle? Tipper did use hepato support, but the numbers were no moving fast enough for me. She is now on S Adenosyl. It has moved her numbers to much a much better range. Also Cush dogs are prone to gallbladder issues, sludge and mucoceles. Tipper had sludge so she is now on Ursodiol and that has helped her numbers too. It is a shame about your babies eye, but like Leslie said now no more infections etc. Stay warm and safe, Blessings
Patti

[Freckles#3/Louise]

Freckles ultrasound report mentioned gall bladder sludge, etc. No one suggested Ursoliol. I have her CBC from October. What numbers should I be checking?
So much to consider.....

Thanks
Louise

[frijole]

When you can please get the exact numbers so we can see what "on the lower side of high" means. Actually it would be helpful if you could post numbers as well as ranges for normal for both alkp and alt.

Thanks, Kim

[thecoz]

Cosmo's ALT 47 5-107 U/L Normal
ALK Phos 389 10-150 U/L High

KJ & Cosmo

[frijole]

Wow those are really good numbers - not like a cush dog at all. We often see alk phos numbers in 4 digits. I know that was from this summer so it could have gone up but very good numbers. Kim

[thecoz]

That's good to know. His AMYLASE number was low on that test.
323 (450 - 1240 U/L)

[goldengirl88]

Renee:
Thank you for telling me about the warm water as I know when I had to take a wash cloth to her butt she really cringed and I know it hurt her. Blessings
Patti

[Renee]

Patti - I think you might have my thread confused with KJ & Cosmo's! :D This is Cosmo's thread... mine is buried back on page 2, lol.

[Renee]

Not to highjack this thread... but, I wonder why a small percentage of cushings dog don't have elevated alk phos, but so many do? Tobey has never had elevated alk phos, but she has all the other symptoms of cushings.

[goldengirl88]

Renee:
Tipper's alk phos was only ever 37 until a like a 2 months ago which is really rare. Then is went to 350 and I knew her gallbladder had sludge. Put her on Ursodiol and it is coming down nicely so far. Blessings
Patti

[Arizona Boston]

That recent picture of the Coz looks like Lucy's CC. But hers just keeps getting worse. I'm glad his is improving.
Lately I have been massaging her with Curel (unscented) because her skin just seems so dry and unprotected.

Lucy's last Alk Phos was 4322! I have her on the Marin Milk Thistle.

[Renee]

Hey KJ - just checking in on you and Cosmo. I was wondering how the CC is going? My girl pug's is just getting worse and worse. :( I was using the DSMO every few days, but I think I am going to start every day for a while and see if I can get some of it to dry out more. What a horrific thing the CC is.

[flynnandian]

this summer my flynn had it very severe. they were even bleeding and from neck to hindquarters. before i knew he had cushing, i thought he went through some plants or bushes he was allergic to. they were not itching at all. during the fall they started to disappear and now in winter they are almost gone. without real treatment [just using vetramil] hope the cc will stay away, and that it will improve with your doggies too.

[thecoz]

Thanks to all those checking in on Cosmo...and his cc. The vet saw him again today for another ACTH test (his 2nd one) and to remove the stitches from his eye surgery. Vet said she is surprised/pleased with how well his cc is coming along. She noticed improvement since she saw him 10 days ago. We are "guessing" at this point that a vetoryl dosage increase just might not be necessary. Results should be in soon from the test. He is still on the initial starting dose of 10mg once per day. It would be great if we didn't have to increase the dose for now...but we'll see.

[doxiesrock912]

That's great news!

[molly muffin]

I am so happy to hear this. CC can be the hardest symptom to clear up and Cosmo is doing just excellent.
I hope his eye is healing okay too. It must be, if the stitches came out. yay!
Awesome job.

hugs,
sharlene and molly muffin

[thecoz]

Well, to our surprise, Cosmo's ACTH test results from Dec. 19th's test is showing a higher pre & post level than the last test one month ago.

pre-ACTH 7.6

post-ACTH 19.1

We will start giving him one 10mg pill twice a day.
Previous dose has been one 10mg pill once per day.

[Renee]

Sorry to see the numbers went up.

[thecoz]

Sorry to see the numbers went up.

thanks. me too.

Glad you get to start the cushings meds now! You will both start to feel better!

[Renee]

thanks. me too.

Glad you get to start the cushings meds now! You will both start to feel better!

Oh I know! I can't wait to get these meds started. My poor girl. I am trying to document her CC better, so I hope to make an album soon to put up. Cosmo gives me hope that it will improve though. :)

[thecoz]

Yes, it will improve. Just remember, it takes some time. I remember when we first started the vetoryl on Cosmo....I had such a feeling of relief that we were finally starting the med that was going to begin helping him feel better.

[molly muffin]

His numbers went up but at least the cc is improving. It should all get even better when the numbers stablize at a lower number too.

You Are doing good!
hugs,
Sharlene and Molly Muffin

[goldengirl88]

Renee:
I hope Coz is doing ok and coming along with that eye. I am so sorry you are both suffering over this CC. It has to be so miserable to deal with on a daily basis. What a horrible thing it is. Blessings
Patti

[thecoz]

Overall, Cosmo is doing well. I'm really not surprised that the low dose of 10mg per day just wasn't enough to hold him at. I think he should do good on the 10mg twice a day. His cc isn't worrying me anymore...it's stopped progressing and is getting better as days go by.

KJ & Cosmo

[frijole]

Agree - the cc healing is terrific. Take that as a win. sometimes we focus too much on the numbers and not the symptoms. If you are seeing progress that is a very good thing... just a little tweaking and you are there with the numbers. Keep up the great work. Kim

[thecoz]

Thanks, Kim. His drinking/peeing and asking for food still needs some improvement. So, if upping the Vetoryl dose helps that, we should be good!

[thecoz]

The vet will re-check his level in 2 weeks.

[Renee]

Good luck KJ. Your thread gives me so much hope since you are just a few months ahead of us!

[thecoz]

Good luck to you too, Renee! That's part of the reason I'm posting on this great forum...to let others know that just the right treatment/meds for each individual dog can truly help them.

[molly muffin]

We super appreciate that you are posting too :) Sometimes you don't even realize how much it helps others. Not everyone comments,but they do read. :)

hugs,
Sharlene and Molly muffin

[molly muffin]

Happy New Year to you and Cosmo

I hope this year will bring much joy and happiness and continued improvements.

hugs,
Sharlene and Molly Muffin

[Renee]

Hey KJ and Cosmo!

Happy New Year. Checking in on how Cosmo is doing with the increased dose of vetoryl?

[thecoz]

Happy New Year to you too, Sharlene and Renee!

Cosmo is still doing pretty well. I might say he seems a little bit better since we increased the vetoryl. Just had another ACTH done yesterday to check his levels since the dose increase from 10mg to 20mg. We should hear results of that any day now.

They checked his thyroid again. Said it's now in the normal range and to continue with the medication for that.

KJ & Cosmo

[molly muffin]

That's great about the thyroid Hope the stim results come back right where they need to be too. :)

That would be a great start to the New Year!

hugs,
Sharlene and Molly Muffin

[thecoz]

Stim results are in:

Pre-ACTH 6.2
Post-ACTH 5.4

We think this is good!!

[Renee]

Those are great numbers KJ!

But, do tell -- why would the pre be higher than the post? Is that normal?

[goldengirl88]

Great news about the thyroid and hearing your Coz is doing better on the dosage change is welcome news also. Keep up the good work. Blessings
Patti

[thecoz]

I'm not sure why the pre number is higher than the post number.

[goldengirl88]

I saw that too, and sort of started wondering about that also.

[thecoz]

ugh, I hope it's nothing bad!

[labblab]

According to noted endocrinologist, Dr. Mark Peterson, here are some possible explanations for a lower "post" number:


I recently rechecked a dog on VetorylR. The post-ACTH stimulated cortisol concentration was lower than the pre-value. What does this mean?

There are several explanations for discordant results, i.e., those in which the baseline cortisol is greater than the post-ACTH value. These include laboratory error, mislabeling of samples in the clinic, interference by exogenous steroids, and use of an ineffective ACTH product.

If the patient is clinically well and both results are between 2 - 7.5 μg/dl, it is appropriate to continue VetorylR at the present dose and recheck as usual. If both values are below 2 μg/dl or above 7.5 μg/dl, or if the dog is not clinically normal, the test should be repeated as a dose adjustment may be necessary.

Since your dog is doing well, it sounds as though it is probably OK to let this test slide. But I would probably choose to comment about it to your vet so as to alert him to the fact that this is not a typical result. If the next test also turns out "backwards," I think he needs to investigate what's going on.

Marianne

[thecoz]

Thanks Marianne. While I do think Cosmo is doing well, I would like to see his drinking/peeing decrease just a tad more. It's still not back to his "normal" yet.

[labblab]

Remind us how long Cosmo has been taking this increased dose? Because if it has been close to a month and the test numbers were indeed reversed, he probably could handle another incremental dosing increase to bring his "post" results down to within an approximate range of 2-5. :o

[thecoz]

he started the increased dose approximately 2 weeks ago.

[labblab]

Well, to our surprise, Cosmo's ACTH test results from Dec. 19th's test is showing a higher pre & post level than the last test one month ago.

pre-ACTH 7.6

post-ACTH 19.1

We will start giving him one 10mg pill twice a day.
Previous dose has been one 10mg pill once per day.
OK, I'm now seeing that he has dropped significantly during the two weeks with the increased dosing. So no, I would not increase at this time regardless of whether or not we suspect the samples were reversed. Cosmo's level may still drift further downward on this same dose.

[thecoz]

yes, I figured his level could still decrease a bit. Re-check is now in 30 days. We do have a call in to his vet just to ask/mention these odd results.

[Renee]

yes, I figured his level could still decrease a bit. Re-check is now in 30 days. We do have a call in to his vet just to ask/mention these odd results.


I'll be interested to see what the vet says!

[thecoz]

I'll let you guys know what the vet says about the test results. I'm actually not too concerned at this point. We monitor Cosmo very carefully and he's doing quite good right now.

[thecoz]

Vet didn't really know why the latest tests results came back with the funky pre number. She's seen that happen a time or two in the past. We've all decided to let this one slide though. He's doing good. We keep close watch on him anyways. We'll just see what develops from here....

[molly muffin]

He will probably be fine and maybe it was just a weird one. His cc is clearing up still?

hugs,
Sharlene and Molly Muffin

[thecoz]

Yes, the cc is much improved. No new spots or anything. Current areas continue to heal without a problem, except the one spot that his cone has been rubbing on for weeks.

[goldengirl88]

Just checking in to see how Coz is today. Hoping that nasty stuff is going away and never comes back. Blessings
Patti

[Renee]

Yes, the cc is much improved. No new spots or anything. Current areas continue to heal without a problem, except the one spot that his cone has been rubbing on for weeks.

That's really great! Are you still using the DMSO? Does Cosmo have any open sores / cracked areas of the CC? I am afraid to put the DMSO on those areas, because I think it may hurt Tobey. Her CC is still spreading. It's disturbing to watch the flesh just disintegrate.

[thecoz]

Sorry Tobey's CC is still so bad. My husband's the one who's been actually applying the DSMO to Cosmo. He stopped using it on him when Cosmo had his eye removal done. Since then, the CC has not gotten any worse. Most of it is looking better. He's going to ask the vet tomorrow if he should apply anymore of the DSMO to Cosmo-and if so, what areas would still need it. The reason he stopped using it on him was because he figured Cosmo would have enough to deal with, with the eye surgery and the cone for awhile. Plus, the vet had said she thought his CC was improving pretty well.

If Cosmo had any really angry-looking spots, then he wouldn't apply it for a few days. I hesitate to guide you on what you should/shouldn't do in Tobey's case. Perhaps your vet could be of help there? Our vet had told us if an area looked particularly sore, we could skip that area for a few days. I think that Tobey's CC looks worse than Cosmo's did.

I added four fairly recent pictures of Cosmo to his album, if you'd like to take a look.

[thecoz]

Cosmo had his scheduled test done yesterday. The last test results were the funky numbers: pre - 6.2 and post - 5.4. Yesterday's test results are:
pre - 3.9 and post - 6.7.

Our vet says it's up to us if we want to raise his dose. He gets one 10mg in the am and one 10mg in the pm (20mgs per day). We are thinking to stay at this current dose...and not go up to 30mgs per day. His appetite has returned to pretty much what it used to be. His drinking has also gotten back to more normal levels.
KJ and Cosmo

[Renee]

Yay for Cosmo! Those are great numbers!! :)

I don't think I would raise the dose either, unless the symptoms dictated it.

How's the CC?

[thecoz]

Oh, good! I was hoping these numbers looked good. His CC continues to (very slowly) heal and look better. No new problems with the CC whatsoever.

[labblab]

Yup, I'd stay put, too. And good for Coz!! :)

Marianne

[molly muffin]

I third the recommendation to stay this dose and see where it takes you. So far Cos has continued to do well on this dose, so I wouldn't mess with it for now.

Congratulations! Good job!
hugs,
Sharlene and Molly Muffin

[Dawn Anderson]

Yeah, way to go Coz and mommy, any improvement with the CC is a clear indication that your on the right track and going at the right speed!!!! Again YEAH!!!!!

Dawn and Butters

[thecoz]

While Cosmo's cc was stopped in it's tracks, and his cortisol levels were looking pretty good, he has not been doing well. He's lost a lot of weight, is often shaky/trembly, is pacing around and a bit wobbly/weak. He looks like he's shivering or having little tremors? both while awake or at sleep. He looks lost at times while pacing the house, and stops and stares at walls. Actually, its not that he's always pacing. Most often, what he does is just stand and stare. Then every so often he'll take a walk around the same several rooms of the house, following the exact same pattern every time. Once in a while he opens his mouth and does this half-yawn thing. And for months now, he will occasionally lift his head up and put it way back, as if stretching his neck out. He seems hungry at feeding time but hasn't been finishing his meals. We're thinking there's something more going on with him-possibly cancer or pituitary tumor.....

[molly muffin]

Oh dear. Have you had full lab work done recently to see where he is at? If not I would do that, just in case something shows up.
How long as this behavior change been going on?
Just to remind others, the last ACTH at the end of January, was pre - 3.9 and post - 6.7

hugs,
Sharlene and Molly muffin

[Squirt's Mom]

I would want him checked for diabetes and thyroid levels asap. Sadly, this could also be a macro or the beginning of doggy Alzheimer's. But first let's rule out the most common physical causes like diabetes and low thyroid just to help clear the picture.

We are here with you, sweetie, always.
Hugs,
Leslie and the gang

[thecoz]

Thank you Leslie & Sharlene. The last check on his thyroid condition was very good. Vet said keep his dose the same. Bloodwork was done yesterday:

LYM Low--0.74 K/uL (1.05-5.10)
EOS Low--0.00 K/uL (0.06-1.23)
PLT High--905 K/uL (148-484)
MPV Low--7.9 fL (8.7-13.2)
PCT Low--0.72 % (0.14-0.46)
BUN Low--4 mg/dL (7-27)
CREA Low--0.3 mg/dL (0.5-1.8)
GLOB Low--2.4 g/dL (2.5-4.5)
ALT High--121 U/L (10-100)
GGT High--20 U/L (0-7)
CHOL Low--74 mg/dL (110-320)
AMYL Low--419 U/L (500-1500)
Cl Low--105 mmol/L (109-122)

Some of these behaviors have been going on for some time now...

KJ & Cosmo

[lulusmom]

Can you please post the actual values as well as the normal reference ranges?

[thecoz]

I've edited my last post to include values and normal ranges.

[Renee]

Oh dear. :( I am so sorry to hear this. Some of these symptoms sound like a former foster I had, who ended up having a brain tumor. I sincerely pray that is not what Cosmo has. I think about Cosmo a lot, since his journey seems to echo Tobey's so closely. Please keep coming back and updating us on how he is doing.

[thecoz]

Thanks, Renee. Sadly, a brain tumor is what my gut is telling me.

[molly muffin]

What did your vet say about these values. There are an awful lot of low ones. I was looking around today, and it is much harder to find definite information about Low values than it is for increased values with some of these.

I am hoping one of the others has some experience with seeing these kind of low numbers.
Cholesterol can be be low due to an over active thyroid but you said the thyroid numbers came back good. There are so many variables in this group, but something is wrong here and I would hope that the vet would be looking to address this.
I can't remember are you seeing a specialist too or a regular GP vet? or both?

Hang in there.
Big hugs
Sharlene and Molly Muffin

[thecoz]

the vet doesn't really know what to make of it. And on past blood tests some values were all over the place. She said we could do an ultrasound this week to possibly at least rule some things out?

[molly muffin]

This would probably be a good idea and I would pursue it, if that is an option for you, both logistically and financially. I'm just not sure what other options there would be to find out.

Glynda or Lori or Leslie might have some ideas.

It's so heart breaking to have to worry about other things, when the cc has been clearing up nicely and the cushings part is doing okay.

hugs
Sharlene and Molly Muffin

[Tina]

Hi KJ,

I'm sorry to read that Cosmo is not doing well, and I am concerned too. I don't know what to make of the abnormal labs that you most recently posted, but I don't see a glucose value on there. Do you know if his blood sugar was checked? Some of the symptoms that you are describing can indicate diabetes. Is he showing any increase in drinking and urination?

Hugs,
Tina and Jasper

[thecoz]

GLU showed "normal" range on his test.

[doxiesrock912]

I can't offer any advice except that the ultrasound is a good idea. How I wish that these vets knew more! We certainly pay them enough!

Hoping that you get answers soon and that Coz feels better.

[lulusmom]

Hi KJ,

I've seen a lot of labs but I'm with your vet on this one. I'm stumped because those abnormalities are all over the board. :confused::confused::confused: Was the albumin normal? I've spent a good deal of time researching, trying to put the pieces together but I'm coming up with multiple possibilities. Inflammatory response (would include calcinosis cutis), cancer, intestinal disease, gall bladder inflammation, bile duct obstruction, liver disease, pheochromocytoma, cushing's. If your vet is general practitioner, he may want to consider consulting with an internal medicine specialist. Usually where there is an IMS, there is an oncologist. My dogs treated at a speciality clinic and the IMS and oncologist discussed cases, including pituitary macrotumors. I think an abdominal ultrasound is an excellent idea! That will give the vet a good look at most of the internal organs to check for masses or other abnormalities.

My little cushdog had infrequent seizures and in my research. I did discover that some dogs who stare into space, hold their mouths open like they are yawning and extend their heads back are actually having seizures. Sharlene mentioned that hyperthyroidism can cause low cholesterol. That's absolutely true but it's also rare in dogs. A more common cause is intestinal disease. This can also cause low chloride, loss of appetite and weight loss. I'm really sorry that I haven't been able to provide anything meaningful and I am also very sorry that you are having to watch your boy go through these episodes. I know it has to be very difficult and my heart goes out to you. I'll be checking for your updates.

Glynda

[Renee]

Just sending my thoughts for Cosmo. I hope the ultrasound can help guide you all to finding some answers.

[thecoz]

Thank you guys for the thoughts, advice, suggestions & research on this.

I forgot to mention that Cosmo has been having some GI issues again too. My husband took him to the vet this past Saturday and again today. He's been dropping weight, not eating hardly a thing and not drinking much. He had weighed about 19lbs through most of this cushings ordeal (used to be a 25lb dog). His weight went from 19 to 11 1/2 lbs in approximately a week. The vet thinks its cancer...possibly a gastro-intestinal cancer. We are no longer planning on doing an ultrasound.

As of today, he's off all meds-except prednisone. She suggested we could try that and see if his appetite perks up. So he's home and we are going to take it one day at a time. That's our plan for today, anyway. She doesn't expect him to last too much longer, maybe a week or two? (I can't believe I was just able to type that!) He's doing okay though, considering all that's going on. I do not want him to suffer, that much I know. I hate prednisone!

Anyway, just one day at a time here...we'll see how it goes.

[Dawn Anderson]

Oh my, reading about whats happening with Coz and his nurological issues, takes me back to the begining of my Journey with Buttercup. Im so so sorry. If Coz was mine, I would say its time to do some real imaging, not only a US for the internal organs but also a Cat scan or MRI to find out exactly what is & is not going on inside of that beautiful little fur baby.

You both are in our prayers and sending you all the engery we can muster your way, so that all that can be done will be done and
what will be will be.

Dawn & Buttercup

[thecoz]

Unfortunately, we don't have the money to do MRIs and such. Plus, the thought is he would not survive any surgeries. He went downhill very quickly. He will be 12yrs old in April. Sadly, I don't think anything we could do (if we even could) would have a successful outcome.

[Dawn Anderson]

Oh dear god, I see you were typing when I was. Yes take 1 day at a time and shower him will all the love you have and as hard as it will be try not to cry, be as happy as you can when you look into those eyes, do not let him see your sadness, he will all ready know, but for him to see in your eyes that you are so proud of him for being such a trooper will do his soul well, for all he wants to do is make you happy and that is very hard for him to do now. You've done the best that you can and no one knows what the future has in store, all we can do is learn from them for the are pure spirit. Hold him & all the joy he has given you close, thats his gift to you.

Dawn & Buttercup

[thecoz]

Thank you, Dawn. He really is a trooper too!! He's always been. I haven't really been updating on here much since his cortisol seemed at a decent level. Partly, because I wasn't sure if he was really doing that well. He did not bounce back to his old self like I had hoped he would. I knew that something else must be going on with him--not just the cushings. So we just watched and waited, hoping for something...some "real" improvement to happen. We are devastated right now.

[lulusmom]

As of today, he's off all meds-except prednisone. She suggested we could try that and see if his appetite perks up. So he's home and we are going to take it one day at a time. That's our plan for today, anyway. She doesn't expect him to last too much longer, maybe a week or two? (I can't believe I was just able to type that!) He's doing okay though, considering all that's going on. I do not want him to suffer, that much I know. I hate prednisone!

Anyway, just one day at a time here...we'll see how it goes.

I'm so sorry to hear this. If Coz has cancer or a macrotumor, prednisone can be a very good thing as it helps with inflammation and swelling. It can improve the quality life for whatever time he has left. My thoughts and prayers are with you both.

Glynda

[Dawn Anderson]

We all feel your devistation and are right here for you.

Dawn & Butters

[Renee]

My heart is truly, truly broken for you all right now. I really thought that no news was good news, and figured Cosmo must be doing good.

I am so terribly sorry to read these updates. I can only imagine how hard this must be.

[thecoz]

Cosmo was doing "okay" for a while there. Just not as good as I had expected. I really didn't "know" until recently that something else must be wrong.

[molly muffin]

Oh no, I'm so very sorry to read this. I hoped that it would be something that could be corrected, but I didn't realize how much weight he had loss so quickly.

I know you are devastated as he is your boy, who has been through so much already. You both have.

Sending you love and hugs,
sharlene and molly muffin

[thecoz]

wow! Prednisone sure = drinking = peeing!

[thecoz]

Other than that, the Coz is enjoying his favorite spot on the couch with daddy, watching basketball! I love that dog!

[molly muffin]

Oh yea, prednisone can make them pee a bucket, drink like crazy, and hungry.

I had a golden retriever on prednisone for severe allergies for years (I didn't realize back then that prednisone long term could cause cushings of all things) but imagine a big dog peeing like that. Yowser. :)

On the couch with daddy watching basketball sounds like a fine activity for the boys to be doing. :) I'd love it too. :)

hugs,
Sharlene and molly muffin

[Dawn Anderson]

Other than that, the Coz is enjoying his favorite spot on the couch with daddy, watching basketball! I love that dog!

And thats right were he should be, like that ole saying goes if you want the best seat in the house sit next to the dog.

Dawn & Buttercup the couch HOG dog:D

[Arizona Boston]

Sweet Cosmo! We all hope the very best for you!
Shelly and Lucy

[thecoz]

Thank you again for the nice thoughts...everyone! It helps.

And...Cosmo's eating and drinking again! Yeah!!

We're just making the most of what we have now.

[doxiesrock912]

Awww, sports nuts.
We hope for miracles here!

Hugs to Coz and family <3

[thecoz]

Cosmo is hanging in there! I believe he wants to stay with us a while longer.

[Renee]

Cosmo is hanging in there! I believe he wants to stay with us a while longer.

YES! Go Cosmo, Go!

[Squirt's Mom]

Oh, I know how that makes your heart sing! :cool::cool::cool:

[goldengirl88]

Yahooooooooooooooooooooooooo Coz keep going!!!!!!!!!!!!!!!!!!!!!!!!

[Dawn Anderson]

The power of love is truely amazing!!!

[molly muffin]

Awesome Cos!

Hugs
Sharlene and Molly muffin

[Arizona Boston]

Good ol Cosmo. May there always be room for you on the couch and food in your bowl. May your bed be sprinkled with moon dust and sweet dreams.
Shelly and Lucy

[Dawn Anderson]

Just popping in to see how Coz is doing, hoping things are as well as can be.

[thecoz]

Thank you again for all the support. We said goodbye to Cosmo yesterday. He was too tired and too weak to continue the fight....

[labblab]

I am so very sorry for your loss. Cosmo was a dear, brave little boy who stole all our hearts. We will always remember him here, and we will always honor his journey.

Sending many hugs to you and to Cosmo's daddy.
Marianne

[Tina]

Oh KJ, I am so sorry to read this sad news. My thoughts and prayers are with you and your family. My deepest sympathy on the loss of your sweet boy.

Hugs,
Tina

[Squirt's Mom]

Oh honey, I am so sorry to hear this. Our sweet boy fought long and hard with his loving mom right by his side the whole way. I know he is so grateful to you for all you did to make his life the very best possible.

Please know we are here for you any time you wish to talk. We do understand.
Our deepest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie, Grace, and all our Angels


See You Soon
by Luka Bloom

I hope I love you enough to let you go
On the road only you can see
I hope I love you enough to let you go
And loosen the hold that you have on me

I want to bless you on your way
Say always to yourself be true
I hope you know there is no sweeter place in the world
Than the places I have been with you

See you soon, see you soon

The weakness in me fills my heart with fear
Telling me to control and try to keep you here
The spirit in me that's what is good and true
Telling me to be strong, and trust the letting go of you

See you soon, see you soon

The road waits patiently before you
Away you go now
Don't even look behind
Fill yourself with riches from the times we knew
I'll keep your goodness here
In my heart and in my mind

See you soon, see you soon

I hope I love you enough to let you go...

[BostonLover]

:( I'm so sorry, and sad to read this news this morning. RIP sweet Cosmo...my Boston's Tyson and AnnaBelle will love to have a new playmate across the bridge.

My thoughts are with you and yours. <3

[addy]

I am so sorry for your loss, my deepest sympathy to you and your family. It is so hard to say goodbye.

[molly muffin]

Oh my gosh, I am very very sad. Cosmo was just a wonderful guy. I will always picture him chilling on the couch watching the game with his dad. I know your heart is just broken. He did put up a good fight and over came many other issues.
My sincerest condolences.
love
Sharlene

[goldengirl88]

I am so saddened to read that your dear Cosmo has passed. My heart goes out to you. Just know he is free of pain, and with all the other Cush dogs that helped him across the bridge. Blessings
Patti

[Spiceysmum]

So sorry. My thoughts are with you.
Linda

[doxiesrock912]

I am so sorry!
Cozmo will have a lot of company waiting for him on the other side of the rainbow bridge.

Rest peacefully brave man.

[Renee]

Oh dear. I am so very, very sorry to hear that Cosmo has passed. His story was very dear to me and I kept him in my thoughts often.

Sail on Cosmo.

[thecoz]

You guys have made me feel a tad bit better! Thanks.

I posted a couple pics of Cosmo in a new album. They were taken last summer, right before his illnesses began.

[molly muffin]

Love the pictures, thank you for sharing them with us and for sharing Cosmo, he quickly became such a dear loved member of our family here. (You and Cosmos)
sending you big hugs,
sharlene and molly muffin

[doxiesrock912]

I hope so, losing any member of our family is hard. We share the good and the bad times here as well as invaluable knowledge. Most of us have been through this at least once too.

Stick around if you need to talk, someone almost always is online to chat.

Hugs.

[flynnandian]

r.i.p. cosmo and say hello to flynn from me.

[Arizona Boston]

Dear Cosmo Man, Your family will miss you and your on-line family will miss you too! You had a good life and were well loved. Be free now.
Shelly and Lucy

[grapey]

I'm so sorry to hear this.

[Dawn Anderson]

He gave all he could to the very end, a real trooper he was. He is now in perfect health and is by your side in spirit. The pain of it all runs very deep as it should for the love you had and still have for each other runs deep. You both gave him the VERY BEST life he could have ever had! He was so blessed to have had you as you were with him.

With our deepest heart felt condolences

Dawn and Buttercup

[Trish]

Oh no, I am so sorry to read this about Cos, what a lovely dog he was. My condolences to you and your family at this sad time. Big hugs you all x

[thecoz]

Thanks so much for all your condolences. Our vets office sent us a lovely card today. They loved Cosmo too! Every one of their staff wrote a personal message on it. This still feels so unreal to me.

[thecoz]

I have uploaded two more cute pics of Cosmo to his photo album.

[molly muffin]

Wonderful pictures of Cosmo.
I can fully understand your vets office loving Cos. What was not to love :)
That is very sweet that each took the time to write something.

hugs,
Sharlene and Molly muffin

[addy]

The whole in your heart is huge. I ran into someone yesteday who had lost her dog eight weeks ago, she said she still was a mess.

It has only been two weeks for me and so far it isnt any easier.

I found this poem in our Loving memory section


Don’t tell me that you understand
Don’t tell me that you know,
Don’t tell me that I will survive
Or how I will surely grow.

Don’t tell me that this is just a test
That I am truly blessed
That I am chosen for this task
Apart from all the rest.

Don’t come at me with answers
That can only come from me,
Don’t tell me how my grief will pass,
That I will soon be free.

Don’t stand in pious judgment
Of the bounds I must untie,
Don’t tell me how to suffer
And don’t tell me how to cry!

My life is filled with selfishness,
My pain is all I see,
But, I need you now,
I need your love, unconditionally.

Accept me in my ups and downs,
I need someone to share,
Just hold my hand and let me cry,
And say, “My friend, I care.”

By Joanetta Hendel

So I will just say to you too that I care.:)

[thecoz]

thank you, Addy.

[addy]

Stopping by to give you a hug:):)

Thought you might need one.

((((((((hugs)))))))))))

[grapey]

Thinking of you today.

[thecoz]

Today was difficult for me...starting out the beginning of the first week without my buddy of 12yrs. Going to work and saying bye to 2 dogs instead of 3. Didn't seem right.

[Spiceysmum]

Thinking of you at the start of this new week.
Linda

[apollo6]

For Sweet Sonja:

So sorry for the lose of your sweet Cosmo,he was such a sweet little guy.
WHEN TOMORROW STARTS WITHOUT ME – Author Unknown

When tomorrow starts without me
And I’m not there to see,
The sun will rise and find your eyes,
All filled with tears for me.
I wish so much you wouldn’t cry
The way you did today
Remembering how I’d lay my head
In your lap that special way.
I know how much you love me
As much as I love you
And each time that you think of me,
I know you’ll miss me too
But when tomorrow starts without me
Please try to understand,
That an angel came and called my name
And petted me with her hand
She said my place was ready
In Heaven far above
And that I’d have to leave behind
All those I dearly love
But, as I turned to heel away
A tear fell from my eye
For all my life I never thought
That I would have to die.
I had so much to live for
So many sits and downs to do
It seemed almost impossible
That I was leaving you.
I thought about our lives together,
I know you must be sad,
I thought of all the love we shared
And all the fun we had.
Remember how I’d nudge your hand,
And poke you with my nose
The Frisbee I would gladly chase,
The bad guy, I’d “bark and hold”.
If I could relive yesterday
Just even for a while,
I’d wag my tail and kiss you,
Just so I could see you smile
But, then I fully realized,
That this could never be;
For emptiness and memories,
Will take the place of me
And when I thought of treats and toys
I might miss come tomorrow,
I thought of you and when I did
My dog-heart filled with sorrow
I’ve entered into eternity,
And how it welcomes you,
Today my life on earth is past,
But here it starts anew
I promise no tomorrow
But today will always last;
For you see, each day’s the same day
There’s no longing for the past
So when tomorrow starts without me,
Don’t think we’re far apart
For every time you think of me,
I’m right there, in your heart.
Hugs Sonja and Angel Apollo