New Member - ?? homeopathic remedies ??

[Jen P]

Good evening! I have a 5 1/2yr old sheltie, corgie mix named Maggie who was diagnosed with adrenal cushings about 3 months ago. It's been quite the journey! After the long awaited diagnosis, she was put on Vetoryl. She went back 4 weeks later for a follow-up, and it showed the medication was working. Her symptoms seems to be improving, I thought everything was going well. About a week after that she went downhill very quickly. I am generally not quick to panic as I have unfortunately taken care of sick dogs in the past, but she couldn't move, barely breathe, and had "that look" in her eyes. The vet gave her some comfort medication, kept her and ran some tests. The cushings was no longer "controlled" and had actually gotten worse. They increased her Vetoryl and continued the prednisone and prilosec, etc. She seemed to get better, but the progress was very slow. Her stomach had increased dramatically, and with those little corgie legs she had trouble walking. I ended up taking her to a specialist who did an ultrasound and ran more tests - turns out she is allergic to Vetroyl. At that point, with both of my vets blessings I took her off ALL meds. Her turn around was amazing. She is almost back to the dog she was before. During this, I moved from New Jersey to Texas - a move I had been planning for 2 months before Maggie even got sick. I have not taken her to a vet here yet as she has no symptoms - but I am not a fool and know that the symptoms will return. I have been reading about homeopathic remedies, such as Dandelion - but one website tells you its great and the next tells you it doesn't work. Does anyone have any experience with homeopathic remedies? I don't believe I need to tell anyone how much I love my Maggie as everyone on here clearly loves their babies, too - she is just an incredibly amazing dog and she is just so young, I want to be able to give her a long happy life as symptom-free as possible. She has already been through so much - torns acls (from her corgie legs and her sheltie body), Lymes which caused arthritis, and now this. Any advice would be greatly appreciated!! :)

[Harley PoMMom]

Hi and welcome to you and Maggie!

So sorry for the circumstances that brought you here but glad you found us.

Could you tell us more about Maggie, such as her weight, the symptoms that she is/was displaying, and the dose of Vetoryl that she was on? Also, if you could get your hands on all tests that were done on Maggie and post any abnormalities that are listed that would be a great help. Any tests that were performed to diagnose and monitor the Cushing's, we would be interested in those results too...Thanks!

I was wondering, also, if you could tell us how exactly the IMS diagnosed that Magge was allergic to Vetoryl.

Sometimes when a dog's cortisol has gone too low with Vetoryl, the need for Vetoryl is no longer required and they remain symptom free.
Lysodren is another medication that is used for Cushing's, has the IMS mentioned the use of Lysodren as a treatment option for Maggie?

We do have another member using homeopathis remedies, here is a link to their thread: Switched to Homeopathic remedies (http://www.k9cushings.com/forum/showthread.php?t=4702)

Please know we will help in any way we can so do not hesitate to ask all the questions you want.

Hugs, Lori

[labblab]

Hello and welcome from me, too!

As Lori has said, it will really be helpful to us if you can be more specific about both the diagnostic and monitoring testing that was performed on Maggie (including the actual test result numbers). There are some missing puzzle pieces that seem really confusing to me.

First of all, are you certain that Maggie's Cushing's is being caused by an adrenal tumor rather than a pituitary tumor? Is that what the ultrasound showed -- a mass or tumor in just one of her adrenal glands?

Secondly, the way in which she was handled while taking the Vetoryl seems odd. It makes no sense that her Vetoryl dose was increased at the same time she was being given supplemental prednisone. The prednisone would be given if the vets feared her cortisol was dropping too low; the Vetoryl would be increased if they thought her cortisol was too high. There is really no reason why the two medications would be given together in this way because they would be treating two opposite conditions.

Lastly, as Lori has also pointed out, there is an alternative conventional treatment medication, Lysodren, that is a possibility for dogs who do not tolerate or respond to Vetoryl. I, too, wonder what is meant by saying that Maggie is "allergic" to the Vetoryl. But if it truly is not suitable for her, Lysodren may be another option. But if Maggie indeed suffers from adrenal Cushing's, surgery is another option altogether for a complete cure. At her young age, this might be a consideration for you. Has this been discussed with you at all?

So in my mind, there are many unanswered questions here. I do believe there is a specialty veterinary practice in Houston that one of our other members is using. If Maggie's symptoms return, would you consider having Maggie re-evaluated once again now that you have relocated there? Given her rather odd course, it seems possible that she may not even have conventional Cushing's at all (meaning that, if she does suffer from an adrenal tumor, it may not be producing cortisol but symptoms are instead being caused intermittently by the release of other adrenal hormones).

Here is a link to the website for the specialty practice (Gulf Coast Veterinary Associates). I believe you would need a referral from a another vet to be seen there. But perhaps you could request a referral from your specialist in New Jersey?

http://www.gcvs.com

Marianne

[Jen P]

I thought things were a little strange - especially after reading articles. The ultrasound did show enlarged adrenal glands, but no mention of a tumor.

Maggies Symptoms:
She started to put a lot of weight on, especially in her belly. She looked like a pot-belly pig. She was panting all the time and constantly looking for a cold place to lay down. She was even panting in her sleep. She stopped eating. She would go 2 - 3 days without eating anything, but she was drinking non-stop. In a 6 week period so put on 10 pounds. She then began vomiting, 4 times in one day. The next day I took her to the vet and they took blood. 3 days later when the results came in I was asked to bring her in for a day of testing - which I did, then a few days later they told me she had Cushings. Results: ALT 158, ALP 1257, AMYL 1444. She was put on 60mg of Vetoryl. A week later, she was still having the same symptoms, but I couldn't get her to eat or drink anything. I started cooking her chicken and rice, which she loves but she would just sniff at it and lay down. That was when they put her on prednisone so that she would eat and drink something. She was on the prednisone for about 4 days, then she was weened off of it. Her appetite did return and she started to make progress. She had more energy, not running around but at least getting up. She went back in for her one month check up and the results showed that everything was under control. Results: ACTH Stim: pre: 4.2, post 8.7. But then, a week or so later, the symptoms started coming back with a new one - constant itching. So, back on the prednisone so she would eat and drink and they increased the Vetoryl from 60mg to 90mg - 60mg in the morning and 30mg in the evening. She was taken off the Prednisone again but this time she didn't bounce back. She started to having abdominal pain. This dog has never been mean or vicious in her life, but she started growling at anyone who touched her belly. My vet sent me to the specialist who did the ultrasound and said that she was having a reaction to the medication, which "wasn't unusual" (which apparently may not have been true). The wording used in the paperwork was "intolerance" but she said allergic to me. So she went off all meds and about a week later she started bouncing back. In total, she had put on 15 pounds - almost all of which she has lost. The panting stopped, she runs around like a maniac and is eating and drinking.
I started looking up different treatments because the panting has returned - not anything like before, but it's noticeable. She has been off all meds for 5 weeks now.
The week before I moved I almost put her down. I know that Cushings is common, but if she couldn't be treated I couldn't let her suffer like she was. I have had dogs with cancer and epilepsy and none of them were ever as bad as she was. I was carrying her everywhere. She LOVES attention and hugs, but she didn't want to be touched. She laid on the cool bathroom floor and would actually just urinate because she couldn't get up to go outside. I don't want to see her back there again.

[Jen P]

Sorry - I was trying to remember everything that I forgot to say Thank you! Being able to talk to someone is very comforting so thank you very much for starting this! I have never joined one of these before, apparently I've been missing out! :)

Jen

[labblab]

Oh Jen, you are so welcome! I've got some more thoughts to add but I have to cook dinner now so I will be back again later on. But yes, this is a wonderful family here :o. We all hold one another up and do our very best to figure out the best path forward for our furbabies. :)

Marianne

[molly muffin]

Hello and welcome from me too. :)
My immediate though seeing the high AMYL is a pancreatic episode, which is very painful. They should not be on vetroyl while having a pancreatic attack. You feed small meals of like, chicken rice, much consistency, throughout the day. Nothing too much at one time.
You said an ultrasound was done, did they mention the pancrease, gall bladder, etc? or just the adrenal glands. Has she been tested for diabetes, thyroid issues? Glucose and T4 on the lab work, would give you and idea about that.
Allergic is Not something we hear very often, maybe I've heard it once, and not sure it was confirmed.
Not saying it doesn't happen, but what is more common is two things, one is every dog is different and some are more sensitive to vetroyl than others, in other words, they drop real fast too far. The other is that a dog is put on vetroyl who does not in reality have cushings. This can be a bad thing and cause quite adverse reactions.
Seeing as how cushings is one of the hardest disease to get a firm diagnose on, this isn't surprising that it happens, more often than we would like. If anything else is going on, the the cushings test can be inaccurate. Adrenal glands can be bi-laterally enlarged, if they are in fact responding to something else going on long term. Or a pituitary tumor, which is the most common cause of cushings.
So there are many variables to be looked at in this.
Again, these are just my preliminary thoughts and I'm thinking that a nice timeline of what happened when, along with blood results that are off (high low) with the range and dates of those tests could be helpful to sort this out too. I know it's a lot of work, but Maggie is just a young thing and I think if we get this into some sort of order, we can start by looking it over thoroughly and planning out possible next steps to be taken to make both of your lives better.

Again, welcome and yep, forums can be truly wonderful. :) Alot of support on here.
You can brows through other threads and get an idea of current things going on. Don't forget to check out the resource thread too.

Sharlene and Molly Muffin

[Harley PoMMom]

Hi Jen,

Most dogs with Cushing's have a ravenous appetite so with Maggie's inappetence I do question the Cushing's diagnosis. Another reason that I have some doubt is because the LDDS test, which I believe Maggie had done, can create false positive results when other non-adrenal illnesses are present. With the elevated amylase (AMYL), vomiting, lack of appetite, and tender tummy, I agree with Sharlene that Maggie does have pancreatitis and I highly suggest that a spec cPL test be performed so that pancreatitis can be ruled in or out.

Hugs, Lori

[Dawn Anderson]

Hello Jen,
I am also a newbie to all of this and these wonderful people in this forum are so dedicated to helping cushys and their families. They are truly amazing , I've learned so much in such a short period of time , my Buttercup was diag with PDH Cushing's on 11/14/2013.
So sorry your baby is so sick, just hang in there and keep asking ? And supplying as much info as you can and have and they will help you find the answers. Its a team effort and we are all in this together.
I couldn't have made it through last week with out them.:p

Dawn & Miss Buttercup:)

[labblab]

Hi again, Jen. Sorry it took me so long to get back to you, but here are some more thoughts that come to my mind. Bottom line: if it were me, I would definitely want Maggie re-evaluated again now that you've relocated to Houston. I still have a number of question marks related to her previous diagnostics and treatment. You'll find my thoughts below in red.


I thought things were a little strange - especially after reading articles. The ultrasound did show enlarged adrenal glands, but no mention of a tumor.

When both adrenal glands are enlarged with no evidence of a visible mass, this finding is consistent with the pituitary form of Cushing's rather than the adrenal form of the disease.

Maggies Symptoms:
...She stopped eating. She would go 2 - 3 days without eating anything, but she was drinking non-stop. In a 6 week period so put on 10 pounds. She then began vomiting, 4 times in one day...

The other symptoms you mentioned are consistent with Cushing's, but the total lack of appetite and vomiting are not. As the others have said, this would be more characteristic of pancreatitis (to which Cushpups are vulnerable).

The next day I took her to the vet and they took blood. 3 days later when the results came in I was asked to bring her in for a day of testing - which I did, then a few days later they told me she had Cushings. Results: ALT 158, ALP 1257, AMYL 1444.

At that time, did your vet perform a blood test that is specifically diagnostic of Cushing's: either the LDDS or ACTH? An accurate Cushing's diagnosis cannot be based upon blood chemistry values alone. And as the others have noted, that elevated amylase could definitely be associated with pancreatitis.

She was put on 60mg of Vetoryl. A week later, she was still having the same symptoms, but I couldn't get her to eat or drink anything. I started cooking her chicken and rice, which she loves but she would just sniff at it and lay down. That was when they put her on prednisone so that she would eat and drink something. She was on the prednisone for about 4 days, then she was weened off of it.

Was a monitoring ACTH performed at that time in order to determine whether or not her cortisol level had actually dropped too low? Was she taking both the Vetoryl and prednisone at the same time? If so, that really makes no sense whatsoever since the prednisone is given to compensate for low cortisol -- which additional Vetoryl would only lower further.

Her appetite did return and she started to make progress. She had more energy, not running around but at least getting up. She went back in for her one month check up and the results showed that everything was under control. Results: ACTH Stim: pre: 4.2, post 8.7. But then, a week or so later, the symptoms started coming back with a new one - constant itching. So, back on the prednisone so she would eat and drink and they increased the Vetoryl from 60mg to 90mg - 60mg in the morning and 30mg in the evening.

Was she put back on the prednisone as a preventative action -- to keep her appetite stimulated? Or was she again having appetite issues along with the rebound in other symptoms? Either way, again, layering the prednisone alongside the Vetoryl makes no physiological sense.

She was taken off the Prednisone again but this time she didn't bounce back. She started to having abdominal pain. This dog has never been mean or vicious in her life, but she started growling at anyone who touched her belly.

Again, these symptoms are consistent with pancreatitis as opposed to Cushing's.

My vet sent me to the specialist who did the ultrasound and said that she was having a reaction to the medication, which "wasn't unusual" (which apparently may not have been true). The wording used in the paperwork was "intolerance" but she said allergic to me. So she went off all meds and about a week later she started bouncing back. In total, she had put on 15 pounds - almost all of which she has lost. The panting stopped, she runs around like a maniac and is eating and drinking.

It is a bit of a mystery as to what the specialist meant, and why pancreatitis wasn't considered nor addressed. Again, Cushpups are thought to be vulnerable to pancreatitis and I am totally puzzled as to what the specialist's intentions were as to Maggie's long-term treatment plan. Even if she couldn't tolerate Vetoryl for some reason, if Maggie indeed suffers from Cushing's, there is an alternative conventional drug that is used to treat the disease (Lysodren).

I started looking up different treatments because the panting has returned - not anything like before, but it's noticeable. She has been off all meds for 5 weeks now...

So my own thought is that Maggie may indeed suffer from pituitary Cushing's, but it sounds as though pancreatitis may have been a major complicating factor in both her diagnosis and also her treatment. Vetoryl may not have been the problem at all. But at this point, we are not even sure whether she has had any specific diagnostic testing for Cushing's. So I would start back at Square One and have her seen by some fresh eyes!

Marianne

[Jen P]

Thank you everyone for the replies... and pancreatitis was ruled out during the ultrasound. My head is definitely spinning right now!

When I moved I asked my vet to copy her file for me - but it's notes with abbreviations, very difficult to see the names of tests and their results.

I'm going to find her a vet this week. It would be nice to get a baseline on her while she is fairly symptom-free.