unable to reach diagnosis due to severe vet anxiety..... any advice appreciated x

[roscoe]

Hi everyone. My name is nicola and my dog is roscoe. He is a 9 yr old staffie/german shep mix. Around early oct 2013 he started with extreme thirst, excessive urinating, ravenous hunger so after a couple of wks off we went to the vets. Roscoe has always been very healthy and we do not advocate vaccinations therefore his only trip to the vets in his lifetime was following a bad cut to his leg around 3 years ago which he found highly traumatic. So due to his limited experience visiting the vets he finds the whole experience traumatic. It might be worth mentioning that he is already a very anxious boy who suffers terribly with separation anxiety.
So when we took roscoe to the vet following the onset of these symptoms he would not let the vet take his blood. Although muzzled, he is all arms and legs and really puts up a fight. This resulted in 3 visits and 3 sedations...... all of which were unsuccessful and poor roscoe was getting himself into a right state. On the 4th visit the managed to get his blood as we sedated him with tabs before settin off tht morn. However he still put up massive fight and it took 5 people to restrain him in order to get the blood. The results showed some kind of issue with his liver (sorry at this stage I dont have details but will be obtaining these tomoro so can come bk wiv more details). The vet said they dont suspect diabetes and kidney levels looked fine. Now vet strongly suspects cushings but lddst and acth tests will be impossible with roscoes anxiety and vet agrees, she also thinks his high stress levels will give false readings. Only other option they gave is creatin urine ratio test. I have not done the test yet as vet agrees that even with diagnosis it would be too risky to try the cushings meds as monitoring would be impossible with roscoes stress levels and i also worry the stress might exasperate his illness. Also if creatin urine ratio isnt most accurate then i wouldnt want to try high risk meds without certainty tht this is what we're dealing with. Roscoes other symptoms are pot belly, hard lesions on elbows and some skin tags on lips and body, extreme hunger, digestive probs i.e. upset tummy, smelly flatulence, diarrhea, loud grumbling from tummy, 1 bald patch on his side, and his wound from blood taken got infected and still hasnt healed after 6 wks when he is usually an excellent healer. He is also depressed, out of sorts and doesnt want to go for his walks anymore. All his enthusiasm for life seems to be deteriorating. With these symptoms in mind vet said shes confident its cushings which is why at this stage I still haven't taken creatin urine ratio test as if cant put him on the meds I thought whats the point? However now I have read lots of posts on here im not so sure it is cushings as have read cancer can cause similar probs. After much research and consideration we took roscoe to a homeopath who has prescribed 200c calc carb drops, 1 a day into mouth. Also changed from dry kibble mixed with wet canned food (which is what hes always eaten) to low fat raw food diet with no grains whatsoever. Well this has been for last 2 wks and his thirst has improved but thts all so far and now we're having more diarrhea issues and wind and probs firming his stools. I consulted nutritionist and tried bland meals small and often and have seen some improvement but nothing significant yet. Firmer stools but nowhere near where they need to be. So now im worrying about dehydration and malabsorbtion. Theres jus so many possibilities and without veterinary tests and diagnosis I dont know im doing whats best for him. I've started him today on slippery elm bark and psyllium husks so am praying they help. Have alredy tried rice, sweet potatoe and butternut squash (cant get pumpkin as out of season) but this seemed to make him worse wiv diarrhea. I guess im just so overwhelmed with everything I'd love some opinions from like minded people who understand all this. My family dont understand and say he's just a dog and im going over the top which infuriates me. I'd do anything to make him better and his back legs have started with muscle weakness already. This seems to be a rapid progression considering this started in oct so only 3 mths. I read tracy and woodys journey last nite and was heartbroken and thought the support was amazing so hope this is a good place for me to start learning and hopefully get some support myself. Thanks in advance for any advice, opinions...... anything really. You all seem like wonderful loving people so I think im in the right place xxxxxxx

[frijole]

Welcome and glad you found us... wow that is difficult that you can't get Roscoe calm enough to do testing. I will be honest - my gut is wondering if it isn't something besides cushings because it seems like diarrhea is the biggest issue and it is certainly not a cush symptom. You said:

Roscoes other symptoms are pot belly, hard lesions on elbows and some skin tags on lips and body, extreme hunger, digestive probs i.e. upset tummy, smelly flatulence, diarrhea, loud grumbling from tummy, 1 bald patch on his side, and his wound from blood taken got infected and still hasnt healed after 6 wks when he is usually an excellent healer. He is also depressed, out of sorts and doesnt want to go for his walks anymore. All his enthusiasm for life seems to be deteriorating. With these symptoms in mind vet said shes confident its cushings which is why at this stage I still haven't taken creatin urine ratio test as if cant put him on the meds I thought whats the point?

Alot of members here have used Slipper Elm Bark (SEB) and have had alot of success. I certainly hope it works. You would need to get the digestive issues under control before you could even consider using the drugs to treat cushings.

I think doing the UCCR test (creatine urine) that your vet mentioned is an excellent idea because while it cannot confirm cushings, it CAN rule it out. So at least you wouldn't be chasing a cushings diagnosis for nothing.

Is the stress issue all of the time or only at the vets?

Please get us the results of the blood work that was done. We need to see the items that are out of normal range. Post the item that is high or low as well as what the ranges are for normal.

Thanks. Kim

[Woodydog]

Welcome Nicola and to Roscoe. Another person from the UK yippee I don,t feel so out numbered any more lol. Thank you for reading mine and Woodys journey I hope it made you laugh in some parts. As you know Woody wasn,t a cush pup so I can,t really advise on that but you have two stubborn and strong breeds in one dog although lovely at the same time.:D

Like Kim please do the UC/CR urine test, you can do this at home, I did as Woody would get stressed at the vets, it has to be done when the dog is at its calmest so as not to interfere with the results. I usually did it on Woody,s first walk when he was too busy with sniffing to worry about me and my tub. Can you try a DAP collar on Roscoe try and reduce his stress levels, I used one on Woody for the first 2 years they can be expensive but worked for him, I also used Rescue Remedy just before we went to the vets again it helped didn,t cure but helped somewhat. Has the vet given anything for his tummy/diar ? What are you feeding him now? Try and stick to one diet as the dog has to be on it for I think at least 3 months to see if it is working or not.

The main thing you need to do is take a big deep breath, as you are in the right place, without this forum I would never have got through my journey with Woody.

[molly muffin]

Hello and welcome from me too.

I'm going to throw something out that might work if your vet is willing to pursue it.

The University of Vienna has done studies involving testing for cortisol and cushings via hair. It has been shown to be a valid way to monitor cortisol levels. If your vet was willing to contact, Claudia Ouschan at the University of Veterinary Medicine, Vienna, and tell them of the problems with trying to get blood from Roscoe, then perhaps, they would be willing to work with your vet.
This is just a thought, it hasn't been tried by any vet that I know of as of yet, but the studies are valid, so it is a possibility.
This is a link to an article that you can print out for your vet:

http://medicalxpress.com/news/2013-07-hair-dog.html

It can't hurt to ask.
It is possible that cushings is not the problem, other avenues to look into would be thyroid. I'm not sure if that was tested on the initial blood work or not, but you can ask your vet about that too.

If he can be sedated, then an ultrasound might work too, to help determine the problem. I don't know how expensive that would be where you are and if it is an option or not. Right now I'm just throwing things out as avenues to be looked into.

It is true, that diarrhea prior to medicating for cushings is not usual and a urine culture, might be beneficial, and even a course of antibiotic if it is a gastro baceterial infection.

Welcome to the forum.
Sharlene and Molly Muffin

[roscoe]

Wow thank u all for your replies..... didnt expect to hear from u all so quickly! I really appreciate your input!

Kim - most of the diarrhea issues started after the diet change to raw meat. Sorry my post wasnt clear. I was too eager to post haha And am using smart phone so posts take a while without proper keyboard lol. The homeopath said to expect this but shes still on annual leave from xmas (bk weds thank god) so ive been unable to seek her advice and have been panicking. And before she went away she advised me if he had bad reaction not to get meds from vet as wud interfere with the homeopathic remedy so ive been worried about dehydration, pancreatis etc. As diarrhea on/off now for 2 wks...... bless him. He also gets stressed with loud noises and when hes alone. Im defo gonna pursue creatin urine ratio but insurance wont cover anything as say symptoms started before we took out policy and sedations, vet visits and homeopath currently stand me at approx £350 and with xmas jus gone im awaiting my nxt wage to cover this you see. Have also spent a further £200 on supplements, his remedy and organic chicken/turkey which is so so expensive not to mention hard to source. Plus I need freezer to buy in bulk which I cant afford at mo. My nxt step is the urine test and u/s which they quoted around £120 for but am concerned about his stress levels and pumping him full of sedations all the time...... he even fights under sedative so im worried I'll pay and he wont co - operate and hate sedating him especially when its unsuccessful as I feel then I've put him thru it in vein. Thanks so much for ur advice x

Tracey - your story made me laugh and cry. Such a character ur woody. I especially liked the story bout him throwing his bowl at u and opening fridge lol reminds me of roscoe. He can open doors (push or pull) and defo knows how to giv me the look and wrap me around his little paws lol. He is food crazy like ur boy. Apparently the homeo remedy will help calm him but can take time so am being patient (or trying) before trying bachs. Hadnt heard of the collar thou so wilp defo look into this. Jus think if strong sedative doesnt calm him...... will anything? I too am grateful tht I found somebody else in uk who can relate. Not tht u guys in usa arent great of course :)

Sharlene - l found that article too and plan to speak to my vet tomorrow but to be honest the vet hasnt been great and most info ive obtained has come constant research over last few wks. Im on google 24/7. I think my homeo (who is also a vet) wud be my best bet for vienna uni so I'll speak to her about tht on weds wen shes bk. I think the creatin urine ratio shud prob b my first port of call to rule cushings out thou as I suspect the vienna option wont be cheap! Money isnt an issue (once I have some more funds avail) we're struggling but I'd giv every penny I have to help my boy.

Your msgs mean a lot...... its like a weights been lifted just having like minded people to talk to.

Thank u all dearly xxxxx

[roscoe]

I'll try and get blood results tomoro and post them and am currently feeding chicken, turkey and white fish small amounts of squash sweet potatoe spinach peas (very small amounts at min as fiber goin right thru him) also eggs once or twice wk, pumpkin seeds, probio yoghurt. Been sticking to chicken last few days lightly poached as worried raw is perhaps adding to diarrhea. Also probio enzyme tabs once day mixed with food x

[frijole]

Trying to connect dots here... so did your vet have you go on a raw diet because cushings was suspected? If so, why? FWIW there really is no diet necessary for cushings other than low fat food with high protein. I say this because the diet you are on sounds expensive and if the previous diet was working you could use the savings from the food to pay for testing.

The reason that cush dogs are ravenous is not because they are actually hungry but because they think that they are due to signals given by their bodies. With that their bodies over produce cortisol - more than they need. They either have adrenal or pituitary tumors disrupting their metabolisms and so the goal of treatment is to reduce cortisol production and with that the symptoms of appetite and thirst return to normal.

Please respond to question regarding hyperactivity - is it just at the vets or all of the time? If I missed it sorry. Thanks, Kim

PS I tried a raw diet once and both my dogs had diarrhea so bad I gave up on it. I went with holistic natural food and they lived to be 16 yrs old despite the cushings.

[roscoe]

Hi kim..... the vet said the bloods ruled out diabetes and kidney probs and only other condition she knows of tht can cause these symptoms is cushings. She said they wud b willing to try vetoryl meds if creatin ratio points to cushings but risky due to difficulties they will encounter monitoring his blood due to his refusal to co-operate with vets. Also he cannot be sedated for bloods to monitor as apparently this wud affect results and it will be next to impossible to get blood without sedation without pinning him down which is traumatic and I dont want to put him thru this every 3 mths. So this is why I found homeopath to try natural approach. I found the homeopathic vet myself and asked my other vet for referral to homeo who is also regular vet as well. The homeo agreed it wud be difficult getting diagnosis or monitoring which is y we are trying homeo remedy and she said raw food diet wud provide best nutrition if we're not gonna follow med route or further stressful diagnostics. She claims organic best as animals not vaccinated or given antibiotics so less toxins in meat which is better for him????

He used to be super hyper until around sept wen he started to slow down I.e. pacing, destructive behaviour wen left alone, aggression towards other dogs, tendency to try and escape if bitches on heat (hes not neutered), anxiety when post man comes, cries whines if hears car pull up outside. We got roscoe at 6 mths so are clueless why he is like this as he lives in calm environment. We used to giv him bad foods before I learnt more about his nutrition I.e. the odd biscuit, sausages, scraps which I suspect wudnt have helped his hyperactivity but I was ignorant bk then. For last 6 mths hes had healthy diet and no scraps but has developed taste for our food and cravez sugar. I feel terrible tht I stupidly put him at risk like this naively as ive always had his best interests at heart and genuinely didnt kno wot I was doin. Also cats n squirrel s make him crazy xxx

[beaglemom3]

Hi and welcome, I don't know much about cushings so will defer to all the experts on here, but wanted to give you my best wishes for you and roscoe.
I will though suggest an anti anxiety jacket/shirt called thundershirt, it helps with 80% of dogs. It is used to calm dogs for all sorts of anxiety issues w/o drugs. You can google it and see what I am talking about if you want to.

I have donated several to rescue organizations for abused dogs that were traumatized by certain things and it helped them a lot some were completely cured of their anxiety. But there is a small percentage it does not help.

[roscoe]

Thanks vicki I'll have a look at the thundershirt and see. Prob is he wont wear sock on his bad foot so I'm doubtful he'll co-operate wearing shirt. It took us 3 mths to switch from collar to harness he hated it haha little arkward one he is and very strong willed x

[beaglemom3]

aww poor little guy filled with so much anxiety, my heart goes out to him and you. The thundershirt works on calming dogs by gentle pressure.

http://www.thundershirt.com/

[Renee]

If he's having stomach upset and diarrhea from the raw diet, then I would discontinue it. I'm not against raw feeding in the least -- when it's done properly, but done incorrectly, it can be very damaging. I hope he's getting a calcium supplement with the raw diet (unless you are feeding him raw bones).

When a dog switches to a more moisture rich diet (i.e. canned or raw), their water intake will drop significantly. My dogs are on a dehydrated raw diet, and other than my cushings pup, my other two pugs drink water maybe once a day. They just hardly ever need the additional moisture because they get so much of it from their food.

[Budsters Mom]

The Thundershirt didn't work for Buddy. I bought it for fireworks and the occasional thunderstorm. The instructions say to use it sporadically when they are calm, so they don't associate it with anxious moments. I did that, but Buddy hated the gentle pressure. He was used to shirts and sweaters, but did not like wearing the Thundershirt. I have tried it with Rosie. She has the okay, whatever attitude and doesn't mind it at all. I haven't tried it for stressful situations with her. It depends on the dog, I suppose. xxxx

[beaglemom3]

The Thundershirt didn't work for Buddy. I bought it for fireworks and the occasional thunderstorm. The instructions say to use it sporadically when they are calm, so they don't associate it with anxious moments. I did that, but Buddy hated the gentle pressure. He was used to shirts and sweaters, but did not like wearing the Thundershirt. I have tried it with Rosie. She has the okay, whatever attitude and doesn't mind it at all. I haven't tried it for stressful situations with her. It depends on the dog, I suppose. xxxx

exactly, it doesn't work for about 20% of dogs.

[roscoe]

I am pretty sure roscoe wud be in the 20% it wouldnt work on since he always leans towards being difficult. But I'm going to giv the thundershirt a pop since its not too expensive...... gotta be worth a shot.

With regards to his diet..... im gonna persevere for now and speak to homeo vet wen shes bk weds for sum advice. If he doesn't adapt after month or so I'll have to consider his diet options again although he had his first solid stool yest following the slippery elm bark and psyllium husks yest...... yay!!! I've never been so happy to see pooh before haha.

So I managed to get sum info today from vet regarding his blood results. They said all results were in normal ranges except his liver as follows:

ALT - 170 (normal range less than 100)
ALP - 229 (normal range less than 130)

The normal ranges I've quoted are what the vet advised???? I kno this isnt much to go off but this is all I have for now.

My nxt step is the urinary creatinine ratio test at the end of this mth wen I'll have some more money. If the results of this point to cushings then my vet wud be willing to further investigate the possibility of contacting vienna uni to see if hair testing wud be feasible for firmer diagnosis.

Not sure if the liver readings are indicate anything to anyone who knos more in this area?

Thanks

[roscoe]

Oh and forgot to ask about thyroid..... would a thyroid disorder affect any levels on regular blood test thou?

They did say high count red blood cells which they say is good indication no cancer????

Any thoughts?

[labblab]

I am really glad you mentioned the possibility of hypothyroidism, because thanks to a suggestion made to me by another reader ;), I do think it is another avenue that could/should be explored for Roscoe. I do believe that hypothyroidism can elevate liver values, it can cause some of the same outward symptoms as Cushing's, and it has also been linked to behavioral changes such as excessive fear or aggression. Hypothyroidism could possibly be the primary issue for Roscoe, or it could be an additional, secondary issue in conjunction with Cushing's.

The bad news is that additional blood would need to be drawn for diagnostic purposes involving a complete thyroid profile. But the good news is that low thyroid is one of the easiest abnormalities to treat in dogs -- you simply give a daily supplement. Here's a link that talks more about the behavioral ramifications that can be associated with thyroid abnormalities:

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

Marianne

[lulusmom]

Hi Nicola and a belated welcome to you and Roscoe,

You really have had quite a time with Roscoe's severe anxiety at the vet's office. Poor you and poor Roscoe. Your description of Roscoe's combative attitude was pretty vivid in my mind so I can see why your options for a confirmed diagnosis are limited. I can also understand your hesitance to treat with conventional drugs that require routine blood monitoring, even if you were to get a confirmed diagnosis. I tend to agree that at this point, having a UC:CR done may not be cost effective if you aren't going to treat with Vetoryl.

With respect to hypothyroidism, there are two hormones that are produced by the thyroid gland and most blood chemistries include T4 (thyroxine) so your vet probably has that result already. This hormone is low if a dog has true low thyroid but is also often low in dogs with cushing's. If cushing's is the cause, T4 will resolve when cortisol is reduced via effective treatment. With the exception of excessive drinking and peeing, most of the other symptoms associated with hypothyroidism are also associated with cushing's. Hypothyroidism is more likely to cause aggressive behavioral issues than cushing's. As Marianne mentioned earlier, to confirm hypothyroidism, blood would have to be drawn again for a full thyroid panel but not all vets opt to do the full panel and will prescribe supplemental thyroxin to see if symptoms resolve. Unfortunately, a subsequent blood draw should be done to check t4 levels in 60 to 90 days. Ugh. It seems like everything we mention requires blood draws. I feel so inadequate right now because I can't come up with anything that's going to be easy for you or Roscoe. I can definitely see why you would try alternative medicine. Unfortunately, we've not seen any alternative treatments that lowers cortisol; however, the goal of treatment is to remedy symptoms so let's hope your holistic vet can find something to improve Roscoe's symptoms.

I can't believe I'm going to say this but some holistic vets recommend Petalive Cushex Drops, so you may want to have your vet look at that product. I personally think this product is snake oil and I would like to drop kick the person in charge of marketing this product for putting unsupported claims on the internet and preying on pet owners who are desperate for a cushing's cure; however, we have had some members who told us that the drops worked very well for a while. Amazon also has some pretty rave reviews but you should always read those reviews with a grain of salt. I wrote to Nativeremedies, the manufacturer of Cushex Drops, asking if they did controlled studies, using appropriate testing, i.e. acth stim tests, LDDS and UC:CR to validate the safety and efficacy of their product. Their answer could only be interpreted as being no. They avoided my questions completely and sent me what looked like a page out of their marketing brochure. Dealing with charlatans is always frustrating. :D

Glynda

[doxiesrock912]

Would the vet be willing to come to your home to do these tests? Stress can really skew results.

[Renee]

Would the vet be willing to come to your home to do these tests? Stress can really skew results.

I was thinking this too, since it is just blood draws.. but, I wasn't sure if a vet would be willing to do that.

[roscoe]

Ive enq about home visit today - thanks for the advise. £100 home visit which is reasonable so following urine creatine ratio at end of mth if cushings ruled out then I'll arrange home visit for more bloods to explore poss thyroid probs. Thanks all x

[molly muffin]

Oh so glad they will do that. It is the only chance probably of getting any blood from Roscoe. He just doesn't do vets and needles. :)
It's good and one of the things we always say on here is that you always feel better, once you have a plan in place. Very important those plans for your own peace of mind. :)

hugs,
Sharlene and molly muffin