Adrenal Cushings: home treatment advice?

[Lboots]

Hi, my ~10-11 year old Boston terrier was diagnosed with cushings disease about six months ago. An internal medicine specialist confirmed via ultrasound that Roscoe has a large tumor on his adrenal gland. Due to the tumor's size, location, and Roscoe's age and other health conditions (heart murmur), surgery is not an option and she did not recommend any medicine.

Since then he has had a stroke, and possibly a seizure. But his health has been pretty good the past two months. He is a good little fighter and does not ever look in pain.

I am posting to ask if there are things I can be doing to make him more comfortable, especially in his diet. Everything I read is related to treatments but since we aren't using any medicine, are there things we should be doing or more careful about? I know he is now more susceptible to infections, but he spends 90% of the day sniffing and licking the ground!

After having stool issues in November, I stopped dry food and he has been eating ground chicken and pumpkin (we have always added pumpkin to his food bc the fiber helps). I also added 2x per day vitamins. Since his stool has been solid, I feel like I should keep cooking him food. Is this diet nutritious enough? Last week I added peas, but made the mistake of leaving them whole. The peas came out whole too! Today I have puréed canned peas and carrots. He also gets a vitamin 2x per day.

Also any suggestions on amounts to feed him? Since he looks so skinny, we feed him a good amount. I cook 2lbs of ground chicken every 3 days or so. It feels like I am always cooking for him, more than I cook for myself!

Thanks for any advice you have.

[frijole]

I am bumping this thread up so that those who home cook for their dogs can see it and give you advice.

In addition to diet you might give your dog supplements for the liver since it is affected by cushings. Many use milk thistle. I bought it and sprinkled it over the food out of the capsules. (I did it every meal)

What cushings symptoms does your dog have? Excessive water/food intake? Frequent urination? Hair loss? Muscle wasting? Back legs trembling?

Tell us more about your dog and we'll help the best we can. Kim

[Renee]

I home cook for one of my dogs and have cooked for many past fosters.

Not sure what vitamins you are using, but it sounds like your homemade diet may be incomplete. You'll need to supplement with fish oil, and a complete vitamin mix, and MOST IMPORTANT - a calcium supplement.

Your vegetables should have more variety, as should your protein source (you can alternate between chicken, turkey, lamb, beef, pork, etc). The ideal balance for protein vs. carb/veggies is 70/30, and you can adjust that up or down, depending (never go below 50/50). I personally use a food scale when I measure out food for cooking. My pug, at the moment, is getting 7 ounces of meat and 2 ounces of sweet potato per day, split into two meals. I then add in a rotation of veggies. Most veggies are so very low calorie that you can add them in after measuring out the protein and carb source.

I cook every other week in large batches and freeze the food into daily portions. It makes is much more manageable!

A really excellent guidebook for homecooking (and raw) is Raw & Natural Nutrition for Dogs by Lew Olsen.

I am confused about why your pup was diagnosed with cushings, but no discussion on treatment? Are the symptoms very mild?

[Trish]

Hi
I am wondering if Roscoe had testing for cushings or was his tumour just picked up on ultrasound? I only ask as treatment can depend on the type of tumour it is. Some increase cortisol... ie functional adrenocortical tumour these tumours are more likely found on the cortex or outside layer of the adrenal gland. But other types of adrenal tumours secrete catchecholamines which can make things like stroke more likely as they can have BP swings from a sudden rush of adrenaline. They are called a pheochromocytoma which is what my dog had, these tumours are usually found arising in the medulla (inside) of gland. My dog had an adrenalectomy at 11 years of age, he is a fox terrier and has done well. He also just had a liver resection a few weeks ago for a large mass and he also has a little heart murmur and that did not put the surgeon off operating on him. I guess it depends on how bad the heart murmur is and I would imagine your IMS talked to you about that.

If it was this type of tumour, which is worth considering with his stroke/seizures then there are meds than can help keep his BP under control and maybe prevent further episodes of stroke. Has his BP ever been checked?

I have swapped around food and struggle with keeping it nutritious too, I have just swapped Flynn to Ziwipeak which he seems to love and I am happier that he is getting all his nutrients in that. He is having half wet food and have dry and fingers crossed it is not upsetting his tummy (he has IBD too). Good luck with finding something Roscoe likes and is good for him!

Trish :)

[Lboots]

Thank you for all your comments! This is all very helpful.

Roscoe started urinating in the house back in May, and I took him to the vet. I've been to the vet so many times the last year (unrelated to Cushing's too), some of the details are a little foggy. The vet did a urine test, and a few others which made her recommend to have one of the Cushing's tests. I forget which one they did though (I think they kept him for 8 hours that day, so the longer test). These results also indicated Adrenal dependent Cushing's, which is why they recommended getting an ultra sound to confirm if there was a tumor. Previous x-rays had also shown he has a large liver.

The internal medicine doctor saw the large tumor, near a blood vessel and did not support surgery (and neither did we). She thought his urine was so diluted that something else might be contributing to his increased thirst and put him on pills for Diabetes Insipidus. It has been difficult for me to tell if the pills help because every time I tried taking him off the pills, something else happened to be going on. I have kept him on the pills the past 6 months, but I see fluctuations on how much water Roscoe drinks. Early on, I had to wake up 1-2 times in the middle of the night (in addition to taking him out before bed, around 10 or 11 and then his normal AM walk at 5am). Currently it's not too bad, and he sleeps through the night. We let him out at least every 6 hours or so during the day. I recently read that cortisol production can fluctuate, which perhaps could be why his water intake changes? I've also read that feeding natural diets could help, and I have been doing that the last month (and during this time, Roscoe has been going pee less often).

To be honest, I can't really remember why the internal medicine doctor did not recommend medicine specific for Cushings. I remember asking if there was anything else we could do, and she said no and then I was asking her about what signs I would see when he was close to the end of his life.

After his stroke in September, they did take Roscoe's BP and it was high enough to treat, so he is on BP medicine.

FYI, Roscoe is a rescue and there was some confusion about his age. We had thought he was 12 or 13 until recently, but now think it's more like 10 or 11.

Roscoe's symptoms:
-Increased thirst and hunger (he was always food-driven, but I swear he gets a crazed look in his eye when he gets the idea of food in his head!)
-Increase urination
-Loss of hair (and hair thinning)
-Pot-belly appearance and loss of muscle mass
-Back legs have grown weaker (first he stopped being able to jump on furniture, now he can't walk up/down stairs without falling - at least our wooden slippery ones, so we carry him up/down)
-Head is looking skinnier too
-Not sure if this is related, but he is obsessively licking his front paws.

For the last 5+ years Roscoe's back legs have been trembling. Vets never knew what it was from. They suspected arthritis, but medicine did not help. He never seemed in pain, so we left it as is. His trembling has gotten much worse (spread to his front legs) but he still does not seem in pain. I had a hunch the trebling was related to his Cushings, but could not find any information about that!

Thanks again everyone for your thoughts.

[Lboots]

Hi Trish - I am pretty certain the vet said the tumor was on the outside of the adrenal gland.


Hi
I am wondering if Roscoe had testing for cushings or was his tumour just picked up on ultrasound? I only ask as treatment can depend on the type of tumour it is. Some increase cortisol... ie functional adrenocortical tumour these tumours are more likely found on the cortex or outside layer of the adrenal gland. But other types of adrenal tumours secrete catchecholamines which can make things like stroke more likely as they can have BP swings from a sudden rush of adrenaline. They are called a pheochromocytoma which is what my dog had, these tumours are usually found arising in the medulla (inside) of gland.
Trish :)

[roscoe]

Hi there, my dog (also roscoe lol) is suspected of cushings but no diagnosis as yet due to his stress levels at vets. Due to his stress we are takung natural approach (diet and homeopathy). Im no expert as only 3 mths into process but have done tons of research and could suggest some of following natural supplements:


- Si Miao San*

- Siberian ginseng or astragulus help buffer adrenal response to stress.


- Dandelion root, burdock, garlic, and nettle are good choices for supporting an overtaxed liver and digestive system.


- Cushex drops


-*Vitex Plus (formerly called Canine Cush X) from the English company Hilton Herbs


- Standard process Canine Adrenal Support


- Ginko biloba*

My homeopath has also recommended high protein, low fat diet and homeopathic remedy. Although I understand this may not be for everyone.

There is also a really good book by caroline e levin..... heres a link to amazon

http://www.google.co.uk/url?sa=t&source=web&cd=1&ved=0CCoQFjAA&url=http%3A%2F%2Fwww.amazon.co.uk%2Fgp%2Faw%2Fd%2F 0967225329&ei=0y3LUpY257LsBuXsgbAJ&usg=AFQjCNHeVMb5chxgl329WNjsBiNJkLk3tw

hope you find some of this helpful. Good luck and best wishes for ur lil rosc x

[Trish]

Thank you for all your comments! This is all very helpful.

Roscoe started urinating in the house back in May, and I took him to the vet. I've been to the vet so many times the last year (unrelated to Cushing's too), some of the details are a little foggy. The vet did a urine test, and a few others which made her recommend to have one of the Cushing's tests. I forget which one they did though (I think they kept him for 8 hours that day, so the longer test). These results also indicated Adrenal dependent Cushing's, which is why they recommended getting an ultra sound to confirm if there was a tumor. Previous x-rays had also shown he has a large liver.



That would be the Low dose dexamethasone test, if you could post the results plus any other abnormal test results with the reference ranges it would be helpful for the others here to help interpret. It just seems very odd to me with a dog that has PU/PD with very strong cushings symptoms and supposed positive cushings test for your vet to decide to treat for Diabetes Insipidus. Did they do any testing for that? Mind you, if he is sleeping through the night now and only going out every six hours through the day that is very good and not indicative of polyuria.

It seems like you are fairly positive you did not want to proceed with surgery, but just because a tumour is near a blood vessel does not make it inoperable. My dog's adrenal tumour invaded his vena cava and they managed to get it out ok and that was 13 months ago. I hope they offered you a referral to a surgeon for their opinion. But it appears since then Roscoe has had a stroke which would make surgery much more risky, I know with humans we do not like to operate on a patient who has had a stroke or heart attack for preferably six months after the event. Do you have a copy of the ultrasound you could post

I am pleased to hear he is on BP meds to keep that under control and hopefully reduce the likelihood of further CVA.

My dog has trembling legs too, the surgery has not helped that much.

If I was you, I would collect up all the results you can. It may be meds for Cushings would help Roscoe with some of his symptoms especially if it is an adrenocortical functional tumour. Others here will be able to help interpret them.

I cannot comment on some of those supplements, but I do know that Cushex type meds do nothing whatsoever for cushings pups. They simply cannot lower cortisol, if they did everyone here would be using it for their dogs but they do not work. The admins here have specifically contacted the companies that produce those drugs to ask for evidence of their efficacy so they could best advise our members. They were not able to provide anything concrete at all, they are often mentioned here by new posters and the general consensus appears to be they are snake oil and are to be avoided!! :eek:

I think it is good you are looking at the best possible diet but I do think you need to get this whole cushings/DI confusion sorted out and find out why he is only on DI meds and not cushings meds.

I have probably created more confusion, but hopefully if you can post the test results then we can help figure out what is going on and perhaps get better symptomatic control for Roscoe.

Trish :)

[Lboots]

Ok thanks again.

Maybe I should try taking Roscoe off the DI pills. I'd rather not be giving him medicine if he doesn't need it (expensive too!!). When the vet told me about DI, it sounded like the medicine was really more for my benefit (not having to take him out as much) than Roscoe's. She did not do any tests, because she said we should immediately see an improvement if they were working. At the time, I thought I did see an improvement, but he was going so often back then, anything was an improvement.

I'll look into the records. FYI, all the Cushings, blood, and urine tests were done with my general vet. Based on those results they referred me to an Internal Medicine doctor. That is where I had the ultra sound done and this vet is the one that did not recommend any treatment.

[Trish]

Hi :)
I don't think I would start or stop anything until I had a good talk to the IMS, to find out exactly why she is not treating the cushings as she may have a perfectly good reason to be doing what she has recommended, just hard for us to tell without seeing his numbers! Hopefully you can get copies of all those test results (bloods, urine, ultrasound) to post here, plus list the meds he is on would be helpful. Hope he is feeling OK! :)