12 & half yr old Boxer, heart questions

[Bigdons]

Hi guys,

My lovely boxer George was diagnosed with cushings 2 weeks ago. It took us 3 weeks to get all the tests done.

He had the peeing and drinking problem, but never the ravenous apetite.

WE had him on Cushex drops while awaiting test results and he is now on Vetoryl.

2 days before we put him on vetoryl he suddenly went back to normal toileting. Normal drinking and no peeing in the house ?

His heart rate went up to 180 + But was acting normal.

He now wont eat anything. IS drinking ok and not peeing himself.
He has lost so much weight this past 2 weeks making his pot belly look bigger.

His heart rate went back to a normal 100 yesterday and vet was happy with that. Today it's sky high again, he vomited up 20 mins after we gave him the vetoryl and after a short walk out for a pee, fell over, paniced cause he couldn't get back up, gums went white. Then after a couple of minutes settled and was back to normal and is now sleeping.

Anyone had such an experience ? As in suddenly going back to normal toilet habbits before meds ? And heart problems like these ?

Incidentally I am awaiting a call back from the vet !

Donna x

[labblab]

My immediate worry would be that his cortisol/aldosterone production may have dropped too low due to overdosing with the Vetoryl. This can produce an Addisonian condition that can quickly become very serious. Was George seen by the vet yesterday? Did the vet test his blood?

If not, I think the vet needs to see him ASAP so that his cortisol level and basic blood chemistries can be checked. And no more Vetoryl until you know the results. Especially in view of the fact that the thirst/urination had resolved before even starting the drug. Makes one wonder whether George may not really have Cushing's at all. Or as a different possibility, that he may suffer from a type of adrenal tumor that is intermittently causing symptoms, including the rapid heart rate. Has George had an abdominal ultrasound performed that provided imaging of his adrenal glands?

Marianne

[goldengirl88]

Please listen to Marianne and take you dog to the vet immediately. Get his electrolytes checked also. How much does he weigh and how much of a dosage did you give him? Please no more Vetoryl. Go to the vet. Please get copies of all testing done and post all abnormal numbers for us to see and the normal range given by the lab as they are all different. We can see what is going on that way. God Bless you both
Patti

[Bigdons]

Yes ultrasound was done same time as the Dex test. no masses were found but they said dex test confirmed Adrenal Cushings.

Vet didn't check him yesterday it was via email. Vet called just now and we are taking him in in an hour and a half.

[labblab]

Ask your vet about the possibility of a pheochromocytoma. If this is the problem, it ought to have shown up as an adrenal mass on the ultrasound. But adrenal imaging can be tricky and it takes high-resolution equipment to get a clear view.

Marianne

[Renee]

If no mass was found on the ultrasound, then how can they confirm adrenal cushings?

And, I didn't think an LDDS could diagnose adrenal cushings?

I would stop the vetoryl immediately, and not even consider going back on it until you have everything else squared away. If his symptoms went away, then there is no immediate need for the meds. Also, sudden weight loss is not a symptom of cushings.

[labblab]

If no mass was found on the ultrasound, then how can they confirm adrenal cushings?

And, I didn't think an LDDS could diagnose adrenal cushings?

A Low Dose Dex test cannot diagnose adrenal Cushing's, but a High Dose Dex test is used for that purpose. Right now, we don't know which Dex test was done. But absolutely right, adrenal Cushing's would involve an abnormality that you'd expect to see on ultrasound.

Marianne

[Renee]

Thanks for clarifying Marianne. I was a little confused, as I am relatively new to this too! When Tobey had her LDDS, it was inconclusive for pituitary vs adrenal.

[Bigdons]

Just back from the vet.. He's now got right side heart failure.
Potassium high.
Been given vetmedin and frusimide and back tomorrow morning to see if it's reduced the heart rate.

If not then they are going to try a Digoxin.

Vetoryl stopped.

Can't tell me why his toileting was back to normal ??

[molly muffin]

Hello and welcome. I'm so glad that you got in to see the vet. Very sorry though to hear of the heart problems.

It could be that he wasn't actually having cushings, but having high cortisol because of the heart problems. I'm not sure if this is the reason, but it could be since cortisol can go high when other problems are present.

Another possibility is a pheo as mentioned by Marianne. Often they don't show up in the first ultrasounds. At least 2 members, had multiple ultrasounds before the pheo was seen. A pheo, is not always active, but when it is, then BP will go up, etc and symptoms can be seen.

However, BP also could fluctuate due to the heart problem. I hope that the meds help with that.

Crossing fingers! Do let us know how you and George are doing.
hugs,
Sharlene and Molly Muffin

[Bigdons]

meant to say, it was the LOW DEX that was done

[goldengirl88]

I am so sorry you are dealing with these heart issues. Did they say what they think caused this change? I am praying for you and your baby. Blessings
patti

[Bigdons]

Nope, they haven't a clue !

He has erratic heart beat that is over 170 beats per minute. Have now given him Vetmedin / Forusimide / Dijoxin and an apitite enhancer as he does not want to eat !

Been on them now 3 days. Slight drop in heart rate, but still all over the place. And STILL does not want to eat !

He looks for food, pops it in his mouth then spits it back out !??

Have managed to get some ham and roast beef into him., a few mouthfuls, but that's all.

Drinking normal, peeing a bit more due to the frusimide !

Vetoryl still stopped. Back to the vet Monday !

I'm stumped ! Exausted !

[labblab]

I still have to wonder about the possibility that he is suffering from an adrenal pheochromocytoma. They are rare, but we have had dogs here who have been diagnosed with them. The profile of intermittent Cushing's symptoms, rapid heart rate, and congestive heart failure all fit:


Clinical signs associated with pheochromo-cytoma are often vague and intermittent, and may mimic more common disorders such as hyperadrenocortisism, diabetes mellitus, hepatic or renal disease, or other neoplasms. Clinical signs frequently observed include weakness, collapse, lethargy, anorexia, vomiting, panting, weight loss, anxiety, restlessness, polyuria, polydipsia, diarrhea, abdominal distention, hind limb edema, epistaxis, seizures or acute blindness. The clinical signs are generally associated with catecholamine excess and systemic hypertension. Elevation of blood pressure induced by sudden release of catecholamines can precipitate acute congestive heart failure, pulmonary edema, myocardial infarction, ventricular fibrillation and cerebral hemorrhage. Nonfunctional tumors can also produce clinical signs by their space occupying nature.
And as Sharlene has said, these types of adrenal tumors are sometimes not easily visible on routine ultrasound. I will ask a couple of members who are personally knowledgeable about this stop by.

Marianne

[frijole]

Hi and welcome. I think Marianne is onto something as my dog was misdiagnosed as having cushing . She had false positives onlike 7 tests! Your dog has all the symptoms my dog did.

Pheochromocytomas are rare adrenal tumors that emit a substance periodically that is basically adrenaline. That is why you see spikes in blood pressure and the breathing that is so rapid you think they are in cardiac arrest.

If you live in an area where there is a vet school or internal med specialists I would get a referral and go there for help as a regular vet really can't help. Surgical removal might be an option. Kim

[Bigdons]

How was it treated ?

I've spent almost £800 since Christmas !! Insurance wanted over £100 a Month to insure him ! I couldn't afford it. Other companies wouldn't due to his age !
SO I am paying this all myself !

If he was referred to the Dick Vet in Edinburgh it would be THOUSANDS £ !

[lulusmom]

A pheochromocytoma came to my mind too but my primary guess would be Dilated Cardiomyopathy based on symptoms and the breed. This is so common in Boxers that you can find "Boxer cardiomyopathy on Wikipedia. They state that this is also known as Boxer arrhythmogenic right ventricular cardiomyopathy. This can cause erratic heart rhythm, hypertension, heavy breathing and loss of appetite. I've provided url's to wikipedia, which provides good info as well as a page I found on Wisconsin State University College of Veterinary Medicine that's more easily understood by us laypeople.

http://en.wikipedia.org/wiki/Boxer_cardiomyopathy#Clinical_presentation
http://www.vetmed.wsu.edu/cliented/dcm.aspx

[Trish]

Hi Donna

So sorry to hear George is having these problems, must be such a worry for you to see him fluctuate like this. I agree with Kim and would get him an appointment at a specialist asap to try and figure this out.

Was the ultrasound done on a high resolution machine? If there was an adrenal tumour present sometimes they can still be quite small and not show up on the scanners the GP vets have. So it pays to have them done on with the specialists scanner.

My dog had a pheo and presented with very high BP, however his breathing was not overtly affected although all dogs are different with their symptoms. Just like the LDDS testing, while Kim's dog had false positives Flynn suppressed on the two he had done so unfortunately a pheo is not easy to diagnose. Flynn had his pheo surgically removed 14 months ago now and is doing well.

They really do need to treat his presenting symptoms which they sound like they are, but to get to the root cause of the problem I think you need to see a specialist pronto. It may well be the cardiomyopathy as Glynda has suggested, but it would be good to rule out any other potential problems causing George to be acutely unwell. Best of luck in getting this sorted out, I hope to hear some good news on George soon.

Trish

[lulusmom]

I found an additional site that I found very interesting. I had no idea that there was such a thing as a non-adrenal pheochromocytoma involving canine heart tissue. Per the University of Sydney Centre for Veterinary Education, it's rare but they've been reported. You will note that dilated cardiomyopathy, as well as hyperadrenocorticism are listed as a differential diagnoses.

I'm not posting this because I feel that this may be what you are dealing with but rather for educational purposes. There was a time when pheochromocytoma never came up in conversation but it's been coming up a lot lately, so the more information we get out there, the better.

http://www.vetbook.org/wiki/dog/index.php/Pheochromocytoma

[Woodydog]

How was it treated ?

I've spent almost £800 since Christmas !! Insurance wanted over £100 a Month to insure him ! I couldn't afford it. Other companies wouldn't due to his age !
SO I am paying this all myself !

If he was referred to the Dick Vet in Edinburgh it would be THOUSANDS £ !

Hi and welcome from me.

I take it you are in the UK (Scotland). I have used the Dick Vet School in Edinburgh and it is a very very good hospital. My Locum vet is a teacher there. It would cost you around £200 to get the first appointment with the IMS, they then will tell you what tests they want to run and then will give you the cost of treatment and you can decide to go ahead or not. I know you said you were funding it yourself. I recently used Glasgow Vet School for Woody and they were fantastic and slightly cheaper than Edinburgh, so if maybe you could travel to Glasgow it may save you some money. There is also a fab school in Stirling don,t know much about them, but again could save money.

I hope you find the answers