New...Near diagnosis

[MyDogOscar]

I'm Josh...have a 11ish(rescue) Boxer. Liver:ALP 918(5-160), ALT128(18-121). Urine creat/cort 108(<34). Symptoms significant for inc drinking/urination, lethargy, hind leg muscle mass, and coat thinning. Appetite not excessive except for kids toys and food droppings from lunch/dinner table. He prefers drinking to eating his kibble. We are getting a expanded thyroid panel prior to deciding on going further with stim test/trilostane. History significant for Boxer cardiomyopathy treated with sotalol/mexilitine. Oral melanoma treated with surgery, vaccine for 3 years thought to be in remission. Any thoughts on going full-bore on a dog towards end-of-life? Thanks...

[goldengirl88]

Josh:
You are being very wise doing a thyroid panel. If your dog has other illness's going on it can skew the Cushing's tests. Are you going to have a low Dex test done? About going full bore with an older dog. Well Cushing's is usually seen in mainly older dogs. If you chose not to treat just know that high cortisol damages internal organs. Cushing's is not curable, but is treatable with Lysodren and trilostane. If you do jot treat you dog will eventually get organ damage. It is an individual decision. Dogs can live out their natural lives if managed well on these drugs with a vigilant owner. Blessings
Patti

[Squirt's Mom]

Hi Josh and welcome to you and your baby boy! :)

11 is getting on up there for a Boxer, no question - and good for you for getting him to this age with all he has been through! He's got a good dad!

As for whether to treat or not - that is entirely up to you. I do want to give you some info you may not be aware of...and I'm afraid it is not going to be easy to hear. Boxers, Boston Terriers, and other breeds with that skull shape are more prone to macroadenomas, large tumors commonly called "macros", on the pituitary which causes the Cushing's. Most pups with the pituitary form never have tumors that grow to the macro size - they remain microscopic, or micro tumors. But those with that smush-faced profile like the Boxer and Boston seem to develop the macros more frequently. Another thing that you should know is that studies are showing treatment with Vetoryl (Trilostane) can cause these tumors to grow more rapidly. It makes sense that the same is true of treating with Lysodren, the other drug used to treat Cushing's. The thinking is that the excess cortisol acts as a sort of "treatment", keeping the tumor smaller. Then when the cortisol is lowered via treatment, the tumor loses its "treatment" via that cortisol and the tumor starts to grow more rapidly. So knowing what I do about macros and these particular breeds / head shapes, in your shoes the first thing I would do is take some time to really observe and remember your boy's behaviors lately. Have you seen ANYTHING that could indicate he is already having neurological issues? If I could answer "yes" to that possibility, I would chose not to treat. To help you determine if a macro is a possibility for your boy, I am going to give you a link to a thread here where members who have dealt with macros have posted their experiences.

Macroadenomas -
http://www.k9cushings.com/forum/showthread.php?t=3567&highlight=Macroadenoma



Liver:ALP 918, ALT128. Urine creat/cort 108

Would you mind editing your post to add the normal ranges and little letters that follow the above values? It would look something like -

ALP 918 ug/dl 150-500 ug/dl

I'm glad you found us and hope to learn more as time passes. Remember one thing above all else - YOU possess the very best medicine no matter what may come....your love for your boy. It is obvious from your short post that you have worked hard to give him the best possible life in the face of some pretty rough times. This is no different - your love will lead you to make the right decisions, your love will guide your heart in all things. Listen to your own gut because you know your sweet boy better than anyone else. We will be here to help in any way we can - never hesitate to ask questions.

Hugs,
Leslie and the gang

[pansywags]

Welcome Josh - I'm sorry for what brought you here seeking help for Oscar (and I am always very sad to see another new boxer owner arrive).

In addition to what Leslie said below about macroademonas in brachycephalic dogs, I'd like to add that depending on how it grows, a macro can put pressure on the part of the brain that controls behavior, and can inhibit appetite. This can be confusing as a ravenous appetite is one of the hallmarks of Cushing's.

I wish the best for you and your boxer boy.

[MyDogOscar]

Thanks all...Nothing pointing to neurological, except perhaps your observation about appetite. I'm an MRI Technologist(for people) and see quite a bit of macro/micro studies and I would say 85% are found due to endocrine disturbance. So, what are the types of things done when not treating? To deal with the symptoms? Esp the titanic drinking/urination? He can't have dandelion because he is on beta-blockers(for his heart)?

[Squirt's Mom]

While Dandelion can help tone the urinary tract and sometimes help one of it's main actions is as a diuretic. ;-) Most of our babies don't need help peeing! :D My old girl is incontinent due to age and Dandelion does help her. Stinging Nettle also helped but it gave her diarrhea, too. If you would like to use herbs I suggest you find an animal herbalist or Holistic vet to work with. They will be able to look at the meds he is on and guide you in the right direction.

[Iraklis]

+infinity on what pansywags and squirts'mom said!

If possible get an MRI...if even possible get a second one after 2-6 months!
You won't regret it even for a second!
It might save you tons of money (that you may need later on during treatment/care) and frustration in the long run ,but most importantly Oscars' life!

A cushpup with macroadenoma is something i would never even wish to my worst enemy ,as they say...
Probably the hardest possible thing to treat or deal with...

P.S. As far as herbs or supplements, curcumin/turmeric ,omega-3 i've found help.
Look into artemisinin/artemether/artesunate if a macroadenoma is found (KNOCK WOOD for not found)

(mine was a rescue husky...long story...)

[MyDogOscar]

Negative on the MRI for Oscar, sedatives/anesthesia a no go with his current heart status...it wouldn't be worth the risk...my Vet has lots of eastern methods(acupressure/acupuncture), which gives her lots of contacts in that community, she is putting word out...hopefully it leads to more hopes...

[molly muffin]

Those are good options to look into too.

I hope your vet hears something back soon.

And welcome to the forum. :)
Sharlene and molly muffin