9 year old JRT/Schnauzer's parents looking for more options!

[roxymama]

First, I guess I should say I have no idea how the forums work, so I apologize in advance. We have a 9 year old "baby" who is the love our lives. In recent years (3 years ago), we've discovered she has Cushing’s and as a result is now diabetic, has catarax and occasional bouts with Pancreatitis (although we think that's because she became atypical from trilostane-she is now off, and does not seem to be presenting as atypical)
I was wondering if anyone has experience with HMR vs SDG lignans?
We've taken our dog off trilostane as she had an adverse (atypical) reaction and have decided to not do lysodren since she is diabetic and if she becomes addisonian, we're concerned her diabetes might be (more) difficult to regulate.
We've been giving her 33mg of SDG for 3 months but as I research it shows the HMR is faster absorbing and seems more effective. I'm wondering if anyone has seen good results with one over the other and what they think would be a good dosage for a 25.5 dog? (I got different recommendations from our vet, acupuncturist, and the Univ. of Tennessee test results from her most recent test)

Also, if anyone has suggestions for further homeopathic/less severe treatments for Cushing’s/diabetes, any suggestions are welcome. She’s currently on Denamaryn, 18 units of insulin, Melatonin, and Flax...soon to have a cooked diet (we've contacted Cornell to help us work on this) and she does acupuncture every other week. Our little girl has been dealing with the trials and struggles with these conditions for a long time, and we don't want to make her a lab rat, but would like to make her as comfortable as possible for as long as possible. Thank you in advance for any feedback!
:confused::confused:

[Squirt's Mom]

Hi and Welcome to you and your baby! :)

My Squirt was initially Atypical and no, Trilo is NOT the recommended drug for these pups, Lysodren is. Trilo has been shown to cause elevations in the intermediates, which are the hormones involved in Atypical. Atypical is a controversial condition - those hormones can be elevated for any number of reasons and many vets simply do not believe in the condition Atypical Cushing's. ;)

The treatment for Atypical is a combination of melatonin and lignans - either from flax (SDG) or from spruce (HMR). Squirt started out on the flax and her hormones came down. Because the HMR would mean only one pill VS 3 of SDG, I switched her to the HMR and lost all control - all the intermediates came back up. So for Squirt, the SDG worked much better. Others have used the HMR with success tho. ;)

I think my main concern right now is the validity of the Cushing's diagnosis. Can you tell us how the diagnosis came about? Was she tested for the Cushing's while the diabetes was uncontrolled? If so, the test results may have given a false positive and she is not cushinoid at all. It would help us a great deal if you can give more detail about the diagnosis of both conditions AND post the actual test results from the cush tests she has had.

I also want to send you to our sister site, K9Diabetes. They are the experts on this disease and will able to guide you best. You can find them and register at -

http://k9diabetes.com/forum

I'm glad you found us and am sure others will along soon to chat with you. We have several members who's baby's have both Cushing's and Diabetes.
Hugs,
Leslie and the gang

[labblab]

Yes, it would be great if you can tell us more about the Cushing's diagnosis and also the details of what you are describing as the adverse event while on trilostane. "Atypical" Cushing's is a specific diagnosis wherein cortisol is not elevated, but other adrenal hormones are elevated. Is this what you mean, or did your dog instead have an unusual reaction to the medication itself?

Also, how well are your dog's glucose levels being regulated after stopping the trilostane? If you are not having problems in that regard, a Cushing's diagnosis becomes more suspect.

Marianne

[roxymama]

I guess I should clarify and give more history, sorry!
Everything came about before she ever displayed any physical symptoms of Cushing’s (that I was aware of) I had taken her in for a teeth cleaning and cyst removal and her blood work showed elevated liver enzymes (I don't have the numbers in front of me) The vet decided against the surgery and we proceeded to an abdominal ultrasound and an acth test (I cannot remember which came first) The adrenal appeared clear of tumors but the liver enlarged. Her acth stim showed a level of 27 when stimulated-to my knowledge this should be between 1-5? We did not do an MRI but based on the stim and ultrasound it was presumed she had pituitary related Cushing’s.
We only treated with Denamaryn for the liver enzymes and prescription food for 2 years until this September when her drinking increased, she became lethargic and started having accidents in the house. We took her in within a week and her weight had gone from 28.5 lbs to 21. (Within a matter of 2 weeks since last being weighed) She was diagnosed as diabetic and it was only then we started treating her with Trilostane and insulin. It Appeared to be working out great-any cysts she had actually gone down, her acth stim tested at around 3, and her blood sugars were getting better. However, after 4-4.5 months on trilostane, she developed a potbelly, severe pancreatitis and her sugars were back up. They treated her for the pancreatitis and ran the more "advanced" stim test (I believe) that went to the University of Tennessee. It showed increases in all hormones, but still regulated cortisol levels. (again no numbers in front of me but I can provide later) The thought is that while she was typical cushinoid, the medication made her atypical. She's now off all Cushing’s meds (the lysodren makes us VERY nervous especially with her other conditions) We discussed with the doctor and since prior to diabetes she did not present any significant signs of Cushing’s, we are hoping to "manage" diabetes without any drastic Cushing’s treatments. I'm sure it's a stretch, but lately we started to feel like our pup was a science experiment, and she did not seem happy. Since off trilostane, her pot belly has disappeared, her muscle tone is great, BUT her sugars are not perfect (300 on the low end as of 2 weeks ago) and she has some skin plaques which we suspect are from the Cushing’s.
I hope this helps a little....I usually have all her #s at an arm's reach, but she's at the vet today as is my husband with her "binder" in the car

[Trixie]

I'm not enough of an expert to have any answers but since you posted the photo I have to comment on how adorable your dog is! I have a schnauzer and I love J.Russells and I've never seen a combo...so cute! This dog must be one energetic pup with those two breeds combined.
So many here started with Cushings in the exact same manner and appt at the vet in which test results showed the high liver enzymes. We had the same and started like you with Denamarin.
My dog's been treated with vetoryl/trilostane for a year and it took many months and dose tweaking to be controlled. I hope you can get some answers for the best way to move forward treating your dog.

Barbara

[roxymama]

Well thank you :) She is a ball of energy, even with everything going on...and doesn't seem to care in the slightest that she can't see, she just runs :)
I grew up with Schnauzers-Your's is beautiful! I can't believe that there are so many with this condition and I had never heard about it until we got our "mutt"
Please stay in touch, and keep me posted on your baby's progress...I have high hopes for everyone that things can stay under control

[goldengirl88]

Welcome to you and your baby. My Tipper is a Jack Russell, so they are very dear to my heart. I have become aware from the forum and my vet the high number of them having Cushing's. Sorry your baby is having troubles. Could you post the abnormal numbers from the tests you had to diagnose Cushing's and the scale the lab provides for normals as all are different. If this were my dog I would not concern myself with anything else but getting the diabetes under control. If your dog was having these issues during the Cushing's tests, they can have skewed numbers because if this. We need to look at the abnormal results to better help you. I would concentrate on the diabetes as I said. Blessings
Patti

[roxymama]

Has anyone done or considered doing a baby Aspirin regimen to help prevent or alleviate blood clots? I know the clots are a potential risk with Cushinoid dogs, but I’m not sure if there’s anything to help prevent them. –Thank you!

[lulusmom]

It is a really bad idea to give baby aspirin to a dog for preventative care, especially if it is not directed by a vet. Long term dosing can have serious side effects. If a vet feels a dog is having hypercoagulation problems, there are anticoagulant drugs that are prescribed. Are you inquiring because you are worried that if your dog has cushings, you are fearful it might cause a blood clot? If so, I can tell you that we have rarely seen this complication. The most effective prevention is to lower cortisol with treatment.

I assume you have posted this in relation to your original thread. We like to keep all information in one place so I have taken the liberty of merging this post with your original thread.

Glynda

[roxymama]

Thank you, yes, I thought I had added this to my original post. I was just wondering if it's something people do, I had asked my vet, and while he didn't think it was a good long term idea, he wasn't sure if it's something people have done as a preventative measure. I didn't think about it as a concern much (I know it's not as common) until A-our dog has a minor clot due to a jugular stick which caused some mild shaking (it was pressing on her vagus nerve) and B-we took our dog off Trilostane (generic, not vetoryl) I will have to ask if we should consider any preventative (approved) medications as we're currently trying to treat only the diabetes with medication and diet, and the Cushing’s with melatonin and flax. There may come a time when we feel comfortable with lysodren, but she's been through a lot in recent months to consider another risky treatment.

[roxymama]

I'm not sure if this is more for the diabetes crowd, the Cushing’s or both....but I'm really wondering if her Cushing's may have taken a turn...or never been as severe as we thought?
Three weeks ago we took Roxy to the vet for a glucose curve-the lowest her sugar got was 300, so we were told to up her insulin to 22 units 2x daily (high for her weight but not unheard of)
Now this past Saturday we stated her on a cooked diet of lean turkey, green beans, rice and barley-a diet we received from Cornell. Since then her water consumption has dropped from 31 oz. (high) to 11 oz. a day (safe) AND her lowest blood sugar was SIXTY EIGHT. We've lowered her dosage of insulin to 15 units 2x daily to try and get her sugar into a safe, neutral place under the direction of our vet...but really, could the food make THAT big of a change?!
The only other thing I can think is that almost 3 months ago we took her OFF Trilostane and put her on Melatonin, Flax and Acupuncture. Perhaps that finally starting to work in full gear along with diet was enough, but it concerns me that there is now some other problem-it seems way too good to be true.
Has anyone ever experienced something like this?!??:confused: