Calypso's story (11.5 y/o Boxer)

[Calypso's servant]

Hi, Calypso & I are new here, it looks like a great place, thankyou.
Calyspo is an 11 & 1/2 year old Boxer, diagnosed with cushings about 6 weeks ago.
In herself she was feeling great, still initiating play etc. The 1st symptom she had was not concentrating her urine, (I can't remember the reason I did a specific gravity test). At the time we tested her kidney values only, as she was otherwise well, the tests came back normal. We kept doing the S.G. tests, & watched. Over time her coat got a little "off", she started to drink a lot, pee a lot, had a pot belly, muscle wastage, (though no weakness), & she was skinny.
We did full standard blood tests, (CBC & MBA), nothing was out of the normal range. One of the vets had a cushing's dog & is our most frequent diagnozer of cushing's, so she suggested we do a Low Dose Dex Test, & this came back as positive.
Calypso is now on Trilostane, doing great, she hasn't got her muscles back & her urine still isn't concentrating, but everything else has resolved.
I stumbled over this site looking for alternate therapy, as the Trilostane is so dear. I had found "cushex" on line & it was via searching about for that & the fact that people here had used the stuff & found it was useless ... so already you have saved me some money .... thankyou.
I will continue to look at alternate stuff, I'm a vet nurse in Australia, & one of our clients has a cushing's horse that she's successfully treating with a combo of "things", garlic, brewers yeast, tumeric, & ginger came up in the conversation.
Interestingly Calypso's father, uncle, aunt, & great grandmother all died with seizures, & as I'm learning about cushings's I find that it can cause seizures, & can be inherited. If I ever have a fitting dog again, I will certainly be looking at testing for cushing's !
Thankyou again, I look forward to learning more about this disease, (& hopefully finding alternate methods, even if I can just cut back on the Trilostane).
Carolyn, the devoted servant of Calypso. ;)

[mytil]

Hi and welcome to you and Calypso. I am sorry she is having these troubles.

When you get the chance, post the actual results (number and following letters - nmol or ug/dl) of the Low Dose Dex test. To get an accurate diagnosis of Cushing's one test is not enough. See the link below to read about the multiple tests.

Has your vet ruled out any other conditions such as thyroid problems or diabetes?

Usually dogs with Cushing's have elevated liver values at the very least so for hers CBC to be normal is odd.

Cushing's is one of those diseases where the cause of the adrenal or pituitary tumor to develop is never really known and the seizures associated with it are caused by macrotumors, untreated Cushing's as well as improper administration of the meds (Trilostane or Lysodren). Some breeds seem to be predisposition to develop this though.

Here is a great link to read through - http://www.k9cushings.com/forum/showthread.php?t=180.

IMO I would not waste a single cent on cushdrops --- they are not effective at all in treating Cushing's at all. They may address a symptom, but does not get to the root of the problem and that is uncontrolled production of cortisol. Natural products such as garlic in large quantities has been proven to be harmful to dogs.

Please keep us posted.
Terry

[goldengirl88]

Welcome to the forum. Glad you found us, but so sorry for the reasons that brought you here. I like Terry, want to ask that you post the numbers. I have two questions was your dog tested for diabetes, and thyroid problems? Did you r dog have any other medical issues going on during the LDDS testing? If so that can skew the numbers and produce a false positive. When you mentioned your dog was skinny that is not a symptom of a Cushings dog, they actually gain weight. Cushings is one of the hardest diseases to diagnose. The other issues above that I mentioned also have similar symptoms. With her CBC being normal I would not have jumped into treatment until these other issues were checked, as Cushings dogs usually have elevated liver values. I would be questioning my vet as to why these other things were not eliminated first before going into treatment. Just know a lot of vets are unfamiliar with this disease and it's treatment. Do not put blind faith in anyone! Some of the symptoms you mentioned are Cushings symptoms, but also symptoms of other diseases. Usually Cushings dogs pee a lot and some stat peeing in the house. Then they have to drink buckets of water form peeing so much. A lot of them have diluted urine, which you said yours was ok. So I would be measuring the water intake, as it does not sound like it has dilutes the urine according to your post on the Specific Gravity Test.
How much does your dog weigh and what is the complete daily dosage you are giving? Again I would be questioning my vet on this diagnosis as you do not want to be giving a dog these drugs if they in fact do not have Cushings. If your dog does truly have Cushings you would not want to start them on anything higher than a dose of 1mg per pound or you can be asking for problems. These are powerful drugs and your dogs needs time to adjust to it's cortisol dropping and this new medication in it's system. Dropping to much too quickly can cause Addison's. Were you given a rescue dose of prednisone in the event this happens? If not you need to get one from your vet. You would be looking for lethargy, vomiting, diarrhea, can't stand, or won't eat. These are all symptoms of an over dose. Please get us the numbers so we can see what is going on with your dog. This forum has many years of experience with this disease and my dog would not be here if it were not for this forum, you can trust these people to help you. We will all help get you and your precious baby thru this. Blessings
Patti

[Calypso's servant]

Thankyou Patti & Terry,
I'm racing to get ready for work so this is just a quick thanks. I will try & remember to get the numbers while I'm at work. A couple of quick things that I can answer. She has been tested for diabetes & that's all good. We haven't tested thyroid, & that thought had crossed my mind as well.
She's normally around 26-27 kg ... that equals abt 57 - 59 kg & she's on 120mg trilostane a day .... gosh ..... the vet double checked that, because I asked about the dose .... I know we have much smaller patients on 60mgm. I will ask about the dose rate again.
Patti, her urine is diluted, it's not concentrating, which is why we tested kidney values only in the 1st test.
Terry, I'm aware things such as garlic can be harmful, although I've been a vet nurse 25+ years & never seen a dog that's been ill from garlic .... seen plenty of dogs sick from onions, sultanas, chocolate & fairy floss though. Thankyou for the link Terry, I will have a look this avo when I get back from work.
Thankyou both so much for your comments, it's very much appreciated.
Just quickly before I go, Calypso is doing really well on the trilostane ... even though it sounds like she maybe getting overdosed :(

[Calypso's servant]

Hi Terry & Patti,
Here are the "numbers'', full pathology report. without my surname.
The vet I worked with today, had not been previously aware of this "side" of Calypso ... so he's a 3rd & new opinion. In his opinion the results tie in to Cushing's. He too commented on the fact that she should have been a bit porky, rather than skinny ... however ... she's always been on the lean side, genetically .... add boob tumours of the last 6 months + surgery for them ... may give us a "false" skinny dog ???
Also he said that the Trilostane would have no effect if it was anything else, & if anything, may make her sick ... & she is sooooooo well.
I also dug out her CBC & MBA. Most stuff was as I remembered ... i.e good ...... NEARLY .... there is a couple of little highs & lows, which on a quick internet search shows that Cushing's might be a possibilty. I will leave that for tommorow .... it's been a big day at work, I'm sorry for not getting back sooner.

LDD test results below: THANKS HEAPS,
Cheers Carolyn & Calypso.

Report: Laboratory Results
Record:76657A
Date: 1 APR 14 08:52
Name: Calypso Name: Carolyn
Desc: Brindle Address:C/- Vet Surgery
Breed: Boxer
DOB: 17 OCT 02 Innisfail QLD4860
Sex: Female Neutered
Animal: Calypso Breed: Boxer Client: Carolyn
Clinical Record: 76657A Clinical Date: 1 APR 14 08:52 Vet: EJ
Date Animal Name Test Type Units Result Normal Range H/L Quick View Lab

2 APR 14 19:16 Calypso CORTISOL... nmol/L 65 (15 - 170) 2000187517
2 APR 14 19:16 Calypso CORTISOL... nmol/L 70 2000187517
2 APR 14 19:16 Calypso CORTISOL... nmol/L 56 2000187517
2 APR 14 19:16 Calypso 1ST POST... hours 4 2000187517
2 APR 14 19:16 Calypso 2ND POST... hours See Notes 2000187517
2 APR 14 13:24 Calypso PATHOLO... See Notes 2000187517
Comments
REPORT: 8
General Interpretive Guidelines
Normal dog:
* baseline cortisol 15-170 nmol/L
* 4 hour post-dexamethasone cortisol <28 nmol/L
* 8 hour post-dexamethasone cortisol <28 nmol/L
Hyperadrenocorticism (hyperA):
* 8 hour post-dexamethasone cortisol >38 nmol/L consistent with hyperA
* 8 hour post-dexamethasone cortisol 28-38 nmol/L equivocal
* a small percentage of hyperA dogs may show normal suppression in a LDDS test. Repeat testing in 2-3 months time or
an ACTH stimulation test may be useful.
* adrenal function tests, such as the LDDS test, may yield a false positive test result (i.e. failure of
suppression) in:
* a sick or stressed dog with non-adrenal disease
* a dog being treated with an anticonvulsant such as phenobarbital
* in cases where there is failure of suppression due to non-adrenal disease or phenobarbital, the deviation from
normal is usually not very pronounced
Localising hyperA:
* where there is failure of suppression 8 hours post-dexamethasone pituitary-dependent hyperA may be diagnosed if any
one or more of the following three criteria is met:
* 4 hour post-dexamethasone cortisol <38 nmol/L
* 4 hour post-dexamethasone cortisol <50% of the baseline cortisol
* 8 hour post-dexamethasone cortisol <50% of the baseline cortisol
* if none of these criteria is satisfied, the LDDS test does not differentiate between pituitary and adrenal-dependent
hyperA (an endogenous ACTH assay, abdominal imaging or a high dose dexamethasone test may be useful for
further assessment).
For the endogenous ACTH test, please contact the laboratory for the special sample collection protocol.
REPORT:
Authorised by Dr. Mark Carrigan BVSc(Hons) MACVSc Dip ACVP Veterinary Pathologist Registered Specialist.
If you require further assistance regarding this report please call 1300 44 33 99 to speak with a Pathologist.
IDEXX Laboratories is accredited for compliance with ISO/IEC 17025 (Accreditation No. 10166) in the field of Veterinary
Report: Laboratory Results

[goldengirl88]

Yes everyone is going to want to see the abnormalities on the CBC to incorporate with the above posted information. Blessings
Patti

[Calypso's servant]

Apologies for not being here .......Patti, thanks for your reply. I have been as sick as "a dog" since Monday ... I am just starting to feel human again. Sorta ! I'm still fuzzy in the head :confused: