kat.steele
09-06-2014, 01:29 PM
Hi all,
I am new to the group, but not to having a dog with Cushing's. I have a specific question which I will get to after I introduce Cody.
Cody is 14 1/2, neutered female, lab mix, 38 pounds. She was diagnosed with hypothyroid and pituitary dependent Cushing's almost 3 years ago. After a rocky first year, with difficulty getting control of symptoms and several bouts of pancreatitis, she finally stabilized, except for a couple more mild bouts of pancreatitis in the past 2 years. She has been stable until recently on Trilostane 40 mg per day, Soloxine 0.4 mg per day, and Proin and DES for incontinence management (which preceded the Cushings diagnosis). She is also on a low fat Rx diet to manage the pancreatitis.
The past couple of months she has started anew with Cushings symptoms: PU/PD with increased incontinence, constant panting, increased muscle wasting and weakness in her back legs, pot belly, and a 3 lb. weight loss despite increased appetite. She has diarrhea on and off, though her stool exam is normal. Her last two ACTH stim numbers have been consistently elevated: July: 6.5 / 10.7 and August: 7.5 / 10.5. Her ALT enzyme is elevated at 186.
A repeat abdominal ultrasound on Sept. 3 showed an increase in liver enlargement and severely increased enlargement of both adrenals since the first ultrasound almost 3 years ago. Diagnosis remains pituitary dependent Cushings. Treatment recommendation is to increase Trilostane to 50 mg [30 mg am & 20 mg pm] per day, which was started 3 days ago (no effect noticed yet, but it's very early).
My question: Does anyone have experience with a resurgence of Cushing's symptoms after some time, and if so, what treatment was helpful and what was the cause?? Cody is really uncomfortable but at her age I don't want to do harm by too much intervention. A dilemma I know so many of you have faced.
Thanks!
Kathy Steele
I am new to the group, but not to having a dog with Cushing's. I have a specific question which I will get to after I introduce Cody.
Cody is 14 1/2, neutered female, lab mix, 38 pounds. She was diagnosed with hypothyroid and pituitary dependent Cushing's almost 3 years ago. After a rocky first year, with difficulty getting control of symptoms and several bouts of pancreatitis, she finally stabilized, except for a couple more mild bouts of pancreatitis in the past 2 years. She has been stable until recently on Trilostane 40 mg per day, Soloxine 0.4 mg per day, and Proin and DES for incontinence management (which preceded the Cushings diagnosis). She is also on a low fat Rx diet to manage the pancreatitis.
The past couple of months she has started anew with Cushings symptoms: PU/PD with increased incontinence, constant panting, increased muscle wasting and weakness in her back legs, pot belly, and a 3 lb. weight loss despite increased appetite. She has diarrhea on and off, though her stool exam is normal. Her last two ACTH stim numbers have been consistently elevated: July: 6.5 / 10.7 and August: 7.5 / 10.5. Her ALT enzyme is elevated at 186.
A repeat abdominal ultrasound on Sept. 3 showed an increase in liver enlargement and severely increased enlargement of both adrenals since the first ultrasound almost 3 years ago. Diagnosis remains pituitary dependent Cushings. Treatment recommendation is to increase Trilostane to 50 mg [30 mg am & 20 mg pm] per day, which was started 3 days ago (no effect noticed yet, but it's very early).
My question: Does anyone have experience with a resurgence of Cushing's symptoms after some time, and if so, what treatment was helpful and what was the cause?? Cody is really uncomfortable but at her age I don't want to do harm by too much intervention. A dilemma I know so many of you have faced.
Thanks!
Kathy Steele