need help with info on k9 cushings please

[Anita]

Anybody have info that would help with Cushing's , my dog has no side effects but was diagnosed last May.

[labblab]

Hello and welcome! We will be happy to help in any way we can. You can help us do that, though, by telling us more about your dog ;). Can you tell us what led to the testing for Cushing's, and what testing was done? Is your dog taking medication for Cushing's or for anything else? How about your dog's breed, age, and weight? Those things can all factor into treatment considerations.

Thanks in advance for any info you care to share with us! We look forward to talking with you and doing our best to answer any specific questions you may have.

Marianne

[Anita]

Sammy 9 years old male miniature poodle 19 lbs. Went for teeth to be cleaned needs to pull2 teeth did blood work found his liver enzymes were elevated. Gave me denimarin to give for 1 month than brought back for more blood work CBC and found it didn't go down much than 2 weeks later. we brought Sammy to the vets for the all day blood testing it was sent out to a vet. university vet school for testing a week later results came back Cushing's I went holistic with milk thistle for liver and adrenal harmony gold which I have been giving both since June he was diagnosed the end of May I stopped the harmony gold as you suggested it was causing him not to pee at all and drink very little water since I stopped harmony gold he pees and drinks normal no signs of Cushing's so far he plays barks jumps and alert is normal my vet is coming in 2 weeks to talk about what to. do do you think the results were correct any help u can give me he is my heart I he means the world to me thank you so much

[mytil]

Hi and welcome from me too.

When you can, post the actual numbers of the all day test performed - since you mentioned an all day test it points towards a LDDS test where there are three results (baseline, 4 hour and 8 hour).

Has your vet mentioned anything about other conditions such as diabetes of which has similar symptoms of excessive peeing and drinking?

Terry

[Squirt's Mom]

Hi Anita!

Nice to see you here! I'm glad stopping the Adrenal Gold seems to have brought some improvements to your baby. Smart move, Mom! :)

To help you out a bit, I'm gonna give you a list of common Cushing's signs. When I first started this cush journey, I didn't realize some of the things I had been seeing in my baby were actually signs of her illness, not just getting older.

From Kate Connick -

The most common symptoms include:
• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures

If you could get the actual results of the testing done so far and post them here, that would help us a great deal toward helping you and your sweet Sammy. The all day test is called an LDDS. We want to see all the info on that test. On the CBC and health screening, we would like to see all the abnormal values, things too high or too low. Be sure to include the little letters and normal ranges for each abnormal value. It will look something like this -

EXAMPLE -
ALPK 1500 ug/dl 150-300

Hang in there sweetie! You are in wonderful hands here and I'm sure more folk will be along to welcome you and Sammy, and share their stories with you. We will be with you every step of the way. You and Sammy have a new family now, you will never be alone on this journey.
Hugs,
Leslie and the gang
(Leslie from Facebook ;))

[Anita]

I will gather all of the paperwork together that was sent to me as of now Sammy has no symptoms that is why I'm puzzled thank you guys so very much my baby is a sweetheart and is by my side 24/7 he saved me when I had a asthma attack when he was only 11 months old he goes overboard for me

[Dixie'sMom]

Hey Anita! I am glad you started a thread on Sammy. The folks here are very knowledgeable and can help you in ways that your vet may not have the time to. I look forward to hearing more about your sweet Sammy and am encouraged since he is not showing any true Cushing's symptoms. Hang in there! Help has arrived!

[Anita]

Dexamethasone supress3 cortisols suppression results
Pre- Dex 12.2 ug/dl 1.8-4.
Post Dex 1. 0.872 ug/DL. 0-0.5.
Post Dex 2. 3.64 ug/DL 0-0.5

chemistry.
Triglyceride 257 H.
Cholesterol 341 H.
ALKphosphatase 164. 174 H
ALT154. 120 H
Glucose 101

he is a dog that gets very nervous away from me has seperation problems. terrible he will even scream like he is in pain when away from me any and all help will be greatly appreciated love and hugs to all Sammy's mom Anita and sammy

[Squirt's Mom]

Hi sweetie,

Sorry for the delay in replying to this. I didn't see it yesterday. And now that I have, I have a few more questions.

There seem to be some numbers that I'm not sure where they belong or what they mean. These -


ALKphosphatase 164. 174 H
ALT154. 120 H

Are the first numbers Sammy's results or the second number?

Also, on the chemistry results that you posted would you mind adding the normal ranges for them? Different labs use differing norms so it helps us to see what they call "normal". ;)

They would look something like this -

ALT 154ug/dl 120-130 (EXAMPLE)

Are there any comments after the results of the dex suppression test (called an LDDS)? There is usually info from the lab about how to read the results.

Now if I am understanding these chemistry results, I can tell you that we have seen liver values (the ALPK in particular) MUCH MUCH higher...in the 1000's is not uncommon. So try to take a deep breath on that one. This liver value is almost always very, very high in cush pups and usually comes back down with treatment, but not always back to normal.

If Sammy is that stressed when away from you, I have to wonder about the veracity of any test results for Cushing's. Stress of any kind can skew the tests causing false-positives but hopefully one of the gurus here will have better input on this facet. :o Have you talked to the vet about something to help calm him? Is it possible that the things you are seeing in Sammy that are concerning you could be the result of extreme separation anxiety and not Cushing's after all? It is so sad to see one in this state. I had a little foster who would literally throw herself at doors if I closed them, like to go to the bathroom. She had to have me in sight at all times or she just fell apart. :( Luckily, she found a home with 2 sisters who are always home and she is as happy as can be. So I understand a tad bit how hard it is to see your precious boy so upset.

I am sure others will be along to offer their input as well. Hang in there, sweetie.

Hugs,
Leslie and the gang

[lulusmom]

Hi, Anita, and welcome to you and Sammy,

Was Sammy fasted for these tests? Even without the benefit of normal reference ranges, the ALKP and ALT elevations are minimal and I'm, therefore, not sure why your vet pursued a cushing's diagnosis given that Sammy is completely asymptomatic. :confused: With the LDDS test being consistent with pituitary dependent cushing's, has your vet recommended treatment? As Leslie has already mentioned, the ldds test can yield false positive results if a dog is highly stressed or has a non adrenal illness. Considering the scant evidence of cushing's at this point in time, I personally would question the validity of those results and the diagnosis in general.

I'll be looking forward to hearing more about your precious Sammy.

Glynda

[lulusmom]

Here are prior results of blood chemistry after one month on Denamarin which now includes the normal reference ranges:

Triglyceride 257 H (25 - 160)
Cholesterol 341 H (125 - 250)
ALKphosphatase 174 H (10 - 150) Previous result pre dental 164
ALT 120 H (10 - 100) 154 Previous result pre dental 154

Hemolysis 2+

All in all, those elevations are very mild and hemolysis may have contributed to some it. Sammy has no symptoms. No PU/PD and will hold his pee forever. He has always been a picky eater and no change there. No panting, coat is fine with regrowth after groomings, no skin issues, no pot belly, no muscle wasting but does have arthritis and displays discomfort if handled incorrectly.

Sammy suffers extreme anxiety in vet's office or anywhere if separated from Anita so result of LDDS test should be questioned, especially since Sammy has no symptoms. Vet has told Anita that Sammy only has two years to live and wants to start him on Vetoryl right away.

Two years is an average, based on the fact that most dogs who are diagnosed are already pretty senior. I absolutely would not recommend starting treatment and would continue with the milk thistle and follow up with recheck of blood chemistry in three to six months. You can recheck sooner, if Sammy should start to display any symptoms that are commonly associated with cushing's.

Anita, I have provided a link to some excellent information on when and when not to test for cushing's. This is one of Dr. Mark Peterson's blogs for veterinarians. Dr. Peterson is a renown endocrinologist who your vet should make a concerted effort to follow. Here are two excerpts that are very relevant to Sammy's case:

Who should be tested for hyperadrenocorticism (cushing's)

Testing for hyperadrenocorticism in a dog should be done because they have one or more clinical signs of the disease. Typically the disease is insidious and slowly-progressive, so most dogs have had clinical signs, such as abdominal enlargement, panting, muscle weakness, thin skin, lethargy, polyphagia, polyuria and polydipsia (PU/PD) for months to even years before the owners recognize a problem and seek veterinary help.

Sammy has none of these so he should not have been tested.

Who should not be tested for cushing's

Testing for Cushing's syndrome is not recommended if the only abnormality is an increased serum alkaline phosphatase (SAP) activity on a serum chemistry panel, and the dog is otherwise apparently healthy. It is difficult enough to interpret endocrine tests in dogs with clinical signs of the disease; if they have no clinical signs, all of the endocrine tests may be difficult to interpret because of false-positive and false-negative results.

I believe Sammy is a dog who should not have been tested for cushing's.

Your vet can also learn a great deal about the disease and treatment from Dechra, the manufacturer of Vetoryl, who offers veterinarian continued education on the subject. They have an excellent line up of specialists who are frequent contributors. I've included a link to their site as well.

http://endocrinevet.blogspot.com/2011/02/diagnosing-hyperadrenocorticism.html

Dechra CE:
http://www.dechrace.com/

Anita, I hope this information will help you when you discuss this matter with your vet. I highly recommend that you provide these links to her. I would also print out the actual blog by Dr. Peterson and give her the hard copy. I would underline the excerpts I posted as well.

Glynda

[Anita]

Dixie's mom can you get in touch with me Glynda has my number thanks Sammy's mom

[lulusmom]

Hi Anita,

If you have any particular questions about Sammy that perhaps Dixie's mom or anyone else might be able to help you with, can you please post them here so that we can all follow along with you on Sammy's cushing's journey.

I hope Sammy is doing well today and I look forward to your update on the visit from your vet. I do hope she is open to learning more about diagnosing cushing's.

Glynda

[Anita]

Hope everyone is doing better everyone has taught me a lot I'm so thankful I found. you everyone thank you please write if you get this I'm still having trouble leaving reply's Sammy is sitting next to me I have been crying since June can't wait to see the vet Oct. 22 thanks everybody especially Glynda your a sweet heart. hugs Sammy's mom anita

[Dixie'sMom]

Hey Anita! I would be happy to talk to you but all I can really offer you is moral support. It sounds like Sammy's diagnosis may be in question since he doesn't really follow the typical Cushing's pattern. My dog, Dixie, is classic Cushing's so it was much easier to make a decision about medication since she was obviously showing most of the symptoms of Cushing's and her testing was also classic Cushing's. There are several parents of pups on this board who are in the same position as you with the diagnosis being in question. For that reason, the experts on this forum (many with over 10 years experience in dealing with Cushing's pets) can best help you navigate thru the medical system with regard to Sammy's particular case. I on the other hand, came here just like you, with so much anxiety and fear about my baby that I couldn't make heads from tails about the next steps to follow. It was so helpful for me to have them say, "We're here for you...You are a part of our family now... and Do this or do that next. It helped me to calm myself and clear a pathway to best help Dixie. And she is doing so well, I will forever be grateful.

I will call you if you would like to talk, but you will have to PM me your phone number. I do not think the moderators or administrators of the forum are allowed to give out personal information and you shouldn't post it publically for your own safety. If you are having trouble posting on the forum, let the administrators know so they can help you with your login, or I will be happy to walk you thru trying some things if you will PM me.

Take a big deep breath. I don't think Sammy is in immediate danger so we have time to figure out whats going on with him. And even if he doesn't have Cushing's, you will still be welcome here. Hugs for you and Sammy!

PS... what did the vet say?

[Dixie'sMom]

Ok, I think we were writing at the same time. Your post came thru fine. We will figure out what is going on with Sammy. Your vet shouldn't have scared you to death. Look at him. He's not dying. He's. Not. Dying. Hes playing and peeing and pooping and barking and eating and loving you just like normal. Sammy probably doesn't even have Cushings so stop crying honey, he's going to be ok. We'll help you figure out whats going on. In the meantime, take a big deep breath and keep reminding yourself that if he has no symptoms, acts like he feels good then he probably IS good. Do you think consulting another vet would help? Maybe someone on the forum knows of a good vet in your area that could give you a second opinion.

Hugs and prayers for you and sweet Sammy. Hang in there Anita!

[Anita]

Thanks Ladies! I keep forgetting about the other forums and all the info there.... Or maybe I just miss y'all and need to see a post from you. hahaha! <3 :)

[[B]hello to everyone I feel a little better now but if someone knows of a vet in the area that deals with Cushing's we have Cornell Veterinary College about 100 miles away I think but I don't think there is a clinic there I think it is a lot more than a vet or a specialist don't really know for surei'm not sure how to private message yet Thanks Dixie's Mom Squirt's Mom LuluMom and to everyone else love and hugs to all by the way we live between Utica and Syracuse New York sSammy's mom anita

[doxiesrock912]

I used Cornell and the specialists there are phenomenal!
Dr. Dormant is their lead expert. If Sammy has Cushings, he'll find out either way.

[Dixie'sMom]

Anita, if you want to private message, just click on the name and choose "Send a Private Message to xxx"

If you want to see if you have any private messages, look at the top where it says "Welcome Anita" and it will tell you if you have any private messages. See mine below. Click on Private Messages. Does that help?

Welcome, Dixie'sMom (http://www.k9cushings.com/forum/member.php?u=4344).
You last visited: Yesterday at 11:01 PM Private Messages (http://www.k9cushings.com/forum/private.php): Unread 0, Total 10.

[molly muffin]

Checking in to see how you and Sammie are doing.

You can start going through the vets in your area, calling them and asking if they have experience diagnosing or working with cushing dogs, etc.

Sharlene and molly muffin

[Silliam]

he is a dog that gets very nervous away from me has seperation problems. terrible he will even scream like he is in pain when away from me any and all help will be greatly appreciated love and hugs to all Sammy's mom Anita and sammy

My dog had some separation issues as I used to go to hospital a lot more frequently and I found rescue remedy by Bach flower essence to be good. When my grandfather passed (he lived with us) it got a lot worse but my dog is now a lot better although I can't say he is completely cured but a drug called clomicalm has helped a lot. It is a type of antidepressant that seems to specifically target separation anxiety in dogs. I especially like the fact it reduces anxiety and doesn't just sedate your pup. The first day or so of treatment he was sleepy but after that it was more like the anxiety volume was turned down which you can then enhance with behaviour training. Like I would leave the room and then return before he freaked slowly he trusted I would come back.

[Anita]

:)hello to everyone waiting for the vet to come on Wednesday will have more blood work done Sammy still the same more active than ever I don't know if it is the liquid milk thistle or the omega 3 he gets we will see as time goes on I want to see what the vet has to say as far as his anxiety I'm so use to it right now I will see what happens in the future I want to put less as I can into his system I hope you receive this thanks to all and your babies are all beautiful I feel for all of you we all love are dogs they are special to us love to all Sammy's mom Anita again thank you for everything you all have done so very much

[Squirt's Mom]

Good to hear from you, Anita! And it is good to hear that Sammy seems to be doing a bit better! That is great to hear! :cool::cool::cool: Do let us know what the vet has to say. Must be nice to have them come to you instead of trekking off to see them. :)

[Dixie'sMom]

Hey Anita. I'm glad to hear that Sammy is doing good. It will be interesting to see what the vet has to say tomorrow. I'll be watching for your update. Hugs to you and Sammy!

[Squirt's Mom]

How is Sammy? What did the vet have to say?

[Anita]

Hello to everyone very disgusted the vet didn't agree about anything I told her and insisted Sammy had Cushing's she said don't believe everything on the internet she doesn't think Sammy was to nervous when he took the LDDS test she said she knows about Cushing's I told her Vetoryl could be dangerous she said in 10 years she never heard of a dog dying I told her the blood work was mild elevations she said she knows it'cushings plus she said his cataracts got a lot worse than when she saw him a few months back she did another blood test but she couldn't get any urine out of him so she couldn't get that she was I'm the vet and I know better than what your telling me so I'm besides myself been crying all day everybody knows Sammy has anxiety without me she said he was calm maybe because he was scared to death with all the big dogs barking no one knows there dog better than his owner and my friends and family but she has a different opinion her opinion I guess I tried to call area people I needs to talk to someone but the number won't go through I hope everybody gets this cause I'm besides myself right thank you everyone for trying to help me I won't have the results till next week from the bloodwork

[Dixie'sMom]

Hey Anita. I'm sorry to hear that you had a bad day yesterday and the vet visit didn't go as you had hoped. Sometimes vets, like other doctors, can be very arrogant and most of them are quick shoot down anything you have read or learned on the internet. I agree that you can't believe everything you read on the internet, but in this case, you are on a very knowledgeable website where Cushing's is concerned. She just doesn't know that.

I'm sure the others will be along soon to offer their help, but for now all I an really suggest is that you get a second opinion on Sammy. Thats what I would do if I were in your shoes. And it is also important that you have a vet that is willing to work with you and put you at ease. Hugs to you and Sammy today. I wish I could do more to help! Hopefully others will be along soon.

[molly muffin]

Hi Anita, well most of us have been down this road one way or another with vets. My vet too told me not to believe everything I read on the internet. I very kindly have said, I don't believe anything I read or am told without something to back it up.
What I have learned is don't just say "the internet" it is too easily discarded and it's true there is crap on the internet just as there is anywhere. However, if you say, the manufacture of the drug recommends This, and Dr. Peterson, the expert in cushings recommends This or That, Dr. Feldman says this or that.
Now if your vet doesn't know who Dr. Peterson or Dr. Feldman are? Leave as fast as you can. They are the leading experts in cushings disease and Dr. Peterson is on the continueing education with the manufacturer of vetroyl (the cushings med most vets dispense)
Quoting them gives you leverage. Frankly I use that leverage freely as needed.
Now did they do blood work today? What blood work did they do? You said she couldn't get any urine? uh, excuse me? If you have to do a free collection, take it in and get it tested. First pee of the morning is usually best. If male, let them dribble a bit and catch the rest.
Now, lets see what these tests show and go from there.
Sammy is feeling fine right? Playful? :) That is what is important!

hugs
Sharlene and molly muffin

[Anita]

Sharelene and Molly Muffin my vet will not listen the paper I had printed out she wouldn't look at she said I have to trust her if I want her for my vet I tried to tell her he has no symptoms and why did she test him she insisted it was Cushing's I had a very trying day was so stressed out couldn't sleep all night my poodle is my world like I said he saved my life when he was only 11 months old and a friend 's toy poodle died today very sad I will wait for the blood work next week she will insist on telling me if it is better or worse she doesn't want to give me the paper with the facts she wants me to go by her word cause when I mentioned I want the paper she gave me a funny look I know she is the Dr. but to me Sammy is not any other dog like if he dies you can get another no way my last poodle got out of the house and was hit by a car I never got over that I was heartbroken for 20 plus years before I got another poodle Sammy and I will be damned if I let anything happen to him over stupidity it seems like I'm at deaf ears thanks everyone for there help any suggestions or ideas are greatly appreciated and Sharlene I doubt if she would et me get his urine and take it I doubt it very much poodle hugs to all Anita and Sammy

[molly muffin]

What are the possibilities for getting a different vet then? This one does not sound very good at all, as far as being a team player.

Sharlene and molly muffin

[Squirt's Mom]

Anita, you need to RUN from this vet. She is arrogant - and arrogant vets are dangerous. You need a vet who will listen and work with you as a team, not one who insists on being a dictator. ;)

[Anita]

the vet's office called tonight and said the liver elevation was a little bit better and the rest of the blood work minus urine test was good and keep using the milk thistle and mailing results next week I will post them the administrator of Cushing's was right I will find out more next week is the vet finally thinking about what everyone said or read this site I wonder we will see poodle hugs Sammy's mom Anita and bigger hugs from sammy

[Dixie'sMom]

Anita, when you last talked to the vet's office did they say anything about starting Sammy on medication for Cushings? How is he feeling?

[Anita]

hello to everyone no the vet did not say anything about starting any med for Cushing's yet I'm still waiting for the blood work results in the mail maybe it will be here tomorrow I will post results right now Sammy has been sick was vomiting that stopped very loose stools now pudding like putting him on boiled chicken and rice this happened today I guess kaopectate tomorrow I wonder if the kennel cough spray in his nose caused it thank you eeveryone especially Dixie's mom and Squirt's mom poodle hugs to all Sammy's mom. Anita

[jas77450]

Hang in there sweetie!