10.5yrs old Pomeranian with cushing's/thrombocytosis/hypothyroid

[wolfberry]

Hi everyone, I'm new to this wonderful website and hope can absorb as much help,knowldege and information about cushing's disease.
My 10.5 yrs old male Pomeranian weight 6.5lbs diagnosed of cushing's disease in recent LDDS test, and thromboyctosis. He also diagnosed Hypothyroid 6 yrs ago and on Soloxine ever sinced.
My concern is the medication my vet suggested (trilostane) will cause him adverse reactions. He never has frequent thirst and urination, or very hungry,infact he is picky eater!but because he is such a wonderful dog, if I ask him to finish his meal, he will, but takes a much longer time than my 2 other dogs. The only that seems like Cushing's is ALOPECIA X, 2 of my pom started losing their hair when they were 5 and 6 yrs old. My other pom has most of the cushings syndrome,but didnt find cushing's through LDDS and ultrasound.
Anyone's baby pet has ever encountered the situation I am having now? same illnesses Mo has? Should I treat him now, or not or wait.......I understand my vet said every pet reacts differently, but Mo is having thrombocytosis and hypothyroid,seems much complicated. And I also read an report saying that if yr dog does not show the frequent thirst ,urinate, do cough, dont treat Cushing's....Im so frustrating and confused.
Here I will list his test results hopefully someone can help me.
LDDS cortisol basal 5.9ug/dl normal (1.8~9.1)
cortisol,post <1.0ug/dl post dexameth. upto1.4)
cortisol,post2 2.0ug/dl normal (up to 1.4)

PLT always high thought because of his extremrme nervousnous at clinic
2011: 871
2012: 562 (large platelets seen, small sz.clumps)
2013: 656
2014: 659 (THROMBOCYTOSIS confirmed,med sz.clumps seen) he is now on plavix
ALT: 2013: 94 normal 3~50u/l
2014: 235
I only typed the high numbers, the rest of the full blood panel/CBC are normal.

He is happy and playful ,no changes, but he collapsed twice this year for few seconds which we never seen before and back to normal himself after the few seconds. Vet said could be something else,or could be thrombocytosis. Very much appreciated if someone can share your experience and thoughts. Thank you so much! hugs

[labblab]

Hello and welcome to you and your baby! You are correct that in most situations when dogs exhibit only lab abnormalities instead of classic outward symptoms, vets recommend waiting to start treatment for Cushing's. One big reason is that in the absence of outward symptoms, the accuracy of the diagnosis is always questionable. In other words, is it really Cushing's that is causing the problems with the labwork, or is it something else?

However, there are a few exceptions to this, whereby the specialists think it may be important to start treatment in order to avoid disease progression regardless of the absence of obvious outward symptoms. Examples I have seen listed previously are high blood pressure and excessive protein loss from the kidneys. I would think that the high platelet count would also qualify since clotting risks do pose a significant danger in the presence of that abnormality, and the abnormality is known to be associated with Cushing's. Since your baby's LDDS result is consistent with the pituitary form of Cushing's, I do understand why your vet is considering treatment.

If it gives you any comfort, there is at least one study that tracked dogs who were treated with trilostane for Alopecia X rather than Cushing's. Those dogs did not suffer ill effects from the drug even though they did not have elevated cortisol at all. Here is a link:

http://www.k9cushings.com/forum/attachment.php?attachmentid=811&d=1394029526

If you do start treatment, one important consideration will be your dog's tiny size. The current recommendation for treating Cushpups is to start with a dose no greater than 1 mg. per pound. So the trick for you will be finding a way to obtain an appropriate dose. If you live in a country where there are compounding pharmacies, you will probably want to get a customized dose of trilostane made up for your baby.

I am sure other members will also stop by to welcome you shortly!
Marianne

[wolfberry]

Thank you so much for your reply Marianne! That does ease my worries a little, since I have read the link you sent me, those 16 poms were quite strong for over the recommanded dosages...I hope more dogs owner will stop by and share some of their experience n knowledges, will other members will see my post?or do I need to post a thread? thanks again! ��

[labblab]

You are exactly in the right place and from this point on, people will just keep adding replies as you and I have done. :)

Marianne

[Budsters Mom]

Yes, welcome for me too! :p You never quite know who's going to be around to answer, but we all pop in as we are available.

Ask all the questions you want. We have some brilliant angels around here who are happy to help. Others pop in to say hi and give hugs and yet others hang around to offer assistance when possible.

It is all a little overwhelming at first. You will get the hang of it soon enough, so don't worry about that.

Again welcome.

[molly muffin]

Hello, and welcome to the forum.

Since thromboyctosis is already a consideration, based on the LDDS, I would go ahead and treat.

My dog didn't have any symptoms, continuously tested negative on the LDDS, while positive on the ACTH and I put off treating, as it wasn't recommended to treat with no symptoms and she had no other problems. Now she has the protein loss with her kidneys and hypertension which is causing blindness. If I had to go back and do it all over again, I'd have started treatment earlier, although I know that there was no way at all to determine that it should be started until things started to go wrong.
We do the best we can, but I think I would go ahead and go with a compound for the low weight. You can still have many happy years ahead of you. :)

Welcome again

[jas77450]

Just want to say hi and welcome...You will learn a lot from these precious caring folks here.

[wolfberry]

Thank you Kathy,Sharlene n Molly Muffin and Cosmo' mom! I am feeling stronger now knowing I will get some help and comforts here, means alot to me. God bless you all xoxo
If decided (which most likely),I will post his progress from the medication and share with you here. But most likely will start in Dec,since after this period of time, I can fully committed on monitor and look after him.
I also suspect my other pom same age as Mo,female has Cushing's disease while few yrs back, I got them from same breeder which I think and strongly believed inherited from same parent or parents if she has it too,although I may be wrong. She will be tested again end of November. Vet put her on Chitosan and Gastro Intestinal low fat diet since her Cholestrol 402mg/dl (normal 359) and Triglycerides 985 mg/dl (normal 116) tested high.If still high LDDS test will be next.
Does Mo's LDDS test results shown early stage of Cushing's?

Mo's mom xo

[wolfberry]

Momo started trilostane and now is on his 3rd day, since we cannot get any less than 10mg trilostane, the vet suggested 10mg for him, he weight 3kg about 6.6 lbs, the nurse accidently gave him the 30mg pill the first day, which I totally freaked out,what a careless mistake! And returned the rest of 9 days pill exchanged to 10mg. He acts like his normal self, he eats well, play and sleep well, will have the acth test done before my vet on xmas holiday on 23rd, will keep posted.

[Squirt's Mom]

Lots of folks use compounded meds, which you can get in any dose size. So if this 10mg proves to be too high a dose for her, you can have the correct dose compounded with someone like Diamondback Drugs. ;)

[molly muffin]

Leslie is absolutely correct. You can get compounded if you are in north america in any dosage.
If you are in the UK, your vet Can request Dechra a 5mg vetroyl pill. I think it is in only available in the UK though and only by special request.

So, see how this works out and then decide.

[wolfberry]

Thankyou, I will speak to my vet again,what if too high or how it adjust since he told me only available in 10mg ,30mg and up. Maybe we can divide the caspules? Vet asked me to bring him back in 7 to 10days for testing, which I will bring him on the 9th day. Thanks for your reply☺

[wolfberry]

Thanks Leslie and Sharlene. We are currently living in Hong Kong, I will order the compounds from the U.S if necessary when he is stable on the certain dose, at the meantime, not sure how the vet will work.on the doses,will call the nurse tomorrow and ask again. Thanks!