Hind leg lameness - 10 year old Jack Russell on Vetoryl

[Kane]

Hi there, my 10 year old 20lb Jack Russell, Maya, was diagnosed with Cushings about 3 months ago. She started on 30mg of Vetoryl. After some initial improvements in her symptoms, urinating on the floor during the day, increased thirst and panting, after 2 weeks, the symptoms came back. Her first ACTH Stim. test were very good (unfortunately I don't have the numbers). We continued on the same dose for another month, during this time she developed a pot belly and weakness in her hind legs, she could no longer jump onto the bed or couch and had some difficulty with stairs. There was also the occassional time where her hind legs slip out from under her on slippery surfaces, but never collapsing or anything.

After the 2nd ACTH Stim test her levels were borderline so the dosage was increased to 50mg (now using compounded Trilostane). After 2 weeks at this dosage her thirst, appetite, urination and panting decreased dramatically. But the weakness continued, although her energy levels were improved.

This week after jumping off of the couch she was crying (We didn't see her jump, so not sure exactly what happenned) but after she stopped crying she couldn't walk on her right hind leg at all. There seems to be no pain in the leg though.

The Vet examined it and mentioned a pre-existing "clicking" in her leg and is wondering if that is the issue. She wants to do x-rays. She also did another ACTH test and the levels are at 250nmol/L.

I feel it is unlikely there is a physical problem with the leg as there is absolutely no pain but she continues to limp and collapse if she tries to support herself on that leg. I feel it may be more likely due to the Cushing itself, although my vet doesn't seem think it would be so dramatic if it was progression of the disease.

Just looking for any advice or opinions.

Thanks in advance!

[Renee]

Does she have a luxating patella?

[labblab]

Also, Cushing's dogs have heightened vulnerability to ligament tears. I don't know whether cruciate ligament injuries cause tenderness upon manipulation of the leg, but they definitely cause lameness and pain upon trying to walk.

For what it is worth, a "post" ACTH result of 250 nmol/L (9 ug/dl) is the very ceiling for an acceptable test result in a dog being treated with trilostane, and only if all symptoms have resolved. Unfortunately, another dosing increase may be in order.

Marianne

[Kane]

Thanks for the responses!

She did think she may have a luxating patella but couldn't manually disclocate it. She said it was fairly tight.

We discussed keeping her at the current dose until we figure out what the problem with her leg is. She doesn't seem to think it is caused by the cushings.

[LauraA]

My Cushings girl has a luxating patella and her clicking is quite audible. She varies from dragging the leg to holding it up in the air and not being able to straighten it. Yet at the vets it just clicks and doesn't dislocate on manipulation. 1 month on light duties and 2 weeks on tramadol have helped her greatly.