17 month old Maltese with Cushings

[Lollies Mom]

1/15/15 Lollie started shivering, which was odd for her, but I put one of her sweaters on her. This being a Thursday and come Monday she was to the Vet. She was luckily a 10 lbs Maltese when this started. The initial full blood panel came back with all in the normal range. The first phone call from my Vet with these results was Wed morning and was told just to watch her as maybe this was a fluke and shed be fine. By Friday I had her back in the Vets office as she wasn't eating and had lost 3lbs in a week. They took more blood and said they'd call Monday with the results. Unfortunately, I had to demand one of the Vets to prescribe a medicine to stimulate her appetite so over the weekend she potentially could regain some strength as shed become nothing but sleeping flesh and bones. This did work and she started eating. The blood work came back with results of Cushings. The Vet called me with the news and wanted to run a final test to be 100% certain before prescribing 10mg Vetoryl. It came back positive and she started her medicine 2 weeks after symptoms started. Feb 9 she was taken back to the Vet for her testing on tolerance to 10mg and came back good. She will continue on dosage. Lollie is a very smart playful loving little girl who I love dearly. With it being so rare for a 16 month old Maltese to have Cushings of the adrenal gland..Its so hard to ask this..Does any one know what I can expect for her? Will her life be shortened? Shes at 7.4lbs, has lost 1/3 of her fur, sleeps 3/4 of the time, and eats about half of what she used to. Please share..I cant find anything on google relating to Cushings effecting a younger dog. Thank you in advance.

[Harley PoMMom]

Hi and welcome to you and Lollie!

I have manually approved your membership so now all your posts will be seen right away. Also, please just disregard the validation email that was sent to you from k9cushings.

Although it is rare for a young pup such as Lollie to have Cushing's it's not impossible. You mentioned that Lollie has the adrenal type of Cushing's, was this diagnosed via an ultrasound?

It would help us if you could post the results from all test/s that were done on Lollie, we only need to see those abnormal values, as an example: ALT 150 U/L (5-50). We are especially interested in the test results that were performed to diagnose her Cushing's. Is/was Lollie taking any herbs/supplements/medications?

Cushing's is one the most difficult endocrine diseases to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing it and other non-adrenal illnesses can create false positive results on tests for Cushing's. Dog's with Cushing's usually have a ravenous appetite, drink buckets of water and pee rivers, they also tend to have some hair loss and skin problems, does Lollie have any of these clinical symptoms?

A diagnosis of Cushing's is not a death sentence for a dog. Cushing's is a treatable disease but success in treatment does depend on a few things; keen owner observation, a pet parent willing to educate themselves about Cushing's, and a vet/IMS that has experience treating Cushing's and is knowledgeable about the protocols for Cushing's.

The primary goal of treatment is not to cure the disease but rather to eliminate clinical signs. However when a dog does have the adrenal form of Cushing's surgery can be a complete cure if Lollie is a good candidate.

Please know we are for you and Lollie so do not hesitate to ask all the questions you want, ok? Looking forward to hearing more about your precious Lollie.

Hugs, Lori

[ShibaMom]

Welcome, Lollie's Mom,

I'm so sorry to hear your sweet little baby has Cushing's. That must have been scary to experience the onset of her symptoms, and not know what was going on. That was a lot of weight she lost! I'm glad you pressed for something to stimulate her appetite. Way to go, Mom :)

Once you post Lollie's test result values (abnormal ones), Lori and others will have plenty of feedback and guidance. I'm pretty new here, too, and it's priceless to me, to have found this amazing group of caring people.

Cheers,
Samantha

[labblab]

How is Lollie behaving now? Has her appetite returned? I must tell you I am very concerned about the Cushing's diagnosis and trilostane treatment because there is absolutely nothing about her clinical presentation that is consistent with Cushing's. From what you have said, her only symptoms are shivering, loss of appetite and weight loss. Cushing's dogs typically exhibit ravenous appetites. Plus, her original blood panel was normal (which would be unusual with Cushing's). I am very puzzled as to why your vets even suspected Cushing's in the first place so as to even test for it. The problem is, both of the blood tests that are used to diagnose Cushing's can register "false positives" in the face of illnesses other than Cushing's. There is no test that is 100% accurate in identifying the disease, and that is why evaluating symptoms is perhaps even more important than a blood test when making a Cushing's diagnosis.

I have to tell you honestly that unless Lollie has other symptoms than what you have described so far, the Cushing's diagnosis would be highly questionable in my mind, regardless of the test results. As I say, the tests can both be unreliable in the face of other illness.

Marianne

[Squirt's Mom]

Hi and welcome to you and Lollie! :)

To reinforce what Marianne said about false-positives, I wanted to tell you about my Squirt. She was diagnosed with the pituitary form of Cushing's based on five different tests - the LDDS, HDDS, ACTH, UTK panel, and 2 abdominal ultrasounds. The ultrasound found a tumor on her spleen. Once the tumor was removed, her cortisol returned to normal. The stress of that tumor caused her cortisol to rise as a natural response - that is what our bodies are supposed to do in other words when under stress of any kind.

Had I simply accepted that first test result and started treatment, my Sweet Bebe would have died much sooner. If not from the treatment itself, from the tumor when it ruptured. Instead, she lived another 6 years, passing in May of '14 instead of sometime in '08.

Because of our experienced, it always terrifies me to see someone start treatment based on one test. Please watch your baby very carefully for ANY thing that is different. I'm glad you found us!

Hugs,
Leslie and the gang

[Lollies Mom]

Hi! Thank you for the response! I do not have the results from the tests, as the Vet just called the results to me. I can attempt to retrieve a copy on Monday. He only stated they were all on the normal range. Her symptoms were constant tremors, even while sleeping. Barely eating a couple teaspoons of food a day, drinking almost non stop, urinating as soon as shed drink. Also I wanted to share that she isn't around other dogs and only uses puddle pads..shes never been outside except if I was holding her. The test that have been ran are:HW/Lyme/Ehrlichia/Anaplasmosis/ADD220, A-ACTH Response-2 samples ACTH2,Dexamethasone SA(ml),Dexamethasone Supp test,Dex Supp test(T450), Dexamethasone SA (ml), then A-ACTH response- 2 samples ACTH2 and ACTH-Cortrosyn .25mg These were all found, by date order, on all of my receipts. He stated Adrenal gland tumor. They do not have ultra sound equipment in their office. Id inquired about this once we hit $800 and the hours of reading Id done that potentially an ultra sound might alleviate some cost by narrowing down where the problem actually was. Lollie is doing better. She still isn't what she was before as an active 17 month old now, but she's better. She's eating, (about half of what she did before), drinking normal, urinating normal, medication causes constipation,but she's now more normal. She sleeps a lot. Tremors are gone. I will forward the test results as soon as I can retrieve them. Thank you for your thoughts. They are very appreciated. She was not on any medications prior to diagnosis.

[molly muffin]

Hi, just checking in on you and Lollie. Did you get a copy of her test results yet? How is doing?

[Lollies Mom]

Hi! I just received the test results. Cortisol Serial 3(DEX) time 1 845
time 2 1245
time3 445
Cortisol Sample 1 4.4 ref range 1.0 - 5.0
Cortisol Sample 2 Dex 7.9 (high) ref range 0.0 - 1.4
Cortisol Sample 3 Dex 4.5 (high) ref range 0.0 - 1.4

Lollie has lost half of her fur, she sleeps most of the time now, she eats about 1/3 of what she used to but she is acting more normal now when she is awake. Her tremors are gone. today was day 27 on her 10mg dosage. I hope this helps. Please share your thoughts on test results please. Thank you for helping me.

[labblab]

Thanks so much for returning and giving us this additional information -- both the test results and also some more specifics about her symptoms. This test looks to be one of the original diagnostic tests, is that correct? It appears to be a LDDS test, and if so, the results are consistent with Cushing's. However, they do not point to one type over the other (tumor of the pituitary gland vs. tumor of the adrenal gland). You would need to advance to an ultrasound or some additional blood testing in order to sort that out. That info would be of value to you if you might consider surgery in the event there is an adrenal tumor. Surgery can offer a total cure, but it is an expensive and risky undertaking.

But overall, the test is generally consistent with Cushing's, as are some of the symptoms. Other symptoms remain somewhat puzzling. However, if your assessment is that Lollie is doing better since starting the trilostane, that does give greater confidence in the accuracy of the diagnosis. Can you possibly get the actual numbers for her recent monitoring ACTH test? This was the test that was just performed in order to judge the appropriateness of continuing with the 10 mg. dose.

Thanks again, and I am very glad that Lollie seems to be doing better.

Marianne

[Lollies Mom]

Thank you for your response. It makes me feel better having someone else confirming the initial findings. I apologize, Id requested all the test results to date and this is what I received. Ill inquire to the ACTH test you've mentioned and reply with those findings. Ill attempt to attach a copy of the sheet with the initial findings as well. There was blood taken and sent to a lab in Chicago for her final assessment to determine if that of the adrenal or pituitary. I was called with the results indicating adrenal. I could email you the sheet Ive received, but Ive attempted to include in this post with out success.
Thank you again for your help...I cant express enough the comfort to hear Im doing the right thing means to me.

[molly muffin]

The best way is to convert something to a jpg (you can do this online for free) from a pdf and then load the picture into an album.

How is she doing?

[kaibosmom]

My dog Kaibo was very young when he got Cushing's disease, unfortunately it took way too long for the actual diagnosis. In the end, he had an adrenal tumour (right) and we did have it removed in July 2013. The Cushing's was cured for several months. Unfortunately, Kaibo makes his own rules up and he has recently been diagnosed with Cushing's again. It is my understanding that this is not normal. Did I mention, Kaibo doesn't follow the rules? Lol. I'll keep checking in here but feel free to ask me any questions. I have similar questions about his life span after getting Cushing's so young, but in the end, it's best to just enjoy every day I get with him. Take care.

Nikki