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Tobyroo
03-21-2015, 01:38 PM
Hello everyone. Thank you for having such a wonderful community built here. I have been lurking and reading comments for a few days and I am finally ready to post and ask for some advice, help and some understanding.
I will start at the beginning of this journey that we have been on with Toby. I have had him since we was a teeny pup, only 5 weeks old. He just turned 11 on February 26th of this year. He has always been very active, woo wooing all day and just in a generally good mood. On January 23rd, 2015, Paul took Toby for a walk. Everything was as usual until they got back to the door. Toby fell to his side and had a grand mal seizure. Paul rushed him to the vet within the hour. The vet ran a blood test as well as a urine test. I thought for sure that he had diabetes ( I had a cat with diabetes that had seizures at one point in my life) Toby had exhibited a few other symptoms that came to mind after his seizure. He had become food crazed, even scavenging for 10 to 20 minutes at a time even though he had just had a full meal. He also become a bit lethargic, just kind of lying about. I chalked it up to old age, but after the seizure, I started trying to piece together other symptoms. The blood test came back. Thyroid levels were low. Glucose was fine. And the urinalysis showed a uti. We treated him for he uti. The vet thought that is what caused his seizure. The uti cleared and he had another seizure on February 20th, 4 weeks exactly after the first one. Paul took him back to the vet and while there he had an episode of what I call "shaky legs." I have since found out that his legs shake more than likely due to muscle weakness and general intolerance to exercise.....anyways the vet freaked out and said that she had never seen that before and that we needed to take him immediately to a neurologist.....as much as I wish we had an endless money supply, we don't, and a neurologist would cost thousands of dollars. I knew that there had to be a more cost efficient way to diagnose his issues.
My sister in law raises boxers and she thought with his symptoms that it could be a thyroid issue. She suggested that I have his blood tested with Jean Dodds at Hemopet. Not knowing that Jean Dodds is a celebrity of sort with thyroid research in dogs, I gave her a call and low and behold, she called me back. She was very kind and told me after sharing Toby's symptoms that he more than likely had a thyroid issue and thyroid issues are easy to manage.
That same day I called a new vet, because I was not going back to the other one. The universe aligned for Toby that day, because this vet was familiar with Dr. Dodds, thyroid issues and just seemed to have a better knowledge of what we might be dealing with. We ran more blood tests and checked his urine's specific gravity. His kidneys are fine but his thyroid was not. But the vet believed that the thyroid issue was a secondary condition and that Cushings might be the primary condition causing his issues. The doctor recommended that we have an xray done as well as the ACTH Cushings test. She went ahead and started him on Soloxine twice a day for the thyroid and we discussed our options. We decided to have the ACTH test as well as the Xray. The xray showed that his liver is slightly enlarged and that he does definitively test postive for Cushings. We just found this out today. The vet wants us to have an ultrasound done to figure out the location of the Cushing's, whether it be in his adrenal glands or pituitary. I have read that the majority of cases in his breed are pituitary and managed through medication. The vet will not prescribe the treatment until we have the ultrasound completed. I just want opinions on what those of you who have dealt with Cushings think. Is this common to diagnose the issue but still require yet another expensive test before treatment? I understand that he could have a tumor near his kidneys that might even be malignant, but I also know that the chances are more for the treatment with medication route. We are going to do what we need to for the sake of our Toby, but I want to make sure that what money we have to put towards his treatment is used as wisely as possible.
His symptoms are still present....he has the telltale pot belly at this point as well as lethargy, increased hunger, leg shakes and he has had a few seizures in the last three weeks since we started the soloxine. We can't walk him for very far for fear that he will have a full on seizure. We give him diazapam when he has a seizure or if he exhibits the sign that it is inevitably going to happen. We do take him on car rides when we can to get him out of the house. About three days of the week he acys perfectly normal...playful, vocal and normal. Any advice or wisdom that you have in our situation would be greatly appreciated.
Oh not sure if this is helpful, but we do feed him Keen from Honest Kitchen if anyne has any feedback on that as well. I just picked up Andi Brown's pet food book and plan on looking into that to see if we want to go back to making his food ourselves again.

Harley PoMMom
03-21-2015, 05:53 PM
Hi and welcome to you and Toby,

Although I am sorry for the reasons you need to be here, I am glad that you have come out of hiding, started a thread for Toby, and now are part of the k9cushing's family. ;)

Poor guy, having them seizures sure can take a lot out of them, what medication/s have they rx'd for the seizures?

For what it's worth, I hold Dr Dodds in high regard, she has replied to several of our members here regarding their dog with a thyroid issue. She is considered an expert in canine thyroid problems, so I am happy that you have already contacted her, great job!!

Cushing's is one of the most difficult canine diseases to diagnose, which makes it one of the most misdiagnosed. There isn't one test that is 100% accurate at diagnosing Cushing's so a vet/IMS does need to perform multiple tests to validate a Cushing's diagnosis.

Could you get copies of all tests that were done on Toby and post any abnormalities that are listed along with the reference ranges and units of measurement..e.g...ALT 150 U/L (5-50)...thanks! We are especially interested in those ACTH test results, and when the ultrasound is done could you post those findings as well.

Concerning the diet, the dog food should have a good quality protein listed as the first ingredient. There really isn't a "set" diet for a cushdog, it should be tailored to that individual dog.

Please know we are here to help in any way we can, and do not hesitate to ask all the questions you want. ;)

Hugs, Lori

Tobyroo
03-22-2015, 01:53 PM
Hello Lori,

Thank you for your response. I have to admit that we feel really alone in dealing with all that has happened to Toby in such a short amount of time. None of my friends seem to get it that we have to base our schedule around his meds and if he had a seizure. So it is great to find a community of support.
He had another seizure at 5am. Luckily I was awake to get him through it, ice his back and give him a valium afterwards. He has been averaging a grand mal once about every 2 weeks in the last month and a half.
I will have the vet send me all of his test results tomorrow so that I can share and get your opinions. We are also planning on having the ultrasound done soon as well to determine the type of Cushings.
I also plan on reading through Andi Brown's nutrition book for dogs to determine if I would like to start making his food again or continue on with Honest Kitchen. I would like to keep him on Honest Kitchen but I worry that maybe something in it is causing his issues and that if I made his food again, I know exactly what is in it.

Tobyroo
03-22-2015, 02:13 PM
Here is a list of Toby's habits and symptoms....maybe one of you have experienced something similar and this will help:

He is an eleven year old 17.5 pound Miniature Schnauzer. He has never been overweight
He eats Honest Kitchen Keen- About a cup a day (dry, makes more when the water is added)

Symptoms:
Seizures
Muscle weakness in back legs
Dry flaky skin on his abdomen and legs
Dark skin spots on his abdomen
Completely food driven (begs, watches the floor when we eat, etc)
Lethargy
Xray shows enlarged liver
ACTH test points to Cushings
Low T4 and T3 levels On Soloxine twice a day

Tobyroo
03-22-2015, 04:43 PM
I want to do what is best for my little man, but after reading through a lot of posts here, diagnoses and treatments, I have to ask your opinions.

I really like the vet we are going to, but if his ACTH test points to Cushing's, why would we need to have an ultrasound to confirm? Many of the posts I have read said with similar ACTH results that vetoryl prescribed. I would rather buy the meds to get his treatment started and save money for blood tests, rather than spend a huge chunk on a test that he may not need. The vet told me that she will not start treatment until he has the ultrasound. Either she isn't telling me something or all of the hours I have put into researching so far are wrong. Or maybe I am missing something.....

Harley PoMMom
03-22-2015, 06:23 PM
The ACTH stimulation test is used to help diagnose Cushing's and it is also the test that is performed to monitor cushdogs on treatment.

We do highly recommend having more than one test done in diagnosing Cushing's because there is not a test that is 100% accurate at diagnosing it, so multiple tests need to be done to validate a diagnosis of Cushing's.

Having an ultrasound done, I believe, is an excellent next step. Ultrasounds can be a very useful diagnostic tool, they have the capability to find abnormalities on the internal organs, such as gallbladder mucocele, kidney issues, pancreatitis...etc Our motto here is you get a lot of bang for your buck with an ultrasound. However not ultrasounds are created equal. A good quality ultrasound/interpretation depends on a few things; the tool used, the technician performing it, and the physician interpreting it.

Hugs, Lori

Tobyroo
03-22-2015, 10:18 PM
Thank you! I have no problem having the ultrasound if it is worthwhile. Your words have calmed me about this next step.

Squirt's Mom
03-23-2015, 07:15 AM
I would certainly do the ultrasound. One saved my Squirt's life. She had been diagnosed with PDH, the pituitary form of Cushing's, based on five tests but the ultrasound found a tumor on her spleen. Once the tumor and half her spleen were removed, her cortisol returned to normal and stayed that way for several years. The stress of that tumor caused her cortisol to naturally increase, causing false positives on the tests. If we hadn't done that ultrasound, she probably would have died from either the tumor rupturing or from taking powerful drugs she did not need. So get the US if you can. ;)

Tobyroo
03-24-2015, 07:20 PM
We have an ultrasound scheduled on Thursday at 9am. I hope that we get some answers and Toby can be treated soon. He has been extra sassy the last few days which is encouraging. He is woo wooing a lot more and seems to have found his personality.

molly muffin
03-24-2015, 07:44 PM
Awww, it's lovely to see them acting like themselves. :) Hope this will bring you some answers too and at least let you get started with treatment if that is the best option.

Tobyroo
03-26-2015, 08:39 PM
Just wanted to let you all know that Toby's ultrasound went well. It didn't show any signs of masses or tumors in any of his organs. Unfortunately he was stressed out by the whole procedure that he had a grand mal seizure on the table. :( Good news is we are starting to treat with vetoryl tomorrow as well as an anti-seizure med. I am hoping that we can get him back to normal soon.

Harley PoMMom
03-26-2015, 09:14 PM
Oh I am so sorry to hear that Toby had such a rough time, poor boy, and poor you, I bet you both are exhausted. Were the adrenals visualized on the ultrasound?

Hugs, Lori

molly muffin
03-26-2015, 09:56 PM
Oh poor baby, at least he was there when it happened, so they could immediately see the effects of the stress on him. Poor baby. Hopefully the meds will make a huge difference to the good for him.

hugs

Tobyroo
03-26-2015, 10:22 PM
Oh I am so sorry to hear that Toby had such a rough time, poor boy, and poor you, I bet you both are exhausted. Were the adrenals visualized on the ultrasound?

Hugs, Lori

Yes they were and it was determined from the ultrasound that his cushing's is pituitary based. Which is a huge relief for us.

Squirt's Mom
03-27-2015, 08:14 AM
Bless his little heart. If he has to do this again, you now know to tell them this a very real possibility and that he probably needs some sort of sedation. I am glad he was there when it happened not only for the immediate medical attention but for the fact this is now recorded.

I bet today is gonna be a rough one so I'm sending you both lots of calming energies.

Hugs,
Leslie and the gang