New to the group, new to Cushings

[Crystal]

Hello Everyone! My name is Crystal. I have 3 furbabies and 16 chickens. On March 30, 2015 we got confirmation that my oldest baby Brew has Cushings Disease. He is a bichon x king charles cavalier spaniel that turned 14 years old Oct 29 last year. His troubles had started early in October 2014. He seemed a bit lethargic, then he developed diarrhea which quickly turned bloody, then to straight blood and some vomiting. An emergency trip to the vet and many tests later, it was first diagnosed as just something he may have eaten in the grass. When he didn't improve more tests,an ultrasound and xray later it was determined that he had pancreatitis and hepatitis. He was put on several meds and over time he improved and by the end January his levels had improved so he was taken off all medication. Due to return at the end of 3 months for a blood recheck. At the end of March he seemed off to me. A little more lethargic again and very soft stool, not quite diarrhea. But I felt my spidey senses tingling and took him to the vet. The first blood test made the vet start thinking that due to the last few months maybe they should check for cushings. They did the 4 hour test (sorry, I can't remember the name) and the results came back positive for cushings. After some reading on-line I did question how sure she was, and she said the test was very conclusive. His levels were without a doubt showing he has cushings. He is now on 30mg pill a day of Vetoryl.
Many years ago he showed signs of osteo-arthritis. We put him on a supplement for that and he showed wonderful improvement. After the liver scare in October, he was taken off all supplements and put on a vet diet of gastrointestinal low fat food.
He has gotten increasingly stiff and after a discussion with the vet we have put him back on the glucosamine supplement. He has been on it almost as long as the vetoryl and it doesn't seem to be bothering him.
My questions for the forum are these......
Is it normal for cushings dogs to have "off" day's? He hasn't seemed himself yesterday and today. Very shifty, cant seem to get comfortable. But then other day's he seems fine? This happened once the first week he was on the pills, then he's been fine till yesterday.
Does having cushings cause stiffness? restlessness?
What tips do you all have for making your doggies more comfortable?

Thank you all for your time.
Crystal

[Squirt's Mom]

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[Harley PoMMom]

Hi Crystal,

Welcome to you and Brew! Sorry for the circumstance that brought you here but glad you found us.

I do see some red flags and I'm afraid that I question Brew's diagnosis for Cushing's, for these reasons: Brew is not displaying the obvious Cushing's symptoms that are commonly seen, such as; excessive drinking and peeing, I mean peeing rivers and drinking buckets upon buckets of water; voracious appetite, they are like little hoover vacuum cleaners looking for any crumb they can find; panting; loss or thinning of coat; skin issues; muscle wasting; muscle weakness, especially in the hind quarters; exercise intolerant; difficulty or unable to go up steps or jump on furniture. As you can see vomiting and diarrhea are definitely not the usual signs a dog with Cushing's displays, and also Cushing's symptoms do not wax and wane.

The drugs used for Cushing's do not cure the disease. The goal of therapy is to remedy problematic symptoms of Cushing's, so that is why strong symptoms do play a huge role in the diagnosis for Cushing's. With no symptoms, how do you know if the treatment is effective?

That "4 hour" test that Brew had done, was this the low-dose dexamethasone suppression (LDDS) test? If so, in the face of stress or any non-adrenal illness the LDDS test is more likely to yield a false positive result. With Brew having pancreatitis there is a chance that this non-adrenal illness could of created a false positive LDDS test result.

Unfortunately Cushing's is one of the most difficult canine diseases to diagnose, which makes it one of the most misdiagnosed. One of the things that makes Cushing's so challenging to diagnose is because not one test can 100% accurately identify it, so vets have to perform multiple diagnostic tests to validate a Cushing's diagnosis not just one.

If you would get copies of all tests that were performed on your boy and post those values that are abnormal here that would be great...e.g...ALT 150 U/L (5-50)...thanks! I see that an ultrasound was done, were the adrenal glands visualized? Was an urinalysis done, and if so, could you post those findings too? Could you tell us how much Brew weighs?

We have a wealth of information regarding Cushing's in our Resource thread, which does include articles written by some of the most renown veterinarians that specialize in endocrinology such as David Bruyette, Mark Peterson, and Edward Feldman. Here's a link to our Resource thread: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10) Please know we will help in any way we can, and do not hesitate to ask all the questions you want.

Hugs, Lori

[molly muffin]

Hello and I too want to welcome you to the forum.

Off days yes now and then. But as Lori mentioned there are some things that makes one want to be very sure of the cushing diagnosis. Can you get copies of the test results that your vet did for diagnosing cushings and any cbc and urinalysis that might have been done. Those would help us to understand what the vet was seeing.
Any cushing test can be false if other serious problems are involved. So we want to be very sure. Also how much does your furbaby Brew weigh? Vetroyl starting dosage should be 1mg/1lb.

Was it a 4 hour test or an 8 hour test? LDDS or ACTH used for diagnosing?

I know we start out with a lot of questions but that is so we may give you more accurate feedback.