Too Many Symptoms to Count - Tassy is now at peace

[Tassysmom]

My Border Terrier, Tassy, was diagnosed with Cushings in September 2014 at just 8 years old. She had torn her ACL in a back leg at the same time her gums were bleeding (she was overdue for a cleaning) and she was urinating in the house (drinking her water dish dry). She had her teeth cleaned (lost 7) and recovered slowly from the ACL tear. However, with the increased drinking added to the other issues, the vet was suspicious of Cushings and we had the tests performed which confirmed her suspicions. We did not proceed to determine if it was adrenal or pituitary Cushings because the outcome is much the same. We decided to go with the odds. Instead we turned immediately to treatment. She's had the requisite ATCH Stim tests and is on 30mg of Vetoryl once daily with breakfast.

Tassy was just 8 in July; seemingly at the prime of life, and it seems incredible that she could have this disease. She had been the most active dog I've ever owned and after agility, rally and tracking classes, we became a team; a lovely and loving dog. Now she barely walks anymore. I noticed other symptoms; excess panting, thinning hair with bald patches on tail, and distended belly....all the classic stuff. I am giving her Duralactin; a fish-oil based soft chew for joints, hoping to help her lameness which is the most debilitating of her symptoms. Both back legs are stiff and she can no longer jump up on anything or climb stairs. One day she tried to walk over to us and plunked down on the floor. The front leg had collapsed and when she did manage to stand and tried to walk, she "paddled" with it. The vet was surprised at the speed of her deterioration. We honestly thought we were going to have to put her down but brought her home for one last weekend. That was a month ago but she struggled to her feet and began to walk again. She waddles back and forth and is very pigeon-toed. Every now and again the front leg collapses and she will hit her chin on the ground -especially walking on grass or uneven ground. Our regular walks are completely OUT but we do get her to take a few steps to relieve herself.

I've tried to learn everything I can about what happens next and so I've joined this forum. She is obviously one of those Cushings dogs who is not responding to Vetoryl as her symptoms don't seem much, if at all, improved. I can't really tell what she would be doing WITHOUT the Vetoryl so hard to know if it's helping. (an aside: I purchase it from California Pet Pharmacy online which saves me about $35 a month over the vet's price.)

I've read that dogs, once Cushings is diagnosed, live about 30 months. And I see many dogs in this forum have "passed". How does one tell if the end is near? How does the dog die; of what? What symptoms foretell the end? On what basis have people decided to euthanize their beloved pets - or do they die naturally? I don't want her to suffer and of course, can't really tell if there is pain. She just keeps struggling to live and I feel like I have to help her do that as long as she's willing.

The panting has increased and, next to her lameness, is becoming a prominent symptom. It seems to be worse when she's lying down. I read in another forum where a dog snorted and gasped and seemed congested and the response was that wasn't a recognized symptom of Cushings. Well, my Tassy does the same thing in the morning. When she awakens, she tosses herself from side-to-side, wheezing and snorting and clearing out her nostrils. Sometimes they drip - a clear liquid. In the evening and at night, she lies, stiff-legged, sometimes with her legs extended straight up in the air. All of this is very unsettling.

I would so appreciate hearing from others who are (or have) gone through this agonizing process of watching their beloved "child" die in front of their eyes. My first Border Terrier died suddenly of a botched gall-bladder surgery. Not really easier, but I didn't have to watch her die by inches like this.

To those with recent diagnoses I'd say there IS finally an acceptance that this is your "new dog". You adjust to their limitations and try to cope with each disabling symptom as they present. There is no cure. But my problem now is what to expect; what to look for. My young vet, while sympathetic and willing, doesn't have the experience LIVING with Cushings to be able to offer counsel. That is why I am here.

Thanks to everyone ahead of time for your help.

[Harley PoMMom]

Hi and welcome to you and Tassy!

I am sorry your girl is having so much difficulty with her legs, it sounds like this could be pseudomyotonia. I am providing an url to a blog from a renown and well published endocrine specialist, Dr. Mark Petterson, in which pseudomyotonia is discussed: http://endocrinevet.blogspot.com/2011/02/q-pseudomyotonia-in-dogs-with-cushings.html

If you could post Tassy's ACTH stimulation results for us and tell us how much she weighs that would be great. Also, is the Vetoryl being given with food? Are her ACTH stimulation tests performed 4-6 hours after her dose of Vetoryl? I'm sorry, I only have a moment to post and will make it back later. I am sure other members will stop by to welcome you and to share their knowledge.

Hugs, Lori

[Tassysmom]

Tassy weighs 22.5 at last weigh-in. Prior to all of this she was just hitting 20 lbs - usually 18 or 19. Her appetite is good and with little-to-no exercise, it's hard to keep her weight down.

I called the vet's office and for some reason they don't know how to email me the ATCH Stim results using a "new system". The vet tech said Tassy had an ATCH Stim result of 4.8 after the last test, which yes, is performed about 11am after her 7am dose. The tech seemed a bit confused so I wasn't able to get anything more. She said cortisol levels run normally between 8.0 and 1.7 or 17.0, she told me both numbers. All I can say is the vet was happy with the results of the last test and has put us on a 6-month repeat schedule.

Tassy takes the Vetoryl in the morning right after her 1/2 cup dry food breakfast (nanoseconds later, in fact).

I appreciate your willingness to give me some input. I am going onto the website you provided to see what I can learn.

Back to ya - checked the website and read through the symptoms of Pseudomyotonia. This sounds exactly like my Tass and I'm going to print it out and take it to the vet. Her hind legs were affected first and most seriously and she walks very stiff-legged with them held out to the side. The ACL tear was in her right rear leg and it's the one she holds out furthest.....very straight and unbending. The front legs are weak and wobbly and slanted inward and often the foot curls under at the ankle - especially the left. That is when she stumbles. But she gives it the "old college try" most of the time.

It seems like Tassy is on some kind of accelerated deterioration course and not like the dogs that others describe who can go on to live relatively normal lives; for years even. She spends her days being very lethargic. I don't know if she is in pain - Border Terrier's are relatively stoic about pain. But I know she refuses to walk very far and the only time I've seen the "terrier spirit" in her recently is when she spotted my neighbor's cat. She can't do much about it, but she perked right up.

My big worry is "how will I know when it's time"? Dogs just get on with life and don't complain, so I don't know how I'll know.

[Harley PoMMom]

Shoot, this is a short post too, I'm still at work and they expect me to do something, how dare they!!!???:D

I searched for Pseudomyotonia on the forum and did come across some threads: http://www.k9cushings.com/forum/showthread.php?p=76481&highlight=Pseudomyotonia#post76481

http://www.k9cushings.com/forum/showthread.php?p=75273&highlight=Pseudomyotonia#post75273

http://www.k9cushings.com/forum/showthread.php?p=68141&highlight=Pseudomyotonia#post68141

http://www.k9cushings.com/forum/showthread.php?p=42059&highlight=Pseudomyotonia#post42059

This link is from our Resource forum: http://www.vmsg.com/files/Case_Report_Canine_Hyuperadrenocorticism_and_Pseud omyotonia.pdf

With the ACTH stimulation test there are 2 blood draws, the first is known as the "pre" number, the second is called the "post."

I'm also including a link to our Resource forum where you will find loads of information, we have many published peer reviewed studies from some of the top renown veterinary endocrine specialists: http://www.k9cushings.com/forum/forumdisplay.php?f=10

If you have any questions please do not hesitate to ask them.

Hugs, Lori

[Tassysmom]

Thanks, Lori, for the links. I worked too, "once upon a time in the West", so I know what you mean about the job expecting something from you. I was in IT (used to be Data Processing) and it was very demanding. I'm just grateful you took the time to contact me.

Monday I'm going to ask the vet's office for a hard-copy of the ATCH Stim results because I don't understand the info. the vet tech told me today. Reading might be better. I have confidence in the vet and she seemed to be happy with the last results.

RE: the Pseudomyotonia.... Tassy went to the vet when she collapsed and then paddled around with her front left paw....and performed in the office. The vet didn't recognize what I think (after reading - thank you) are classic clinical signs of Pseudomyotonia. She was thinking perhaps they were neurological symptoms; as in a macro pituitary tumor. But, the vet is young and inexperienced and since so few Cushings dogs present with this affliction, it's probably understandable. I'm sure she'll be interested to see the articles.

I am anxious to see what she recommends. I read one of the links you sent about a dog who got good results from physical therapy. I would be willing to try that. I wonder if it's a good idea to continue exercising her (at her own pace) at a quiet park where she can walk without other dogs around. In other words, some self-physical-therapy. We've discontinued that for fear of hurting her. Also, I want to understand about pain from this. Pain pills (like Tramadol & Gabapentin) give Tassy diarrhea so I'm not anxious to go that route but I don't want her in pain. I suspect the fish-oil tabs I'm giving her for osteoarthritis may be for naught but it I would be interested to know about any supplements that could positively affect this problem. It sounds like the abnormal electrical impulses that don't "shut off" in the muscles and tendons aren't something veterinary science understands very well.

Thanks again for your help and concern. You've calmed my nerves and given me some direction.

Linda

[Harley PoMMom]

Hi Linda,

I believe exercising at her own pace, just as you said, could be beneficial, hydrotherapy may be another option that can help too.

Do all pain relievers cause Tassy diarrhea? I found this comprehensive list of pain medications that can be used on dogs: http://www.veterinarypartner.com/Content.plx?C=299&S=1 Elevated cortisol in itself has anti-inflammatory properties, and for senior dogs when the cortisol is brought done to therapeutic ranges symptoms of arthritis may be unmasked.

Usually dogs in pain do not want to eat so since Tassy's appetite is still healthy that is a good sign. Is she drinking normally?

Hugs, Lori

[Tassysmom]

Tassy's drinking is elevated over what it was before Cushings. As I've read from others; Tassy didn't drink much at all as a pup. So she is drinking more BUT (big BUT) she's not urinating in the house anymore and she doesn't get us up out of bed to drink. In that regard, I see improvement.

Yes, her appetite is very hearty. However, Border Terriers are theoretically impervious to pain (according to Border Terrier breeders) so I'm not sure I would KNOW if she was in pain. I'm guessing a bit because she doesn't want to walk - unless we see something that interests her; like a cat or a squirrel. She's what they call "varminty" in terrier-ese and I can still see that operating at times. Which is encouraging.

I'll check out the list of painkillers for dogs and see if we can't find something without the stool-softening affect. Thanks! I have tended to just back-off using the Gabapentin or Tramadol but I don't want to do that if there is real pain associated with Pseudmyotonia (or any of the other symptoms of Cushings). That might sound like a stupid question, but I really don't know. I don't see anything that makes me think Tassy is in pain - other than her refusal to walk very far unless she's really motivated or jump up and I'd been attributing that to muscle deterioration (as in a strength reduction). I'm probably asking one of those "duh" questions, but she's so stoic, I can't really tell.

[molly muffin]

I just want to say hello and welcome you to the forum.

Unfortunately I don't know anything about pseudomyotonia, but from what I too have read, it does sound like it.

Do you have a specialist anywhere near you that you could get a consult with? Your vet might be able to set you up with one. Anything that is outside the realm of the GP, it is often good to get a consult with the specialist and then have your vet work with them and get direction (if they are unexperienced) about treatment.

Just a thought I had while reading through your thread.

Again welcome.

[Tassysmom]

Yes, it will be easy to get referral to a specialist as I live in a metro. Once I take in the article that Harley PomMom sent to me, we'll see what the vet thinks.

My issue all along with the Cushings diagnosis was the cost of tests vs the benefit. Will it change anything for Tassy? I know from experience with a Border who had a mucocele gallbladder, that you can be pushed along on emotions down a road that is extremely costly with no change to the outcome. My vet has been sensitive to that. If she thinks that it's highly likely that Tassy has Pseudomyotonia (she can consult with the senior vet in her practice), I'll see what she thinks a likely course of treatment will be. I'll keep you all posted because perhaps we'll all learn something about this very rare complication.

Thanks for taking the time to weight-in. I really appreciate this support and of course PomMom has really put me onto something. It has relieved (in some respects) my mind. Better to have something to pursue than to be completely in the dark and think your baby-girl has a brain tumor or something.

What a totally crappy disease Cushing's is!!!

Linda

[molly muffin]

It's true, cushings definitely sucks and as I was just saying on another thread, it can be a real tough balancing act to get things at a good level covering all the areas, without detriment to any given area.

Consulting with the senior vet, coming up with what kind of treatment they think you would be looking at, is a good starting point and let you know what you are dealing with going forward.

Most of us completely understand how you get on that road to constant testing and trying to keep things under control and become a walking money bank to the disease.

Yes Lori (pommom) and Marianne, all our admins are very good researchers and have been around cushings and the various side problems for a very long time. They are walking encyclopedias quite often for which I am thankful. If they don't know the answer, they usually know where to start looking for it.

[Tassysmom]

BTW.....I love Molly Muffin's picture. What is she? Darling dog. Hope she is well. Linda and Tassy

[molly muffin]

Aww thanks. Molly is our little, shih tzu/llhaso mix dog.

She's doing pretty good so far, a bit of a balancing act for us too, with BP, eyes, Kidney, Cortisol and luxating patellas. We just do the best we can and she is still a happy girl, laying on her back, kicking around, running and playing. Running our household in other words. :)

[Tassysmom]

I have gotten the printout from Tassy's ATCH Stimulation tests (referred to as Cortisol Serial 2). First one done after diagnosis and start of Vetoryl in October was on 11/25/14. Test time 1 was 11:40, test time 2 was 12:40. Cortisol Sample 1 was 1.8. Cortisol Sample 2 was 6.5. Units for both were ug/dl.

Reference range for Sample 1 was 1.0-5.0. Reference range for Sample 2 was 8.0-17.0

2nd test was done on 2/26/15. No test time recorded but she went in at 11am so imagine it was the same. Cortisol Sample 1 was 4.6 and Sample 2 was 4.8.

Both times Tassy had taken 30mg Vetoryl at approx. 7am.

I hope these numbers mean something.

[Harley PoMMom]

How are Tassy's symptoms, have they abated? If her symptoms are controlled than those are great ACTH stim numbers!!

Those references ranges they have listed (Reference range for Sample 1 was 1.0-5.0. Reference range for Sample 2 was 8.0-17.0) are for a dog not on Cushing's treatment. When a cushdog is taking Vetoryl/Trilostane the therapeutic ranges are: 1.5 ug/dl - 5.4 ug/dl, and that post number can go as high as 9.1 ug/dl if symptoms are controlled.

Now, according to Dr. Mark Peterson, who is a renown Cushing's expert and is also a contributor to Dechra's continuing education site, he prefers a dog's stim numbers to be no lower than 2.0 ug/dl, so congrats on those ACTH stim results!

Hugs, Lori

[molly muffin]

Yes, I agree with Lori, those are good results on the ACTH test. Congratulations. :)

[Tassysmom]

Good oh! The vet liked these numbers, too. I wasn't sure what I was seeing.

I dropped off the "Dr ME Peterson's treatise on Pseudomyotonia" with the vet today and another I found online (both describe Tassy's symptoms to a T).

The vet called me and seemed to think it was possible that Tass had Pseudomyotonia. However, she had only seen her with her left front leg collapsing and the "paddling" movement so was hesitant to agree. She had originally thought it was neurological. She thought Tassy's hind leg stiffness could be from the ACL tear in her rear right leg - which healed but would leave the leg stiff. I assured her that all four legs were showing definite stiffness and that the rear were in a wide-stance; pointing out and the front were pigeon-toed and she walked with a rocking-back-and-forth gait. I guess she will need to see her to understand what I'm seeing and she will when we return for the 6-month ATCH stim test in August. Without the extensive and rather complicated testing, she wouldn't be able to say for sure nor prescribe the medication procainamide. Does anyone have any experience with that med?

I am not going to have Tass tested (at this point) and instead am going to try some home PT and exercises coupled with Gabapentin for pain and Glucosamine and Co-Q10 supplements; which the vet is non-committal about but did not object to my trying. Tassy's other Cushing's symptoms are improved EXCEPT for the lameness (Pseudomyotonia) which I read is not controllable by Vetoryl. She also, pants a lot. She pants after she exerts herself and she pants when it's warm; as though she has more difficulty regulating her body temperature. So the panting is maybe worse, but the drinking/urinating and hair-loss have been reduced.

Thanks for the feedback. You have been a big help to me. Before I was thinking (with the lameness showing up and possible neurological damage) that it was all over.

Linda

[Tassysmom]

Can anyone help me understand the heavy panting with Cushings? I can't find much online about it except it is a symptom of Cushings. Many of Tassy's major symptoms are lessening with the Trilostane treatment but not panting. In fact it seems to be getting worse. Tassy pants intermittently but very heavily. I put the fan on her and she goes outside and lays on the cool concrete. Is this symptom a matter of her getting overheated? It's like anything and everything causes her to pant. She can't walk two steps now before she sits down and pants. Does this problem need to be taken in to the vet or is it SOP with Cushings? What causes it and can anything be done about it? Thanks!

[2bostonmom]

Hi Tassysmom!

I joined the forum a month or so ago when my Boston Terrier was first diagnosed with Cushings but I have been so busy with him back and forth to the animal hospital and specialists I haven't yet posted anything here like an intro about me and my dog, etc. In any case, I saw your post and just had to jump in bc we both have Bostons around the same age just diagnosed with Cushings.

I was very glad to read after your initial posts where you seemed discouraged, that you have gotten encouragement from the people on this site and feel much more positive about your Boston's future. Please know that Cushings dogs can live for several years after diagnosis if their symptoms are managed and they get the right medications (and aren't prescribed the WRONG medications by inexperienced vets, which unfortunately happens too often - vets prescribe prednisone for Cushings dogs on Vetroyl and don't see a problem - EEK). So hang in there and keep doing what you're doing for your Boston.

My Boston with Cushings is about 8.5 years old, and over the last 6 months to 1 year he has developed all of the major signs of Cushings, but I just thought they were signs of aging. I didn't think much of it until some weird things started happening - like 3 months ago his face swelled up like a balloon and it turned out he had a broken tooth and major tooth infection - but his blood work results showed high liver enzymes and other high levels that were not normal. After wasting time with a regular vet who didn't know what they were doing (and didn't figure out anything until the third visit where the third vet finally said he may have Cushings), we went to a real animal hospital with specialists of all types, and have seen a neurologist and internal medicine specialist. My dog has been on Vetroyl for about 3-4 weeks now, and I think it has helped somewhat, but I am not sure how much. He had the ACTH stim test last week and the internist said his levels have improved but could be better so we increased his dose a little. To add to the Cushings, he also was just diagnosed with diabetes so we started twice daily insulin injections about 2 weeks ago. My poor boy! He is a real trooper and has been so patient and calm with all the poking and prodding.

As far as symptoms, my Boston has had increased water drinking, excessive peeing, ravenous appetite more than he ever had in his life, very dry hair that has progressively thinned, hair loss, very dry skin with white flakes, he developed a big pot belly (ultrasound showed a very enlarged liver), back leg weakness/shaking, he pants a LOT, and he always seeks someplace cool to lay down, like the tile floor or wood floor instead of one of his beds or my bed. In fact right now he is sleeping on my bedroom floor on the wood floor instead of the cushy rug, or 2 dog beds, or my own bed (for the first 8 years of his life he pretty much always slept in my bed, but now he prefers the floor. I was sad for a while until I realized it was just Cushings that made him hot!). Being a Boston Terrier, he has always panted somewhat when the weather gets warm, we go to the beach, we take a long walk in warm weather, etc. But it increased a lot the last year or so, like when we would take a car ride somewhere he would pant (I assumed he was just nervous, although he never was nervous earlier in life riding in cars), and other times when it was not necessarily hot or overly warm he would pant too.

From my online research, there are several reasons why a Cushings dog may pant excessively. Cushings dogs often have developed enlarged livers, which can put pressure on the diaphragm so the lungs can't expand fully. Also, Cushings dogs can develop calcification in their lungs, which makes the airways less elastic and a little harder to open and close for the dog, so the dog puts more effort into breathing and it results in panting. Because Cushings causes muscle wasting, the dog's rib cage/chest muscles may have weakened and so the dog needs to exert more effort to breathe, causing panting. One site mentioned that Cushings dogs could have tiny blood clots that can affect the blood supply to the lungs. That theory makes sense to me because during the last several months while my dog was being diagnosed and had multiple emergency episodes, multiple vets have theorized that it is possible that some of my dog's emergency episodes like falling over and shaking (not a real seizure but somewhat like a seizure) could have been a "vascular event" from a small blood clot or mini stroke, due to undiagnosed/untreated Cushings and diabetes. Also, when my dog had a chest x-ray a few weeks ago, the vet noted that he had something like slight "chronic lower airway disease" - and I was freaking out about that, until I spoke with a friend of mine who is a nurse (and long time mom of Bostons) who explained it is just a term to describe a condition that has been present for longer than just a temporary episode, but it isn't a whole separate disease or condition. Just a descriptor of something is off with his airway but it is not major and they don't have a reason for it.

I feel like my Boston's panting has decreased somewhat since he has been on the Vetroyl.

In my research about Cushings I have found some people mention a holistic remedy aimed to help the panting and inflammation, a Chinese herbal formula called "Si Miao San." I have not tried it myself, and urge you to consult with a holistic vet, or other members on the forum who have experience using it, etc. before you start using it. But it is something to look into if you are concerned about your dog's panting. I do not think there are any specific medications that will help decrease the panting (other than the Cushings medications generally). I don't think the panting is a huge cause for concern unless your dog is really having trouble breathing. If the panting is caused by a weakened rib cage, for example, the panting is a sign of the dog expending extra effort to breathe, which isn't necessarily harmful.

More later, but hello again, and nice to meet another Boston mom! :)

[2bostonmom]

Tassysmom - sorry, I forgot to say one important thing (despite my original reply being very long!).

Beyond Cushings, excessive panting could be a sign that something else is wrong of course. I would definitely ask your vet about it. And I would suggest getting a chest x-ray done, if possible and within your budget to do so. A chest x-ray would tell you if there is something else going on to address or be concerned about, beyond Cushings.

[LauraA]

My girl was a really bad panter. In fact about 18 months before she was diagnosed was when we really noticed it becoming worse. She would have episodes where she would wake us up in the middle of the night as she was so distressed from it. As she has a heart murmur she had numerous test but they always came back fine. When she was eventually diagnosed the panting finally made sense. We started her on the Vetoryl and initially the panting got worse for that first month, then it slowly subsided probably over the next 3-4 months. It was the last of her cushing's symptoms to actually go, despite her numbers being good on the tests. She is more prone to panting in the heat that my other dog, but she is no where near those pre Vetoryl episodes.

[Harley PoMMom]

As for the panting, which is common with our cushdogs, it can be due to a few things: the increased fat deposition over the thorax, an enlarged liver (which is common in a cushdog) that puts pressure on the diaphragm, and with the fat distribution to the abdomen along with the muscle loss in the abdominal area are factors that can cause a dog with Cushing's to pant more. Plus it also seems that our cushpups run at a higher temperature.

The panting should eventually subside, it just may take a while.

Hugs, Lori

[molly muffin]

Hopefully the panting will subside. Lori covered the reasons why cushings dogs pant more, they just don't handle the heat as well either, but as the cortisol comes down, then that can improve quite a bit.

[Tassysmom]

Thank you, Lori, Sharlene, Laura and BostonMom (welcome to the forum dear BostonMom).

Your Boston's symptoms mirror my Tassy (who is a Border Terrier, btw - check out my album - 1 pic of Tass), to a tee. Tassy was just 8 (2 months past) when diagnosed. The torn ligament and excessive drinking/peeing in the house came simultaneously and led the vet to think about testing for Cushings.

I also, questioned whether the Vetoryl was helping. Tassy has been taking it since October. The first thing to stop was the peeing in the house - drinking seemed to remain heavy so perhaps we were just getting her outside more often. But it definitely has slacked off now. These symptoms take a long, long time to resolve. Recently we noticed her coat improving a bit - just a bit. The flaking skin seems to be improving. My vet suggested oatmeal shampoo but I hesitate to bathe too frequently due to the dry skin and coat. The pot belly is still there - so there could be some liver enlargement, etc.

Tassy is terribly lame with stiffness in all four legs; the hind legs were first, complicated by the tear in the ligament, and now both front legs. The front lameness started with a total collapse of her left front; she couldn't even stand up or walk at all. Soon; within a day and a half, she was up again on all four but walking very stiffly and pigeon-toed in front. Lori suggested Pseudomyotonia which my vet thinks is a possibility. I don't know that I want to test for it which includes a muscle biopsy. Seems to me the less you do to these dogs the better once you know for sure they have Cushings. Our aim is Tassy's comfort which is why the panting is such a concern.

I am going to ask the vet about liver enlargement, etc. There were some x-rays (not sure what kind) taken when she tore her ligament but not sure if they included her abdomen. I think she did something like an MRI to ensure nothing else was amiss. I just can't remember. It's scary to watch and my husband and I feel so helpless. I think she's going to be spending a lot of the summer outside on the patio concrete where she seems the happiest. She's always slept on our bed - I might have to arrange for a flat surface on the bedroom carpeting for her to lie on.

I'm sorry to hear your Boston has diabetes. I understand it is a common accompaniment to Cushings and complicates the care.

I'm getting a feeling that dogs with Cushings share common problems but also, respond differently to the disease and the medication. This forum is a life-saver and it let's us know we are not going through this alone. I appreciate your description of your Boston and wish you the best in coping with this terrible disease.

[Tassysmom]

Lori - got back to the forum and re-read the postings from you and Sharlene re: panting. I'm glad to know (and hope) that the panting will abate eventually. Every symptom has taken SO LONG to back off after starting the Vetoryl; it's like watching the grass grow. During Tassy's next ATCH Stim test, I will ask the vet to evaluate if we don't see an improvement. She's sitting here beside me calm and cool right now, so that is good. There is an uptick in panting after exertion and/or when the temperatures rise. Luckily, we live in the cool Pacific NW, so she doesn't have to endure temperature extremes. Thanks for the help. You guys are "the best".

[Tassysmom]

I wanted to post an update. There is a tendency due to the stiffness that comes with Pseudomyotonia (rare side effect of Cushings), to stop all movement. We were carrying Tassy around and up and down stairs and had all but given up walks. I received some input from a "human" Physical Therapy doctor that exercise is extremely important with myotonia (muscle & tendon stiffness). So I am making it happen more frequently and for shorter periods. I massage her legs, first one side and then the other in a rocking-back-and-forth motion. Then we play "chase the ball" for a few short feet.. or chase a treat upstairs (she wasn't going upstairs but will for a treat). I am working to find ways to motivate her to move. We go to the park for walks where she is attracted by the sounds and smells. Also, I am looking into hydrotherapy. All in all, the more Tassy moves, the more willing she is to move. Exercise is making this disabling side-effect more manageable.

[Harley PoMMom]

Thanks so much for the update. I don't know much about Pseudomyotonia, so knowing that exercise does help will be valuable information to our members dealing with this in their own dogs.
Sending positive and healing energy your way...Hugs, Lori

[Tassysmom]

Thanks, Lori. I hoped this information would help someone else.
Linda

[molly muffin]

When you think about it, it makes perfect sense. That old saying, if you don't use it you lose it, certainly works with mobility. The longer a person can stay active, the better they are and the longer they will have mobility. So, it makes sense that this would be true for dogs too.

I think they hydrotherapy is a good idea. We've had members use it with good success and the dogs once they get use to it all seem to enjoy and look forward to it.

[Gabriel]

Hopefully the panting will subside. Lori covered the reasons why cushings dogs pant more, they just don't handle the heat as well either, but as the cortisol comes down, then that can improve quite a bit.

My dog Gabriels's panting stopped once the meds kicked in and the cortisone levels came down - so yes you are right - I didn't notice until now you mention.:)

[Tassysmom]

Tassy's panting has slowed A BIT. But not much. Anything and everything seems to get it going; exercise, exertion of any kind, excitement and even just anticipation, and of course, warm temperatures. We aren't getting anything I'd call heat here in the PNW (75 highs), but she seems happiest when it's about 50 or lower. I'm looking forward to the panting slowing down but after being on Vetoryl since early October, I'm thinking it's about as good as it gets. It will be the number one thing I'll talk to the vet about when we go in next.

Thanks for letting me know that panting CAN (or should?) get better!
Linda

Update in August - still panting. Cortisol level is normal; blood work is normal; except for a low thyroid (and pseudomyotonia). Panting continues. Days are warm, however, so it's my last variable. News in Fall.

[molly muffin]

Well we always hope that everything will resolve and get better with treatment. How is her heart? Did we determine if her liver is enlarged (very common with cushings) and if that isn't pushing on other things? That was mentioned somewhere on one of the numerous threads on here, but I could not for the life of me find it when I wanted to of course.

Just a thought.

[Harley PoMMom]

Did we determine if her liver is enlarged (very common with cushings) and if that isn't pushing on other things? That was mentioned somewhere on one of the numerous threads on here, but I could not for the life of me find it when I wanted to of course.

Just a thought.

Hey Sharlene, Is this it?


As for the panting, which is common with our cushdogs, it can be due to a few things: the increased fat deposition over the thorax, an enlarged liver (which is common in a cushdog) that puts pressure on the diaphragm, and with the fat distribution to the abdomen along with the muscle loss in the abdominal area are factors that can cause a dog with Cushing's to pant more. Plus it also seems that our cushpups run at a higher temperature.

The panting should eventually subside, it just may take a while.

Hugs, Lori

[molly muffin]

YES Lori! So funny it was your post.

[Tassysmom]

I don't know if Tassy's liver is enlarged. Her tummy is quite pudgy but that could be the fat redistribution of Cushings. When at first she tore her ACL, a full-body x-ray was taken (MRI? - Ultrasound?) as well as of the leg. She was whisked away and then brought back with news of the tear and that everything else looked normal. That was "early days" however. I believe the only tests done after Cushings was suspected were the ATCH Stim tests (she's had 3) and also, blood tests. Would the blood test show raised liver enzymes if her liver was enlarged? I was not told that was the case. Is there anything that can be done for an enlarged liver? Due to a tight-budget, I'm doing tests where the results can lead to improving Tassy's comfort or the outcome of the disease. With both Cushings AND Pseudomyotonia, testing could be endless. The myotonia has not been proven via lab tests; only clinical observation and (thank you), Lori's input. In reading everything I can about this disease, it seems highly likely in Tassy's case.

We will visit the vet in August (if not before) for a 6-month ATCH Stim and I will go with my list of questions. I hope to get more answers and perhaps more tests will be done at that time.

[molly muffin]

Usually the pot belly look will include an enlarged liver. The muscles weaken and that sort of lets everything redistribute. I think they can maybe also feel if it is enlarged, but I would think it is likely, although not every dog has enlarged livers, a large majority do. Yes it Can decrease with the medication, ours has not though.

Quality of life and comfort are some of the most important considerations I think.

[Tassysmom]

Hi again Sharlene,
I suspect that something (prob the liver) is enlarged and contrib to the panting, too. I feel like she is struggling to get enough air. It ALWAYS happens when she exerts herself...even just a little bit. And often, like now, for no apparent reason at all. She's lying beside me as I write this and she starts panting so hard she rocks up and down....legs held stiffly to the side, tongue hanging out. Then it will stop just as suddenly.

On another note. The panting and the Pseudomyotonia seem to work at cross purposes. With PMT (my own shorthand), I've learned that she needs exercise which then increases the panting. I could certainly understand if this adversely affected her heart at some point.

One way I'm getting this little chow-hound to take longer walks is to use a treat as a "carrot". She skips right along to get another chunk that I break off the cookie. You wouldn't know that she was refusing to take one step only moments before. Still I keep the walks short - 1 short block about, to avoid ramping up the panting. Catch-22.

Being a Cushings mom is certainly a life-changing experience, i.e. learning to deal with this degree of disability...and in a previously very agile and energetic little dog. Cushings sucks big time. How is Molly doing? How long has she had Cushings?
Warm hugs, Linda

[molly muffin]

Molly is doing pretty good, mostly good. She has been on medication since October, but has had high cortisol for awhile (years). Just never could get a positive LDDS test. Still haven't but other issues have necessitated treatment be done, so we are on the journey.

Thanks for asking.
Cushings is all consuming experience. I know that our lives have changed so much since she first tested high for cotrisol and just continued to change as the years have gone by. I now know more about cushing than I ever wanted to that's for sure. :)

[Tassysmom]

My Border Terrier, Tassy, has the rare side-affect of Cushings called Pseudomyotonia and the first time I heard about it was in this forum. It's been a life-saver as far as understanding what I'm seeing. The vet has finally concurred but had never seen it before. Another, older vet had only seen it once in 30 years. It is a disorder of delayed muscle relaxation - her legs don't bend and her walk is stilted and rocking. She isn't interested in walking anymore let alone running or jumping. She can barely walk over thresholds and takes steps very very slowly.

Tassy was diagnosed with Cushings almost a year ago. The myotonia came on soon after. The cortisol levels are being well managed by trilostane (Vetoryl) but nothing can be done for the myotonia (pseudo). So we live with it - carry her when needed, massage her limbs and give her Gabapentin for pain at night (which allows her a good night's rest). Other than this disability, she doesn't appear to be in pain or disinterested in life - so we are keeping on.

I have a question and would love to hear from the forum experts (of which there are many). Tassy is doing a lot of jaw or teeth grinding; especially when she is settling down at my side or for a nap. She grinds away and it's very audible. There is nothing wrong with her teeth or gums according to the vet. Does anyone have experience with grinding? Could it be caused by the muscle stiffness? I suppose the myotonia could be present in any muscle. Another thing she does excessively is pant (and drool). Any exertion or excitement causes panting. These are things that never happened before the onset of this disease.

My heartfelt sympathy goes out to all the forum members with Cushing's dogs. It is quite an educational process and the first instinct is to panic. I was making cremation plans for Tassy. But low and behold, she has adjusted to this new life and lifestyle and so have we. And so will you. It is an expensive disease to treat but there are ways to reduce the expense. Buying Vetoryl at a mail-order pharmacy has helped us. And scheduling tests to use the test medication to it's fullest. I will look into the dilute suggestion I read about here, as well. Good Luck to everyone!

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about Pseudomyotonia into Tassy’s original thread. We like to keep all posts about each pup in a single thread as it makes it easier for members, and parents, to refer back to the pup's history when needed. Thanks!

[Tassysmom]

How did you do that? I couldn't find it. I even entered a couple of comments under "visitor". I get totally lost in this forum for some reason. Is there somewhere to go for help?

[Harley PoMMom]

The drooling, teeth grinding, and panting could be caused by pain, dogs can be so stoic when it comes to pain, so I wonder if her dose of Gabapentin needs increased.

To find your Thread easier: When you log in take the mouse over your user-name and click, a window will appear with options, click on the first one which is "View Public Profile" this will take you to your user profile, on there will you see some tabs under your user-name, click on "Statistics" and then you will see "Find all threads started by Tassysmom" and click on that, this will list all threads that you have created, so then you just click on the one you want to open...hope this helps ;)

Hugs, Lori

[Tassysmom]

Lori, Thank you so much for the instructions.

I'm going to try giving Tassy more Gabapentin 100mg - maybe mid-morning. I hated to give it to her during the day because of it's sedating affect. But Vetoryl is sedating, too, so maybe in the morning close together won't be any worse. Thanks, I'll give it a try.

I also, have 50mg Tramadol. Do you think that would be a better choice?

[Harley PoMMom]

Adding the Tramadol may be a better choice, however I would ask the vet what they think...keep us updated, please.


For pain control, gabapentin is usually used in conjunction with other pain relievers which may later be tapered away. Unfortunately, it is common to develop tolerance to gabapentin so that the pain relief dose must be increased as time goes on. How long a dose is adequate before it must be increased is highly individual. found here: http://www.marvistavet.com/html/gabapentin.html

Hugs, Lori

[mommyslittlegirl]

Hi Tassysmom,.

[Tassysmom]

Hi Again Lori,

I'm so glad you are here!! Thanks for responding so quickly.

My vet is totally inexperienced with pseudomyotonia and I think much of my dogs problem is with that neurological aspect of her disease. And it makes it difficult to assess her condition because her blood work and cortisol levels look good but she isn't even close to being her old self.

The vet originally prescribed the Tramadol (I was wrong...she prescribed 1/2 of a 50mg tablet - twice a day for discomfort; as well as the Gabapentin at night). So, without seeing obvious signs of discomfort (how to recognize?) and not wanting her sedated all day, I discontinued the painkillers. Nights were a "nightmare" where she was restless and panting non-stop. Neither of us could sleep. Additionally, it was warm and so it was easy to blame it on that. However, at the vet's advice, I have restarted the Gabapentin at night and she's doing much better.

Now, if you are right, and the panting, drooling and grinding may be a sign of pain, I am going to go back to the 1/2 dose of 50mg Tramadol once or twice depending on how she acts. Again, the vet had no suggestions about that; only that her teeth and gums looked great (I brush them every night).

I might add, there has been little-to-no reduction of panting even though we've seen the cortisol levels correct themselves, which may be, as you suggest, a sign of pain.

Years ago, when I had my first Border Terrier, I was told they tolerated pain almost too well. So I am having trouble knowing when there is pain. My husband and I agreed we would continue on as long as Tassy wasn't in pain and appeared to enjoy life. When she's sedated, she doesn't even know about life let alone enjoy it. She just sleeps all day long.

So, if there is pain and I need to keep her on pain meds for it, then I have another decision to make.

This disease (and esp. the pseudomyotonia) makes knowing what to do so hard. When is enough, enough?

[Tassysmom]

Hi Tassysmom, kiki sounds a like like your Tassy. The vets can not find her problem. She too has lots of muscle weakness. It started with the hindlegs and now the front legs,knuckling etc. If its ok with you,i would like to see if we can help each other. She is also on pregablin for pain. Thank you,Dawn
Hi Kiki's Mom - I didn't see your reply before getting back to Lori. I wish I could remember the website I visited that had a video of a Basenji with pseudomyotonia. It would help you to know if Kiki has it. Less than 1% of Cushings dogs get it so it's rare and many vets have never seen it.

Tassy's case started with the hind legs - in fact she tore her hind ACL bouncing around on uneven ground - the first sign we had even before the Cushings was diagnosed. Both hind legs are stiff and yes, then in a week or two, the front started to knuckle; one side worse than the other. She is reluctant to walk and won't go far. She did finally figure out how to use her stiff legs better - a learning process for her. Because when it first happened, she sat down and wouldn't move. That didn't last long but we took her immediately to the vet who didn't have a clue.

Here is one thing you have to ask yourself. How important is it to have a label? The next steps for us would be testing ($$$) including a neurologist evaluation ($$$). And there is no cure - not even any treatment other than managing any pain (if you can tell). I've resisted all that as we are on a fixed income (retired). A clinical evaluation (observation) was enough for me....and finding websites that describe the condition and seeing that video.

Pseudomyotonia definitely complicates your problems and makes in more difficult to know what to do and when to do it. What breed is Kiki? How long since she's been diagnosed with Cushings and how are you treating it? I'll look at your info and see if I can answer those questions. I'm still a novice at using the forum so please forgive me if I have trouble finding my way around.

[mommyslittlegirl]

Hi Tassysmom,

[Tassysmom]

Wow...you and Kiki have been at this for three years!!! Tassy was diagnosed last Sep at just barely 8 yrs old. That should have been her prime. She is/was a very active agile Border Terrier. After using trilosane for almost 9 months we finally saw her hair grow back in. She has a double coat and so bare patches were only visible on her tummy and tail. The rest of her coat was merely very thin and her skin scaly. All of that is much better w 30mg of Vetoryl a day. Her last ATCH was perfect. Her vet doesn't give me the actual numbers which wouldn't mean much to me anyway. Her blood panels were also normal except for a slightly underactive thyroid which the vet didn't seem too worried about. We go back in 5 months for another ATCH assuming nothing else happens. Also, the vet doesn't feel a greatly enlarged liver but says it's under her rib cage so can't be totally felt. She (the vet) is taking a very conservative approach with us as she knows we don't have money to perform tests that don't change Tassy's treatment or alter the outcome. As a result I don't know as many details as people who do the whole battery of tests.

I've been blown away by all the symptoms as you can see from earlier posts. Tass is still panting like crazy, drooling more than before Cushings, grinding her jaw, sleeping a lot, stumbling and refusing to walk very far. I've been watching the drooling since it was suggested it might be due to pain. It appears to be associated more w anticipation of eating. She watches us prepare her dinner and drools. She sees us going to the cookie box and drools. Lots more sticky saliva than we ever saw before. We just mop it up...

What other symptoms does Kiki have and how are you dealing w them? How would you assess her quality of life? I've been concerned about that with Tassy. I sometimes feel like we are keeping her going w meds but she can't do any of the things that she used to enjoy. She doesn't play with her toys, hates walks, can't jump or run. This was a dog who enjoyed doing agility and was incredibly athletic. I would be appreciative if you would share your thoughts with me.

Thanks for getting back.
Tassy and Linda

[Tassysmom]

Also I want to say how sympathetic I am about Kiki having this terrible illness. The pseudomyotonia makes it worse. I can only imagine what the last three years has been like for you and Kiki. I am very sorry. These are our children and if they suffer, we suffer.

[Tassysmom]

Here I am again. It has been a couple of months. Tassy has plateaued a bit (I almost hesitate to say). After getting a good Stim Test in August (I don't have the nos. but the vet was happy) and a recall in 5 months, she has had a few ups and downs. It's been 1 year since her diagnosis.

The weather has cooled which is MUCH better - she likes it cool. Her coat has returned with a vengeance. I saw it was called CushFuzz and that's no-kidding. It's not at all like it was before Cushings. Now there is a full, fluffy undercoat that falls out about as fast as it grows in. It's all over everything and this is a "non-shedding" breed (Border Terrier). She looks like a bear - maybe a beaver.

A new symptom showed up. She now has a strong body odor - kind of smoky - not bad but strong. It clings to everything. The teeth-grinding and drooling are about the same. The lameness from the myotonia is worse. That, and the panting, may be the hardest symptoms for us and for her to live with. She's falling a lot; skidding on smooth floors, and "butt over teakettle" on uneven ground. She wants to spring up like her old self and forgets that she can't. She took off after a squirrel at the park and did two somersaults. The spirit is willing.

So I bought a dog-stroller. I recommend it. They are inexpensive; get the job done without costing a fortune. She absolutely loves it; sits still and looks in all directions. She hated that we were walking without her and I'd hear her barking in reproof. But she couldn't get very far walking before she'd stop and wouldn't budge and then my husband or I had to carry her home. This is saving our backs and giving her some real enjoyment.

There are nights - usually nights - where her panting is non-stop. She's getting the 100mg Gabapentin before bedtime and that seems to help her relax and sleep. She's on 30mg Vetoryl (Trilostane) after breakfast - once a day. I read John II's saga with Angelina where he experimented with two doses a day and then back to one and then back and forth. It didn't seem to make a lot of difference and what difference there was, didn't last long. My vet has encouraged me to stay with one dose a day to avoid low cortisol danger.

I just want to thank all of you out there in Cushing's Land for sharing your experiences, and those of your beloved pups, with the rest of us. While I might not post a lot, I do read other's posts and they provide a lot of insight and understanding of what we are all going through. I particularly liked the description of a Twitcher (running to the vet with every new symptom). I can't remember who mentioned that. It is a real easy thing to become since the disease presents so many symptoms. As a result of reading this blog and seeing that we share this experience, my hope is that I can avoid becoming one. Reading these posts is like attending group-therapy and it is very helpful.

[labblab]

Welcome back and thank you for this update! Can you do us a huge favor, though, and please get us the actual numbers for Tassy's August ACTH test? I know your vet was pleased with them, but I noticed that you described them earlier as being "normal," and that is always a bit of a red flag for me because dogs taking trilostane actually need results that are below what would be normal for a dog without the disease. Sometimes lab reports will give the desired ranges for dogs both taking and not taking medication, but this is not always the case and we have frequently encountered vets who did not realize that the norms differ. So please get us those actual numbers. It may be the case that Tassy might feel even better in the event that her cortisol still needs to be lowered a bit further.

Marianne

[Tassysmom]

Yes, I'll get a copy. Should have asked at the time. She was so pleased with them that I just went skipping out the door! But we have had several occasions since then of uncontrollable panting which is very alarming. News at 11.

[Tassysmom]

Okay - here were the results of tassy's tests taken 8/14/15.
Tassy is on 1 30mg Vetoryl in the am after breakfast and 1 100mg Gabapentin about 10pm.

Cortisol Serial 2 (ACTH)
Cortisol Sample 1 3.1 ug/dl 1.0-5.0
Cortisol Sample 2 3.5 ug/dl 8.0-17.0

Epithelial Cells - None Seen
Fat Droplets - 4-10

Superchem Tests Ref. Range Units
Total Protein 6.7 5.0-7.4 g/dL
Albumin 3.8 2.7-4.4 g/dL
Globulin 2.9 1.6-3.6 g/dL
A/G Ratio 1.3 0.8-2.0
AST (SGOT) 41 15-66 IU/L
ALT (SGPT) 6 (LOW) 12-118 IU/L
Alk Phosphatase 233 (HIGH) 5-131 IU/L
GGT 3 1-12 IU/L
Total Bilirubin 0.1 0.1-0.3 mg/dL
BUN 20 6-31 mg/dL
Creatinine 0.7 0.5-1.6 mg/dL
BUN/Creatinine Ratio 29 (HIGH) 4-27
Phosphorus 3.9 2.5-6.0 mg/dL
Glucose 99 70-138 mg/dL
Calcium 10.5 8.9-11.4 mg/dL
Magnesium 1.9 1.5-2.5 mEq/L
Sodium 147 139-154 mEq/L
Potassium 4.9 3.6-5.5 mEq/L
Na/K Ratio 30 27-38
Chloride 110 102-120 mEq/L
Cholesterol`257 92-324 mg/dL
Triglyceride 487 (HIGH) 29-291 mg/dL
Amylase 440 290-1125 IU/L
Lipase 278 77-695 IU/L
CPK 352 59-895 IU/L

CBC Tests
WBC 10.6 4.0-15.5 103/uL
RBC 7.0 4.8-9.3 106/uL
HGB 16.6 12.1-20.3 g/dL
HCT 51 36-60 %
MCV 73 58-79 fL
MCH 23.8 19-28 pg
MCHC 33
Platelet Count 464 (HIGH) 170-400 103/uL
Neutrophils 8692 82% 2060-10600 /uL
Lymphocytes 954 9% 690-4500 /uL
Monocytes 742 7% 0-840 /uL
Eosinophils 212 2% 0-1200 /uL
Basophils 0 0% 0-150 /uL

TOTAL T4
T4 <0.5 (LOW) 0.8-3.5 ug/dL

Urinalysis
Natural Voiding
Color - Yellow, Appearance - Clear
Specific Gravity - 1.040 1.015-1.050
pH 8.0 (HIGH) 5.5-7.0
Protein 1+ (HIGH) Negative
Glucose-Strip Neg Negative
Ketones Neg Negative
Bilirubin Neg Negative to 1+
Occult Blood Neg Negative
WBC 0-1 0-3 HPF
RBC None 0-3 HPF
Casts/LPF None Seen Hyaline 0-3 LPF
Struvite (MgNH4PO4) Crystals - 2-3 HPF
Bacteria None Seen None Seen HPF

[Harley PoMMom]

Hey, can you add the reference ranges and reporting units for those Superchem/CBC values...thanks! And those ACTH stim results look great!

Hugs, Lori

[Tassysmom]

I've added the information you requested but it was all scrunched together (took out the spacing I added to make it easier to read). I hope it is readable.

I missed the TOTAL T4 the first time and it was LOW. I've added it - of course I don't know what it means. Also, I had the incorrect result for the Struvite Crystals (s/b 2-3) and there is no reference range on that.

I would love your reaction. I see several LOWS and HIGHS. There is a note under the TOTAL T4 that says "result verified - Total T4 result is less than 1.0 mcg/dl. A Free-T4 by equilibrium dialysis may be helpful in supporting the diagnosis of hypothyroidism in patients demonstrating clinical signs compatible with hypothyroidism. (What are those clinical signs??) The vet didn't say anything about this.

Thanks so much for your time on this. Tassy has some particularly worrisome symptoms while her overall interest in life, eating and pooping/peeing and such remains normal. One is the non-stop panting along with excess drooling. Also, the teeth-grinding. Her odor has gotten quite noticeable, too....musty/smoky. And I've never seen so much hair on this dog!!!

[Tassysmom]

I don't see my edited version unless I go into it specifically. But then I guess you know what you are looking for. I'm still unfamiliar with this website - it's not intuitive, which could be just me. :(

[Harley PoMMom]

Thanks so much for adding that extra info for us. All in all, I think Tassy's results look pretty good, the only thing that I am a bit concerned with is her having struvite stones/crystals. I would definitely follow up on that, either by having another clean urine sample taken or having a look with an ultrasound. Struvite stones/crystals may cause some pain which can cause a dog to pant more and drool.

The T4 is for the thyroid, and although the Free T4 results are a better indication of how the thyroid is functioning, to me, the best option is to send samples to Dr Dodds. Dr. Dodds is considered an expert in canine thyroid issues and has developed a new diagnostic tool to evaluate thyroid disorders in dogs called the T4:FT4 Ratio. Some of the symptoms of low thyroid are: lethargy, cold intolerance, weight gain, aggression/anxiety issues, and elevated triglycerides/cholesterol.

Here are links about Dr. Dodds: http://www.hemopet.org/education/jean-dodds-veterinarian.html

Thyroid testing (Dr. Dodds): http://www.hemopet.org/hemolife-diagnostics/veterinary-thyroid-testing.html

T4:FT4 Ratio: http://www.hemopet.org/hemolife-diagnostics/thyroid-vet-references/t4-ft4-ratio-thyroid.html

You're doing a wonderful job!

Hugs, Lori

[Tassysmom]

Thank you, Lori, for BOLDING the HIGH and LOW results. Makes them stand-out better. Would love to hear from someone who knows what all of that means - any picture emerging? I felt very positive after the ACTH Stim results and I'm glad to see you agree. However, some of the "clinical signs" (as I mentioned previously) that I live with (that the vet never sees), have me worried.

I contemplated having Tassy see a neurologist for the limb-rigidity (pseudomyotonia was suggested here and it fits!). It would cost another $xxx, so I decided against it as this disease is already so expensive to treat. I'm not sure having an "official" name will change anything for Tassy. However, I hear her grinding her teeth (bruxism) and wonder if this is due to the myotonia and whether I should be doing something for her.

Any thoughts would be appreciated.
Lin and The Tasker

[Tassysmom]

Oh thanks, Lori. I didn't see your response before my last post. I'll call the vet tomorrow and get Tassy in for a review of the struvite crystals with reference to the teeth-grinding/drooling.

I'll take a look at Dr Dodd's website. I'm not seeing the clinical signs of low thyroid, but I will look for them.

Lin and Tass the Lass

[Harley PoMMom]

Thank you, Lori, for BOLDING the HIGH and LOW results. Makes them stand-out better.

Can't take the credit for that, someone was so nice to do that for us. ;)

[Tassysmom]

I called the vet about the 2-3 Struvite crystals in the test results I posted. She didn't think that indicated a serious problem. She was concerned about the teeth-grinding and gave me a prescription for an anti-inflammatory med. However, she felt she was at the end of her ability to help Tassy (without moving forward to more testing and/or referral to specialists). She said that the pseudomyotonia, from what she understands, accelerates the Cushings deterioration process. I've read that as well. So the question is - when is enough enough? I still don't know the answer to that.

Tass had another bad night (always on the weekend). The panting was non-stop so she rocked the bed. It wasn't warm but I put a cold towel on her for awhile. Also, a fan. Then she tossed herself around as though she was trying to get comfortable or find a better position to breathe. Her throat "clicks" with the panting exertion and occasionally, she clears it as though it's congested. I offered her water and she drank and drank but her urination wasn't excessive. I think she expires the water through the panting. Finally, finally, she calmed and slept (and finally, so did I). Today she is very subdued. What I am seeing is her breathing is less labored and there is less panting during the daytime when she's lying on her belly. Lying on her side seems to produce the panting. In the bed at night, she actually rolls onto her back with all four stiff little legs up in the air and holds that position for awhile. Since that is the reverse of lying on her belly, she seems to breathe better in that position; strange as it is. So there is another "clue". From what I can read, she could be having difficulty getting enough oxygen due to weak (or stiff) chest muscles, due to deposits in the lungs, or due to congestive heart failure (or all of the above). None of this is fixable.

On we go.
Linda and Tassy

[molly muffin]

i am sorry that Tassy is still having such difficulty with the panting

i guess if nothing is fixable you are looking for your vet to be able to make Tassy as comfortable as possible for as long as she can really. So that is what I'd be talking to her about at this point. Anything to help with the breathing perhaps.

[Tassysmom]

Sharlene, Thanks for your response. It helps to know we are not alone in this process and that there are people reading and feeling our pain. Tassy had a good night and woke with pep and energy. She sat up, ears perked, and when I put her on the floor, she hopped down the stairs to breakfast. Who Knew?? This has happened before. It's like she hears us talking about that "final trip to the vet" and says loudly "Not Yet!"

So we are having a good day - hope it keeps up.
Linda and Tassy

[addy]

It can be a roller coaster of a ride, take the good moments
and hold them close.

You are never alone here.

[Tassysmom]

Oh yes, it's a roller coaster. After a good early part of the day, the panting started at about 2pm. It was such a good morning we took her to the park. She walked a short distance, could go no further, so we popped her into her stroller and finished the walk that way. She loved it! Later the panting started. She gets a far-away look (inward, I think) and pants and drools. Now I'm back to thinking we are close. I'm doing a "wait and see". If we go more than a day or so like this, it's time. This disease is not only torture for her, but for us, too. I guess we have to figure out if she's having more good moments than bad ones.

Thanks for the sympathy and understanding.
Linda and Tassy

[molly muffin]

It's never easy to know exactly when but it doesn't sound like it was too horrible a day for her. They do love the stroller rides don't they. :).

Hugs

[Tassysmom]

The stroller is the best purchase I ever made. I wish I'd thought of it sooner. She would take a few steps, relieve herself, and be too pooped to walk home. One of us would carry her. Then we would leave her home and go for our walk. She'd know we were going without her and I could hear her barking down the block. Now she gets to go with us and you can see she just loves it. When we tell her it's time for a walk in her stroller, her eyes light up and she drags herself up from her prone spot on the carpet ready to go.

No it wasn't too horrible a day - actually a pretty good one all things considered. We'll see how the evening/night goes. At least she gets the Gabapentin at night and that helps her sleep. I keep wondering if two doses of Vetoryl, morning and evening, would help, but the vet is unwilling to try it for fear of Addisons. And I read John II's account of doing just that and it didn't seem to make a difference.

Hugs,
Linda and Tassy

[molly muffin]

That is just precious. I hope she has a food night.

[Tassysmom]

Not a good night. Not a good morning. Tassy was definitely worse. We decided to call the vet and went in and had her put to sleep. It went very fast - about 5 seconds. So fast, we didn't even do sedation. She was somewhat sedated from the Vetoryl anyway.

Just so everyone out there knows, what killed my Tassy was the pseudomyotonia; not the Cushings. It's a side-effect (very rare; less than 1%) of Cushings so in that respect it WAS the Cushings. But Tassy had an accelerated case. The myotonia causes severe muscle tension and was first noticeable in the legs. Her front legs toed-in and the back splayed out and she didn't want to walk very far. But the real issue became breathing. I believe (without conclusive proof) that she couldn't get a full breath and so to get enough oxygen she panted constantly - and drooled - and was having trouble eating and swallowing. Anywhere there was a muscle in her body, it was becoming rigid. It's like slowly turning to concrete. It was horrible.

But I miss my girl like crazy. Thanks for everyone's kindness. We are all in this together for sure!

Linda

[judymaggie]

My heart goes out to you -- it is so hard to see our pups suffer but it is still so difficult to let them go. Be gentle with yourself and try to focus on all the good times with Tassy.

[Tassysmom]

Yes, knowing when to let them go is the hardest part. We probably kept her going too long. The vet was actually surprised that we kept going as long as we did - once she saw the paralysis set in.

I want Tassy back but not in the condition she was in. So I miss her, want her with me, but not unless she was whole and healthy again... my wonderful, frisky, adventuresome, curious, friendly, smart, happy Border Terrier. Lots of antics, lots of fun and funny times. She was a "character" with more personality than any dog I've had.

[Harley PoMMom]

Oh Linda,

I am so sorry for your loss of dear Tassy, and my heart goes out to you and your family. Letting them go is so very hard, we sure do understand the pain you are feeling and we are here for you always.

With Heartfelt Sympathy, Lori

[Tassysmom]

Everyone in this blog is going to lose their beloved dog. Some sooner (as with Tassy) and some later. It is wonderful to have people such as you, Lori, sending eSympathy. It's therapeutic to talk about it. I kept reading the online articles and hearing that we probably had 2-3 years but I would always think "BUT". The "but" was the pseudomyotonia. It was the uncommon denominator and it was the thing that brought this all to an early end. I hated to see the effort Tassy took to move around and when it started to be a breathing problem, I figured it wouldn't be long. She only got to live about 2/3rds of her lifespan. I just feels so unfair!

Thanks for your help with the pain. Tomorrow will be better (I hope).
Linda

[molly muffin]

Oh Linda. So sorry it came so soon.

It is always it seems the other things that come along with complications perhaps caused by Cushing's that seems to do the most damage. :(


I know it was best for her and you did everything to make her as comfortable as possible. That doesn't make the hurt and missing any less.

My sincerest condolences.
Hugs

[mommyslittlegirl]

Hello Linda, I am so sorry for the loss of your sweet Tassy. My heart breaks for you. You gave her so much love, a wonderful life. And than the final loving gift of letting her go even tho you knew the terrible pain you yourself would suffer.. Many hugs.

[Tassysmom]

Thank you Sharlene for all your good input and help during Tassys last days. And I am grateful for your kind wishes as well as mommyloveskiki. Mommy loves Tassy so much, too. I've tried to be sensible about this and know it had to happen. But at Tassys young age, I feel she was cheated and so was I. She almost didn't make it to nine. And she was a little star of a dog...did everything well. I'm missing her terribly.

Linda

[SandyH]

I am very sorry for your loss, no matter how long they are with us it is never long enough. You did everything you could for her and more.

[apollo6]

I am so sorry for the loss of your sweet Tassy. It sounds like she was your one and only. There is never enough time with them. She will always be a part of your heart and soul. May you rest in peace sweet Tassy.
Sonja,Apollo,

[Tassysmom]

Thank you Sonja and Apollo. And SandyH.

Tassy was my 2nd Border Terrier and I've only had 3 dogs in my life. The first was a Std Schnauzer. Tassy came along when I lost Bebe, my first Border Terrier. Bebe lived to almost 13 and died of complications of mucocele gallbladder surgery. It shouldn't have killed her but her sutures broke and her brain was flooded with stomach acid after her first meal. It was pretty traumatic. I grieved for 6 months and wasn't planning to get another dog when Tassy became available from a breeder. She was 6 months old; a beautiful blue and tan and a livelier, more active pup was not to be found. We did many AKC classes together for obedience, agility, rally and tracking and formed a tight bond. So it was a complete shock when she tore her ACL at 8 years old, followed by a diagnosis of Cushings Disease. My young vet was very on-top of Cushings symptoms and recognized the ACL tear, as well as the excess thirst and urination that we mentioned, as possibly Cushings. And it was.

I was prepared for the 2-3 year period of Vetoryl treatment that I read about. I was not prepared for the collapse of her front legs, the total lameness in her hind quarters, followed by the stiffening of other muscles in her body; like throat and jaw and chest. Nor that there was no treatment for this. She was slowly turning into a block of concrete and there was nothing that could be done. This took 1 year and a month from diagnosis. She was 9 in July 2015. And now gone. I am in shock and it will take a while but everyone on this blog helps me.

Thank you all so much.
Love and Heartfelt Good Wishes for your pups and you.
Linda

[Allison]

Linda, hi.

I'm sorry for your loss of Tassy. Also for all the pain of the rollercoaster ride. My husband and I went through the latter with our senior adopted dog, Gizmo, before losing him this past spring.

These words of yours resonated so greatly with me: "I miss her, want her with me, but not unless she was whole and healthy again..." My husband and I fell in love with Gizmo's personality while fostering him. Seeing him deteriorate was an emotionally exhausting experience.

My thoughts are with you. I understand the pain. We all do here. Hugs.

[Tassysmom]

Hi Allison,

Condolences on losing Gizmo. Is he a terrier, too?? I never was able to get Tassy's picture to show up in the blog but I have one in my gallery. Take a look.

When you say "emotionally exhausting" you are absolutely right. I'm wrung dry. I am still fighting tears. I've sobbed so much I've put my back in spasm. It's marginally better today, but that is all. And I don't want to go this route again. So far, I feel like my age, emotional well-being, and energy-level (and that of my husband) is against having another dog. But time will tell.

Thanks for taking time out to send your best-wishes.
Linda

[molly muffin]

Deep breaths. This is one of the hardest and most emotional experiences to go through. Being exhausted emotionally takes so much out of you. Some days will be better and some worse, but it all takes time.

hugs

[Tassysmom]

Dear Molly Muffin,

You have been such a brick for me! I am back to 2nd guessing myself and our decision last week - was it too soon? Could Tassy have gone another few days, a week, a month? With the constant hard panting and the paralysis, we didn't think so. Our heart was full of love for her and we felt, we KNEW, she was suffering. She was such a trooper, I know she would have continued on. But this damn disease is relentless and nothing was going to get better. I hope time will heal.

I got Tassy within 6 months of losing my first Border Terrier, Bebe, and I never really stopped grieving until Tassy came. I see neighbors (usually women) go right out and get that next dog in the week of losing one. I understand the instinct. It's the "quick fix" and diverts attention from grief... but, for so many reasons right now, I don't think it's the right choice. One being I am care-giving for my 98-yr-old mother in my home.

You are right; some days are better than others. It's amazing how the grief will side-swipe you just when you think you are doing better.

Thanks for your kind words and encouragement. I hope this horrible feeling fades and leaves behind only wonderful memories of our little girl.

Linda

[molly muffin]

Everyone does the second guess after having to make this horrible decision. Everyone! So don't beat yourself up over doing so, but do keep in mind one thing, when you ask yourself, could she have lasted longer and was it too soon, remember for every decision there is a result and sometimes the result is not what we hope or wish it where. Just as we ask ourselves, was it too soon, could she have made it longer, comes the flip side of the coin, what if you hadn't made the decision when you did and she got worse and was in more distress. There is always two sides to every coin remember and we have no way of knowing which way things would go.

Knowing when to get another pup or If you will get a another pup, is like so many things, personal to each person and there is no right or wrong in general, there is Only what is right for me, for my family today. Tomorrow the answer might be different or it might not and that is all okay. There are always a ton of factors to be considered and you, yourself is only one of them, what is best for the whole and what Feels right, is what IS right today. Hold on to that, listen to what your heart tells you and you won't go wrong, not yesterday, not last week, not tomorrow and not a month or year from now.

Big hugs!

[molly muffin]

You know, I just have to throw this out there too, I love to see your sign in from Lacey, Washington. I lived in Yelm for quite a bit of time back eons and another life ago. It is a small connection to an area that I loved for a long time and still do.

[Tassysmom]

So are you in BC? I see you are in Canada. I love Canada - love the dog-culture for one thing. Lovely people. Yes, Yelm is right next door - and growing, too. I've considered moving there to get a little more property for a dog. That's another thing; we live in a townhouse affair with a patio and a wee yard but not enough for an energetic younger (and healthy) dog. At least not right now.

Your comments help me a lot. You say things that I need to hear. One of the things that terrified me was having a crisis on the weekend and having to go to the emergency vet. Been there, done that with my previous Border and it was horrible. I felt a crisis looming; her decline was so marked. And there is nothing good about watching a loved-one gasp for air - there were rigid muscles all over; her legs, her ribs and lungs, her jaw and throat, why not her heart?

Thanks for helping me so much.
Linda

[molly muffin]

I am in Ontario now. I've been here for years and love Canada. I still call California home too, as that is where I am from, where my immediate family live, with a whole bunch of them in the midwest US too, so we are back and forth quite often. Or enough at least.

yes we are a dog culture here, but I find the same in the US. My dog is from a rescue in Quebec. Again though, lots of great rescues in the US also. We do have a lot of dog parks, off leash parks and that sort of thing, still that is all true in the US too. I was at a restaurant in Santa Cruz area on the patio and there was the people menu and then the dog menu and I have to say, they both looked pretty darn good. That is the kind of thing I love.

[Tassysmom]

Me too!! And I grew up in southern Michigan - near Ann Arbor!

[spdd]

I meant to post earlier, and I'm sorry for the loss of Tassy. I know how you feel, and it's not easy. It was just myself and my beloved boy, so I miss him terribly even now. My sincerest condolences... and yes Sharlene is a rock isn't she? She even came with me to the specialist with Keesh. The people on here are wonderful and although it's almost a year, I come back to see how the others are doing... the bond remains.

[Tassysmom]

Thank you Judi for stopping by to share condolences. I'm sorry for your loss of Keesh and no, we don't stop missing them, do we? Not the ones we love.

Linda

[Beaglelover]

Linda

Please accept my deepest sympathy for your loss of your beloved Tassy. While I haven't read all your thread I know from what I did read you and Tassy had been through a lot. Please don't second guess your decision to let Tassy go, it's painful for us because we are here missing them, but Tassy is now at peace. May time heal your broken heart.

Hugs! Jenna's mommy
Tammy

[Tassysmom]

Thank you so much Tammy. Another Ontario girl! Close to my homebase in Michigan!!

I care-give for my 98 yr old very arthritic Mother, so not only did I have a dying and disintegrating dog, but a disabled Mom. (My life is full of Ds) Today is 1 week since we put Tassy to sleep and I'm a mess all over again. Very, very hard. These animals are our children! They can't talk to us but boy can they communicate. And I miss that daily company and conversation.

I'm sorry to see so many people suffering on this blog and off. You realize how many dogs and families are going through this. I wish they'd discover an ability to laser the tumor out altogether - something not invasive. Someday, I imagine.

Best Wishes to you and your Jenna.
Linda

[SuperCupcake64]

Linda, my condolences to you and your husband. I think letting a dog go can be a really courageous, selfless, and loving act. I've been following your thread and it's so clear how much you loved her. You were lucky to have each other. It's so hard at first, isn't it? Every day gets just a little bit better, I've found, and I've lost 2 in the past two years.

May your memories of Tassy help console you.

Jen

P. S. I saw that you're originally from around Ann Arbor--me too! :)

[Tassysmom]

Jen, omyg - two!! I am so, so sorry for your loss and the time you've been through. Both Cushings? I've seen people here back with ANOTHER Cushings dogs and I can't imagine going throught that again. I was thinking this morning as I was still in bed at 6:45 that normally Tassy would have us up easily by then because of the panting and discomfort. I feel like I've slept in if I make it to 7am!

I grew up in Chelsea.....e.g. Jiffy Mixes. My dad owned a Funeral Home (of all things). I didn't leave for the west coast until I was 25. I'm meeting so many wonderful people on this blog - what a wonderful support network this is. The one thing you don't get with a Cushings dog is support locally. No AA meetings or group therapy or long chats with the vet about what is happening and what to expect and that there are others going through it, too. It's a lifesaver - as you well know.

Thanks for taking the time to contact me, Jen. Those little loves of ours will remain in our hearts forever.

Linda

[Beaglelover]

Jen and Linda

I live in Walled Lake MI but work in Ann Arbor, it's a small world.
I'm sure you feel the same as I do, this site is amazing filled with so many compassionate loving and knowledgable people. This is my second round with Cushing's and I know it was the support here that educated and guided me through my first Cush dog. I'm back again.

Time will heal our hearts, and may the memories from our fur babies live forever.

Keep in touch
Hugs! Tammy

[Tassysmom]

Tammy,

My sister has a Beagle (Harley). He's young and so far healthy but I've read where they have a Cushing's genetic propensity. She's owned cats and this is her first dog. I certainly hope she and Harley don't have to go through this. I feel your pain with this horrible disease. Two is more than I think I could bear - but I guess you bear what you have to. I am aching for what you have to go through....again.

Hugs,
Linda

[SuperCupcake64]

Born and raised in Ann Arbor. :) In Chicago now, however. I remember going on a field trip to Jiffy! Tammy, one of my best friends grew up in Walled Lake.

Having people to talk to who understand makes all of this stuff so much easier. My Sammy is going through a health crisis at the moment and the support and information I've gotten here and from other sites has made a world of difference. I'm so grateful.

Linda, neither were Cushings dogs. In August 2013, my beloved Gracey got into a giant bag of semisweet chocolate and it killed her. She was only 5. This past March, I lost my 15-year old Wheaten to old age and dementia. I have two dogs at the moment--Sammy, who I adopted 2 years ago knowing he had Cushings, and Maizie, whom I got from Puerto Rico (she had heartworm when I got her, but that's resolved now). Sammy is currently going through trouble with his kidneys, so I'm syringe feeding him and just learned how to give subcutaneous fluids at home. Now that he has kidney issues, he won't be able to continue trilostane, so I think I'm going to have to do as many natural treatments as possible. Always new things to learn.

[Tassysmom]

Jen, Ann Arbor!! It is a small, small world.

I'm so sorry for the dogs you have lost and Gracey's poisoning must have just about killed you. I can feel your pain.

You are amazingly brave to take on the care of a Cush dog. How old is Sammy? Tassy never seemed to have any kidney problem (that I knew of) but she started to exude an odor that I can still smell in places around the house - like something pretty awful was happening inside. Her biggest problem was the muscle tension which was slowly but surely paralyzing her all over. I've never heard of anything like it and indeed it is very very rare (so no help whatsoever on the part of the veterinary establishment). She was a high octane dog as a pup, so this was horrible for her and for us. I hope Sammy can cope with the natural remedies and it sounds like at least Maizie is doing well. Thank heavens.

Blessings to you for what you are doing for these two special pups.
Linda

[molly muffin]

Isn't it great all the wonderful people you meet on here. :) Small world indeed.

You'd think as prevalent as cushings seems to be these days that they would have support groups for it. :) I have to confess I do have long talks with my vets and specialist about molly, but then I'm a yakker as they say, so that might have something to do with it too. :)

How you doing Linda?

[Tassysmom]

Thanks for asking. I'm doing better. My husband and I got a care-giver in for my mother and got away for 2 days to Eastern Washington. We had a nice drive through the mountains, saw some fall color and had lunch with old neighbors, who knew Tass, and dinner with a couple who also, new Tassy. They were very sympathetic and each person had experiences with losing dogs so knew our pain, like only dog-lovers can. It was very therapeutic.

How is Molly Muffin these days?

Linda

[molly muffin]

Oh that is a beautiful drive over the mountains. I use to do it quite often as had family over in eastern Washington. Not great in the winter sometime but fall is lovely.
It does help to be with others who knew Tassy and can share in the memories.
Molly is good. Same as usual really. Maybe a bit more loss of sight which makes her more jumpy and prone to yell fire "bark bark" when there isn't anyThing there but still good overall.

Hugs

[Tassysmom]

We lived in Wenatchee for 12 years. All of Tassy's life. I was going to scatter her ashes and I couldn't part with them. But it was nice to go back over - raining over here - lovely and clear and sunny over there. It was a scary place to leave in winter, however, with the passes all ice and snow. Once my aging mother came to live with me, we could rarely leave. And it became too confining. But for a visit, it can't be beat!
Linda