My 5 year old Pom has Atypical Cushings

[LittlePom]

Hello. I am very happy to find you! My Little (his name is Little) is a 5.5# pomeranian. He was diagnosed with atypical cushings in November. He has very little hair. His exposed back side reminds me of a boned chicken. He's happy and energetic and not overweight. He's had a few seizures where he just stiffens up, looks scared and arches for awhile. They were before the following protocol. He just had another the day before yesterday. He didn't have his lignans/melatonin for 2-3 days while more was coming. We've had him on Lignan's for Life's protocol of flaxseed lignans (6mg/day) and melatonin (6mg/day) since. He doesn't seem to be improving. I did also suppliment with Standard Process Canine Hepatic & Adrenal support. My vet wondered if this is why his tests are about the same as the first time. He said we are trying to suppress the hormones and the suppliments may increase them. I worry about him. I'd love any help & suggestions. They will be greatly appreciated! I just joined right now and have not had time to really dig through the forum yet. I'm just about to get started!

[Squirt's Mom]

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[labblab]

Hello and welcome! Your membership registration has now been finalized, so that is all taken care of. :)

Turning to Little, can you tell us more about his Atypical Cushing's? As a formal diagnosis, this designation is made in conjunction with elevations in adrenal hormones other than cortisol. In other words, unlike conventional Cushing's in which cortisol is elevated, the dog's cortisol is within normal range but other hormones are abnormally high. In the U.S., testing of a complete adrenal hormone panel is only performed on blood samples sent to Univ. of Tennessee in Knoxville. Did Little have labwork performed there, and is that the basis for the diagnosis? If so, we'd love to see the actual test results.

Aside from hair loss and the seizures, does Little have any other problems or symptoms? Thanks in advance for this additional information!

Marianne

[LittlePom]

I wrote my vet to get copies of the tests. He did send in tests, but I don't know where they were went to. I'll call them today since i have not heard back and let you know the details. I can post them here. I'll get both before and after. Should I post them even if they didn't come from the Univ. of Tennessee?

The hair loss is what had us go to the vet - and the seizures. The hair loss seemed to come on pretty quickly.

He is also a licker who licks just about everything - furniture, blankets, people if they will let him (I don't). I tell him to, 'stop licking', and he will but the next time I look at him, he's back at it. I've covered the couch with blankets thinking they go into the washing machine and who knows what the furniture has been treated with. It seems like a neurosis of some kind. He is very loved and spoiled and has someone with him most of the time. My husband is retired and home during the day. I work but I'm here mornings, evenings and weekends. He really seems like a happy little guy, though he wants me to hold him all the time - I'm a pretty well trained human.

I'll include photos of before and after here. The first 2 are in Oct/Nov 2012 when we didn't know he had any problem. The next two were in March, then 3 today and the last one is 2012 again.

I hope it works...

http://s247.photobucket.com/user/goldrushpawn/slideshow/Little

[molly muffin]

Oh my goodness, what a big change in the coat in just a few short months.

Yes, post test results no matter where they are from. But if from Univ of Tenn then just mention that.

We only need high and low test results, if they fall within normal range, then they don't need to be posted. For example:
ALKP 950ug range 50 - 150ug

Gosh they do train us well don't they. :) He sure looks like a sweetheart.

[LittlePom]

Thank you. I should have the results by tomorrow. You are so appreciated! It's nice to have someone to chat about it who knows what they are talking about.

It's amazing how fast he lost his hair. It scares me. He really is a sweety pie!

Our vet has said to continue with the melatonin/lignans for the time being and stop the adrenal/hepatic support and see what happens.

[LittlePom]

I have his results. They were done at the College of Veterinary Medicine in Knoxville, TN.

I'm going to scan them and add them as picture files. I hope you can read them alright. One was done 9/19/2014 and the latest one was done 5/11/2015

http://i247.photobucket.com/albums/gg145/goldrushpawn/Little/Little%201_zpsentbcqeq.jpg

http://i247.photobucket.com/albums/gg145/goldrushpawn/Little/Little%202_zpswu19yzly.jpg

Thank you for your help!

Kathy

[labblab]

Hi again, Kathy! Thanks so much for posting the lab results -- they are just what we needed. I'm heading out for the evening, myself, but will stop back by again tomorrow to add my thoughts after looking the results over more carefully.

By the way, Little is such a cutie pie regardless of how much hair he has! :)

Marianne

[judymaggie]

Hi, Kathy! Since Marianne won't be back on until tomorrow, I wanted to mention that, earlier today, she addressed the possibility of Alopecia X with another member (Kiki's Mom -- thread is "My Baby has Cushings"). I looked up a couple of websites, including one from University of Tennesee, and the pictures sure look an awful lot like Little's skin issues. Pomeranians seem to be one of the breeds that have this condition.

Here are a couple of websites to take a look at:

http://www.vet.utk.edu/hairloss/alopecia.html and

http://www.marvistavet.com/html/body_alopecia_x.html .

I saw on the UTenn reports that hair loss had been reported but I was wondering if any pictures of Kiki were transmitted.

Also, is it possible for you to post the second page of each report? This page would have their treating recommendations. One of the websites I looked at did mention melatonin as a possible treatment but stressed that it was very important not to discontinue it as it often didn't work the second time around. Reports said that it can take several months for any hair regrowth.

Take care -- I will do some more reading and see what else I can learn.

[LittlePom]

Thank you Marianne. After looking at one of these sites I realized this is what I initially suspected but once I was told that it was Atypical Cushings, I'd forgotten. It really does sound like my little. My vet said it was a hormone imbalance and probably a tumor causing it.

He's been on melatonin/lignans for awhile now. I've not seen any improvement yet.

These sights make the alopecia x sound cosmetic but not harmful to him?

We love him with or without hair. I just worry that the overproduction by the adrenals will wear them or other organs out early. It sounds like the only options other than the melatonin can harm him?

When I had the veterinary office fax the results they did not send the treatment recommendations. I may be able to get them Monday though.

I will research more on the alopecia too. Thank you!

[LittlePom]

I almost forgot, he is neutered. I can't remember his exact age when we had it done, but probably 7-10 months old.

[lulusmom]

Thank you Marianne. After looking at one of these sites I realized this is what I initially suspected but once I was told that it was Atypical Cushings, I'd forgotten. It really does sound like my little. My vet said it was a hormone imbalance and probably a tumor causing it.

Hello and a very belated welcome to you and Little. I'm not a veterinary professional, just a Pom lover who is very familiar with the breed as well as the various forms of cushing's....and I disagree with your vet. Poms are a Nordic breed and are famous for hormonal imbalances and it's not caused by a tumor. It's in their DNA. I think it's highly likely that Little has Alopecia X. If he had a pituitary or a functional adrenal tumor, you would most probably be seeing a lot more symptoms than hair loss.

My Pom, Lulu, had pituitary dependent cushing's and was diagnosed at three years of age, which is extremely rare. Despite being successfully treated with both Lysodren and Trilostane over the course of eight years, she never regained her coat. I'm also a special needs rescuer and have had a few bald male Poms who have pulled from shelters. Males, by the way, are actually more likely to have Alopecia X than females so Lulu once again was an anomaly. These boys were asymptomatic and their bloodwork was perfect so I opted for the Alopecia X treatment suggested by Dr. David Bruyette....a sweater.

Alopecia X in Poms, as well as toy poodles, is usually just cosmetic; however, it's concerning enough to pet owners that at least one study was done to test the efficacy of Trilostane in growing hair. As I recall all of the dogs had hair loss but no other symptoms. Some had elevated adrenal hormones and some didn't but regardless, those elevated hormones did not cause any clinical issues in the dogs, other than hair loss. Trilostane is known to increase sex hormones so I was surprised that most of the dogs in this study grew hair and despite higher adrenal hormones in some of the dogs, they continued to be asymptomatic. I think it's safe to say that even if you had a UTK adrenal panel done, your treatment options will be Melatonin and Lignans. Based on the study I mentioned, I'm sure that some vets familiar with this study may try Trilostane to grow hair but I personally would not put my dog on a chemo drug for the rest of their life because my vanity was greater than my dog's well being.

Like you and Little, I loved my Lulu no less without her gorgeous coat. Poms have a way of pulling people in, whether they have hair or not. My Lulu always got attention with her heart melting tiny face. No doubt your precious LIttle garners his own share of attention. How many times have you heard; "oh my gosh, he looks like a stuffed toy?" :D

Because Lulu didn't grow hair on either serious drug and since Melatonin and Lignans are fairly benign, I added them to her regimen. I gave it sufficient time and saw no response at all so discontinued. The fact of the matter is that the efficacy rate of Melatonin and Lignans is quite low which could explain why our boy is not responding. In my opinion, I think it's probably unlikely, but if Little should start to show other symptoms of typical or atypical cushing's, then you can worry about further testing. However, if he's otherwise healthy, then just enjoy loving him and keep him warm in the winter with a sweater.

I hope this helps.

Glynda

[My sweet Ginger]

Aaaaaaah, she's back!!!
We've missed you, Glynda. :):D:):D:):D:):D:):D

[LittlePom]

I was just reading though the thread and noticed my last statement wasn't clear that my vet did tell me that Little has atypical cushings (Though it does sound much more difficult to test for than I realized). I've researched the alopecia x and it also sounds like Little's affliction. What is the difference between the two? They both are hormonal imbalances. The atypical cushings could be a tumor and the alopecia x has unknown origins. The alopecia x sounds more like the darkened skin...

Since I've been giving him the melatonin & lignans (I don't see the lignans suggested for the alopecia x either? So maybe the female sex hormone imbalance is more atypical cushings like?) he does have a better appetite than he had before we added them - though he's not overweight.

Would his treatment be different with alopecia x than what we've been doing thinking it's atypical cushings disease?

Thanks once again!

[LittlePom]

Glynda,

Thank you for your post. I just sent mine and saw yours after the fact. You answered the questions I was wondering about! :D

I didn't realize until this forum that poms have alopecia x quite often. I'm happy to hear it's just a bad hair issue and otherwise he will be just fine.

I'll probably continue the melatonin/lignans for awhile and see how it goes.

The only other real concern I have is that he's had some mild seizures. He had 3 (than I'm aware of) before or about the time we started the treatment and then he didn't have any after that. I'd kind of forgotten about them. Then we didn't give him the melatonin/lignans for a couple of days and he had another mild seizure. I don't know if it's related or not, but I'll watch for that. He hasn't had any more (as far as I know) since he's been back on his melatonin/lignan regime.

I feel much better about his situation overall though. You've all been very helpful.

Have the poms you've had with alopecia x lived good long lives?

I have heard comments like, "He looks like a stuffed toy". He's adorable in a sweater too. He's not sure he likes them very well though. But when it's cold out it keeps him from shivering. I agree, poms somehow wrap themselves around your heart from the start. He's my baby. I'm sure Lulu is yours too.

Thank you again! I so appreciate your experience and advise!

Kathy

[labblab]

I'm so glad Glynda had a chance to write to you, too!

I'm including a link to an article that Glynda found for us a while ago that discusses the question marks that surround the meaning and significance of elevated adrenal hormones in relation to both "Atypical Cushing's" and also Alopecia X. The article is fairly technical -- I've read it several times and still am unsure that I understand it all! But both you and your vet may find it interesting:

http://www.2ndchance.info/cushingsbehrend2010.pdf

Marianne

[lulusmom]

Have the poms you've had with alopecia x lived good long lives?

Hi Kathy,

I'm glad you feel more comfortable about things. I know how hard it is not to think the worst when your once plush coated, adorable Pom is slowly going bald. I saw pictures of Little and just be prepared for him to eventually lose all of the hair on his torso. His head, feet, front legs and lower back legs should retain the hair. The reason for that, per Dr. David Bruyette, is that there is a much heavier concentration of sex hormones in the follicles of hair on the usual bald areas.

Yes, two of my rescued boys with Alopecia X were adopted and last I heard were doing just fine. Another, who was named Otis by a member here, was quite debilitated with serious spinal degeneration and was in hospice care with me until he crossed the bridge. Otis was a bit different in that his skin remained pink. Most, including my Lulu, had black skin disease which usually goes hand in hand with Alopecia X.

I've attached a link below to a picture of Otis and Lulu sleeping in the same bed. The bed looks enormous but only because both were so tiny. Lulu was my heart dog and I helped her cross the bridge a few years ago. I lost my other cushpup, Jojo, also a Pom, six months before Lulu passed and I miss them very, very much.

http://www.k9cushings.com/forum/album.php?albumid=11&pictureid=351

Lulu didn't care for sweaters that much to begin with but got used to them. She had hypothyroidism which made her very sensitive to cold so it was even more important that I keep her warm in the winter. Living in So California was a blessing. She adapted much faster to her thermal one piece pajamas so perhaps Little might like those better as well. You can find them at a lot of online stores but I usually shop on Amazon, which has quite a selection. I've provided a link to an Amazon to give you an idea of what I'm talking about.

http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=jumpsuit+dog+pajamas&rh=i%3Aaps%2Ck%3Ajumpsuit+dog+pajamas

Glynda

P.S. I'd like to thank Marianne for providing you with the URL. I've been away for a bit and am a bit rusty. My thanks to Song also for the welcome back. I'll try to check in whenever I can.

[LittlePom]

Thank you for the article Marianne. I just printed it out. I'll read in tonight or tomorrow. You are greatly appreciated!

Glynda, thank you for the photos. What sweet babies! I love the pajamas and Little seems to have less fur all the time. I didn't realize it would go that far, but I'll bet he'll grow to like sweaters and PJ's too. He gets cold pretty easy and we're up here in Montana near Glacier Park, so he's had to wear them for the first time this past winter/spring - though it's been very nice just lately.

judymaggie, I just got the second pages of the results of Little's tests. I've attached them here.

Thank you all for your help. It's nice to chat with others who know just what I'm going through and have a lot more knowledge about this affliction than I do. It's very comforting.

I'http://i247.photobucket.com/albums/gg145/goldrushpawn/Little/Littles%20Test%20%205-2015_zpsszz4coqs.jpghttp://i247.photobucket.com/albums/gg145/goldrushpawn/Little/Littles%20Test%20%209-2014_zps6o6t4vue.jpg

[LittlePom]

Hmmm... Only the recommendations from the first test in September of 2014 came through on my last reply. I'm adding the latest one as well from last month (5-2015)

http://i247.photobucket.com/albums/gg145/goldrushpawn/Little/Littles%20Test%20%205-2015_zpsszz4coqs.jpg