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SimMel27
07-31-2015, 02:08 AM
Hi! I am Melinda and along with my husband, Sim, we are owned by three doggies: Coco (10 years old), Maggie (5 years) and Katie (6 years). Two of three are rescues. Katie is one of those rescues, and she was recently diagnosed with Cushings. Her story is a long one. I will try to be brief. :D

Katie arrived on our porch in Mississippi, looking for some shade, on August 2011. We already had our puppy, Maggie and our older dog, Coco. So we were not looking to add another family member. I opened my garage, parked, opened my car door and in popped Katie. All smelly, flea-ridden, muddy, and sick, but wagging her little tail stump like crazy. I was so worried about her, that I couldn't just turn her out, so I gave her some water, she drank almost a gallon in minutes. Left in the bowl afterward, was a pile of sand and mud. I carried her directly into our spa tub...and worked on her for almost 24 hours. She had so many matts, that her ear hair had attached itself to her chest hairs, she could barely move her head. She had a raging double ear infection, she had fleas covering every inch of her body, her gums were white from anemia, she was covered in mud, and had a huge bloated belly. I took her the next morning to our vet to check on her health. I had been feeding her small amounts over the previous day, but was afraid to overfeed her. She slept hard, and never was bothered by my cleaning her up enough to have her in my house. The vet didn't find a chip, and ran some general health checks on her. She was still anemic, but doing better, no more fleas helped. She was heartworm and hookworm positive. The ear infection included a yeast infection along with a bacterial one. Shockingly, she was trained, fixed and must have been missed. We posted her on Facebook, Lost Pets, called the shelters, and all the rescues (which couldn't take her, because of the influx of dogs, and all the issues she had). We physically took her to the 10-15 vet offices in our immediate area, no one recognized her. After a week of trying to locate her owners, we decided that we had to help her...and that was a huge commitment given that her heartworm was bad, and could have killed her. Her heart was double the size it should have been. It took a year to get her a clean bill of heath, but we cheered after going through it. She had seizures and convulsions, once from a lightning storm, once from figuring out how to open the step trash can, and eating an entire left over rotisserie chicken. The salt set her off balance. WE love her so much, she has bonded to my husband especially. She is loving, funny, and very challenging. She and Maggie became the best of friends after a few rough moments. Coco, who is blind, aggravates her once in a while, she has learned to be tolerant.

Jump two years ahead, we moved to Las Vegas to be near family. Everything was great the first year, at the beginning of the second year, both Coco and Katie started developing issues. Coco had cancer and had to go through surgery, then she lost her eye, due to cataracts and build up of pressure. Katie started losing energy and strength and then her hair. Drinking excessively, peeing excessively. It was a rough time. In February she was diagnosed with Cushings and has been on Vetoryl 60 mg. This morning she woke up with a bloody nose, which had me searching the internet, which is how I found your group. She has been doing a little better, her hair is coming in, and her energy is up. She is trying to play with Maggie a little. She is still very thirsty and unable to jump onto the bed. We are getting her some stairs. She has the pot belly and she is weaker than she used to be.

I am looking forward to learning more about this disease and what to expect, and how to make her life better.

labblab
07-31-2015, 02:26 PM
Hello Melinda! Welcome to you and Sim and the doggie girls. :) :) :)

First off, you and your husband are angels to have assumed the responsibility for Katie's care. What a lucky girl she was to have chosen your garage to wander into that day. Or perhaps it was not luck at all, but just "meant to be." :o

Regardless, you guys have done a fabulous job of taking care of Katie and your other girls, as well. When you have a chance, it will help us a bunch if you can actually post Katie's diagnostic test results. She certainly sounds like a Cushpup, but given her history, it seems possible that there may be other smoldering issues, as well, that may be raising their head or otherwise contributing to her current problems. In addition to the Cushing's-specific testing, any abnormal values on standard blood/urine panels would be of interest to us.

Turning to her current problems, can you tell us how much Katie weighs and also what her trilostane dosing history has been? Has she always been on 60 mg., and has she had monitoring ACTH testing performed since February? I ask because the first and most obvious question would be, is this the most appropriate dose of trilostane for her to be taking? Even if it was the right dose in February, it may not be the right dose for her to be taking now. Given the lack of symptom resolution, it is tempting to think that her current dose may be too low for her. But we will really need to know more about her dosing and monitoring history to make that judgement call.

As far as the bloody nose, I really do not know what to make of that. But I suspect you should contact your vet and report what's going on. That is not a typical Cushing's issue, so it may herald some other problem that needs to be addressed ASAP. Unless your vet is open over the weekend, you may want to make that call this afternoon. My own girls always seem to sprout their big problems between 5:00 on Friday and 7:00 on Monday, so I'm especially sensitive to contacting the vet quickly with any questions that pop up on a Friday afternoon!

I thank you in advance for any additional information you are able to share with us. And please do keep us updated on the bloody nose, OK?

Marianne

molly muffin
08-01-2015, 12:28 AM
Hello and welcome from me too. What a lucky girl Katie is to find such a loving home. Poor little girl sounds like she had it rough.

Marianne asked some good questions that can help us to answer your questions better.

She is right about nose bleeds not being Cushing's symptom usually. So I'd want that checked out.

If this is all Cushing related then normally they can be treated and have a good life. Water therapy to help build strength might be helpful. What kind of range is her cortisol in now? That would be her pre and post ACTH number.

Again welcome and I hope the nose bleed isn't anything serious.

SimMel27
08-01-2015, 02:18 AM
http://www.k9cushings.com/forum/album.php?albumid=1030&pictureid=7841Hi, thanks for the concern! I will dig that paperwork out tomorrow. We did call her vet, the nose never bled again. If it comes up again. She wants to see her. She does have dry nostrils, and she may have bumped it, but I didn't see her do it. Katie weighs 58 lbs, she is a big girl. I posted her pics and those of her sisters on my album pages. The dose she is taking is what they started her on, due to our financial strain between her, Coco's two surgeries, and my neck fusion...it is my fault, I have been overwhelmed. I know she should have been tested again. We have her scheduled for August 25th. Also, I forgot to mention the bruising on her belly. It gets better, then gets worse. :( is there a specific diet she should be on? We have her on Science Diet and Fresh Pet, she eats raw vegetables, carrots, broccoli, pumpkin occasionally. Thanks!

labblab
08-01-2015, 07:56 AM
Oh, your photos are lovely! :)

And given all the medical issues you've had to deal with, it's easy to understand that finances have been really, really tight. The cost of the monitoring testing remains one of the biggest burdens associated with treating this disease. But unfortunately, it remains the only way to judge, for certain, the actual effect of the medication on the cortisol level. The good news is, it may turn out to be the case that all Katie needs is a dosing adjustment in order to see significant improvement in how she is feeling.

If she does require an increase, here's one suggestion for you that can really help with medication costs. If she is currently taking brandname Vetoryl, you can discuss with your vet the possibility of switching to a trilostane product individually prepared for Katie by a compounding pharmacy. There have been some concerns expressed over time about the comparability of compounded trilostane prepared by some pharmacies in terms of effectiveness. But we have had many members over the years who have been highly satisfied with the performance of a veterinary pharmacy located in Arizona named Diamondback Drugs. Especially if you end up needing to combine Vetoryl capsules in order to change Katie's dose, I'm sure you would save a great deal of money by having a dose custom-made for her. Just something to think about in advance of her test. Diamondback has a website you can visit, and they will be happy to talk to both you and your vet.

We'll sure hope the bloody nose was a one-time deal. Oh, and in terms of diet, we generally recommend diets that contain moderate amounts of good quality protein and lower fat (Cushpups can be more vulnerable to protein-losing kidney disease and also pancreatitis).

Marianne

My sweet Ginger
08-01-2015, 09:12 AM
Hi, is Katie's nose quite crusty and dry? It appears to be in the pic.

My sweet Ginger
08-01-2015, 09:52 AM
Do you know if Katie has high blood pressure? The reason I'm asking is that my pup's nose was so crusty and grew bigger as the crusts were getting larger. It seemed like every time the crusts got bigger, her BP was high. Her BP is now somewhat controlled at around 180 on Amlodipine. I know 180 average isn't all that low but her bps were over 250 before Amlodipine so we have kind of accepted these averages as her normal as long as they don't go any higher.
Here's my Ginger's pic with her crusty nose.

http://www.k9cushings.com/forum/picture.php?albumid=780&pictureid=7850\uc0\u8236 }

SimMel27
08-01-2015, 10:13 AM
Thank you for the info!!! We had found a pet pharmacy in Ca, that we got her Vetoryl for $68 instead of the $102 that Banfield charged per month. If she needs an increase in dosing, my vet will write an RX for her to the compounding parmacy, she is really understanding. I did not know about her blood pressure, but will ask her vet for sure! I assumed the crusty nose was from the overgrowth of keratin, she has a spot on one of her foot pads that looks odd, like hard individual little spikes? When I read up on that, the symptoms were the same!? I will definitely ask the doctor about her blood pressure! Wow, I feel like I have no idea what I am doing. Coco is going in for her 6 month cancer (squamous cell carcinoma) as well the month.

I so appreciate all the information on here! Thank you!!!

labblab
08-01-2015, 10:32 AM
Oh, I'm so glad Song noticed about Katie's crusty nose. I did not know about a possible blood pressure connection, but I can tell you that I believe uncontrolled cortisol, itself, can also result in skin changes that include the crusty nose and also dry crusty areas elsewhere. My own Cushpup Lab suffered from a very crusty nose and also bare crusty patches at his elbows (these were pressure points when he would lay down on the hard floor). Both his nose and his elbows improved once his cortisol came down with treatment. So this may be further evidence that Katie may need a bump up in her dosing.

Marianne

judymaggie
08-01-2015, 10:37 AM
Hi and welcome to your whole family, two-legged & four-legged! Just wanted to add a thought re the nose bleed -- that could may well have been caused by high blood pressure so another reason to get it checked. Not all vets have the necessary equipment to measure BP so you may need a referral to someone who does -- my vet uses the cuff method and takes five measurements over an hour to get an average reading. This week my Abbie had her BP tested at a veterinary hospital where they had a doppler machine -- did three readings for an average and it took all of 10 minutes!

Thanks to you for all you are doing for Katie and the rest of your gang!