Sierra momma!

[Missy G.]

Hi,
I'm Missy and I have a 12 1/2 yr old male Yorkie that was diagnosed with Cushing back in late February. What a blow and it couldn't have come at a better time. :( my mother had been diagnosed with Stage 4 ovarian cancer and had been in the hospital for nearly a month and was not improving at all. Took my little guy in to have his yearly shots and was told by my Vet to take him to our Moonshines dermatologist that he suspects that he has Cushing's, sure enough, he did!
There was the blow with my mom and now the little guy that has seen me through the toughest times of my life is one sick as my mom! Talking bout kicking when somes down, WOW!
I still haven't dealt with the fact that he has Cushing's. He has the classic signs, drinking excessive water, eating like a little piglet, thinning skin, skin discolorition, thinning hair, frequent uination......
We started him on Lysodren with very little results. Not only is it expensive but I have a two hour drive to the nearest pharmacy to pick it up. I'm just wondering if it is worth keeping him on the meds when you can tell that they make him not feel well. He is on his maintenance dose right now and is still show ALL the sign he had before. He has one good in once in awhile. Most he just lays around and sleeps.
Now, on top of all this, his hearing has seemed to disappeared since being diagnosed with this crap, eyesight is going too! Should I keep him on the meds or just let him live out the rest of his life without. I'm so torn right now. This little guy is my baby and it kills me to see him go down hill in front of my eyes.
Thanks for the add and maybe I can find something that will give the little guy a break and start to feel better!
Missy

[Squirt's Mom]

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[Squirt's Mom]

Hi Missy and welcome to you and your baby boy! :)

I'm so sorry you have had such a rough time of it lately! And I pray your mom's treatment will start to help her get thru this very soon.

Can you tell us a bit more about your baby's diagnostics and treatment? What did the vet see that caused him to send ya'll to a derm vet? Does your baby have Calcinosis cutis, a skin complication with Cushing's that effects some dogs? What tests were done to arrive at the Cushing's diagnosis? Would you mind posting the actual results of those tests here? That would help us a great deal. Please include the little letters and normal ranges, as well as notes, along with any value that is too low or too high. We will need to see all of the LDDS and/or ACTH. If an abdominal ultrasound was done, seeing the comments from that would be helpful too.

For treatment - how much does he weigh? What was the loading dose? What is his current maintenance dose? How many times a week does he get the dose? Do you make sure the med is given with food? It must be given with food to be absorbed correctly. ;)

What signs are you still seeing? Have any of them become less strong or have any become stronger?

Personally, at 12 1/2 I would not be giving up. Your baby boy can have several more years of relative good quality as far as the Cushing's goes with the proper treatment, which we will do our best to help you work out. But the choice is yours; we do not know what all is on your plate for sure nor the effect that has on you. I have to believe you want to do what is best for your boy or you wouldn't be here asking for help.

Have his ears and eyes been checked by the vets? Is the loss age related or from another condition? There is a condition called SARDS, Sudden Acquired Retinal Degeneration Syndrome, in which the pup goes blind very rapidly. The pup will often display cush signs and may test positive on the cush tests but it is not Cushing's - it is SARDS instead. Here is some info on SARDS from our Helpful Resource section, where you can find lots of goodies.

http://www.k9cushings.com/forum/showthread.php?t=213

Also from the same section a link on medical complications of an untreated cush pup - we need to make educated decisions for our babies. They cannot speak for themselves so it is our job to be an advocate for them and to do that properly we need knowledge. ;)

http://www.k9cushings.com/forum/showthread.php?t=195

I'm glad you found us and am looking forward to seeing those test results and details about your baby boy soon. We, your new family, will be with you every step of this journey.
Hugs,
Leslie and the gang

[Missy G.]

Well, since I am so new to this, I haven't asked for copies of the ATCH stim test that were done on him. I now know that and plan on asking for copies at his next appt.
He weighs 14lbs! All that I was told is that his initial test his cort levels were at 68 and that after 10 days of 250mg of lysodren once a day his levels dropped to 16. We did another week of a 125mg once a day and levels dropped to 4. He is on a maintenance dose of 125 mg a week and goes back for testing in another two weeks. I was never told to give mess with food nor the pharmacist said anything about giving with food, now I know!
Our normal vet, I guess had suspicions that he had Cushing from his thin skin, pot belly, thinning hair. I took the little guy in for his yearly check up the end of February and was told to make an appt with our basset/rat terrier mix derm vet, who treats her for her allergies and skin probs.
She agreed with our normal vet and did the ATCH stim test to comfirm that he tested positive for Cushings. No ultra sound has been givin, just the ATCH stim test.
Sierra has never really had any health issues except a few allergies here and there.
His hearing and sight problems have recently started up. He is going in on Monday to our regular vet to have it looked at. I have also noticed ratteling sounds when he breaths, which I also want addressed.
He is still drinking excessively, skin discoloration, thin hair and skin! Oh and pot belly with tons of blackheads all over his belly and rear.
I want this little guy around for as long as I can without him suffering. I have shed many tears over his diagnosis and hope for the best and look forward to many years of him being around. I just want the best for my little guy.

[Squirt's Mom]

Ok, from what you have said, the vet is not using Lysodren correctly. This drug has 2 phases, as you know - the load and the maintenance. During the first part, the load, the dog is to take the drug TWICE a day until you see signs that the load has been achieved, such as a reduction in the amount of water he drinks. At that point, you stop giving the drug and call for an ACTH to see if the numbers are in range, which is 1-5ug/dl for a dog on Lyso (it is different for the other treatment, Vetoryl). IF the dog is in the target range of 1-5ug/dl, the the maintenance phase starts. In this phase the dog takes the SAME amount of the drug they took during the load but instead of that amount daily, it is spread out over a weeks time, given 2-4 times a week. ie if the pup took 500mg a day for the load it would take 500mg per WEEK for maintenance.

The loading dose is 50mg/kg/day so at 14lbs Sierra weighs 6.36kg (14 / 2.2 = 6.363636.....). So his loading dose would be 318mg per day which would probably have been rounded to 250mg per day, given in doses of 125mg AM and PM. Some vets may have rounded up to the full 500mg tablet which would have been 250mg AM and PM.

The way your vet has used this drug means the load may have never happened and if it did it probably won't hold. Here is a link from our Helpful Resource section on how to use Lysodren that you can share with your vet. Most of the info came from Dr. Feldman, well known in the endocrine world. http://www.k9cushings.com/forum/showthread.php?t=181

Hugs,
Leslie and the gang

His maintenance dose would be the same amount spread out over the week. You choose which days work best and stick to it - Mon, Wed, Fri or whatever works for you.

[molly muffin]

Welcome Missy and Sierra. Leslie knows much more about lysodren than I do but the protocol for lysodren doesn't seem to have been followed and that is probably why you aren't seeing the symptoms go away.

Another thing that can affect sight, is high blood pressure, so if that hasn't been checked you might want to have it looked at.
I agree, Yorkies can live a long time and at 12 he still has a lot of years in him. The key is getting him regulated.

You can once you know the correct dose and that it is holding also order your lysodren from an online pharmacy, perhaps at a cheaper cost and delivered to your door, you really have to price shop with these drugs.

Definitely get copies of all tests that he has had done. You'll want to have your own file. You have a lot on your plate right now and this makes it easier for you to keep track of his treatment and how he is doing and can be referred to any time you want. Most of us, if not all do that. (i have a book of lab results!!) LOL

Welcome again

[labblab]

All that I was told is that his initial test his cort levels were at 68 and that after 10 days of 250mg of lysodren once a day his levels dropped to 16. We did another week of a 125mg once a day and levels dropped to 4. He is on a maintenance dose of 125 mg a week and goes back for testing in another two weeks.
Hello Missy, and welcome to you and Sierra!

Leslie and Sharlene have already done a great job of welcoming you, and I just have a couple quick thoughts to add. Even though your vet's loading phase may have been unconventional, it sounds as though you did arrive at the target post-ACTH level anyway. Generally you are wanting a post-ACTH result between 1-5 ug/dL, and it sounds as though Sierra's test result before starting maintenance was 4. The question mark now, though, is whether or not the maintenance dosing is keeping her cortisol sufficiently low or whether it has been increasing again as her adrenal gland rejuvenates. That will be the importance of the next ACTH test: to tell you whether the cortisol production is remaining controlled or whether it is increasing. If it is increasing, then the dosing will need to be changed, and hopefully according to conventional protocols.

Marianne

[Missy G.]

Sorry for the delay, things are crazy! I made a call to his derm vet and should be hearing from her today.
Thank you all for the warm welcome. I just want to learn as much as I possibly can to understand what is going on with the little guy.
That was my thought, too is the maintenance isn't enough to to keep things under control.
I have learned so much from reading everyone's posting and how to continue to learn as much as I can to keep this little guy around for another five or six years! 😀

[molly muffin]

Oh dear, sorry to hear things are going crazy. :(

I think Marianne hit the nail on the head so to speak, the question now is whether the maintenance is holding the load or not. That will tell you a lot.

We want that little cutie around with you for a good many years too. Gosh he is just so cute! LOL

[Missy G.]

Well, after getting the results from Sierras last test, still discouraged with the numbers! After asking many questions, thanks to many of you, his numbers before dosing have gone up consistently! I got copies of Sierra's file and past test results from. Found out that his deem vet has not done a full CBC, which I have requested. She has increased his Lysodren dosage from once a week to twice a week. 125 mg per dose. Still no sign of improvement. Plus, his rear end seems to be getting weaker and weaker!

His past tests before dosing was 3.1 and most recent was 4.5. After dosing, it has remained unchanged at 16.4!
We are going to try twice a week and if no results for the better, she want to increase to three times a week!
Y poor little guy just seems miserable. Huffing all the time! 😕

[judymaggie]

Hi! Something for you to consider -- one, although my Abbie's ACTH numbers were quite low during the Lysodren loading period, she was unable to hold the load during maintenance. We tried several dose increases and a second loading phase but her numbers continued to go up. After a break from the Lysodren, Abbie is now getting Vetoryl (the other drug that Leslie mentioned) and her cortisol is now consistently controlled. This might be an option that you could discuss with your vet/dermatologist.

Sending healing thoughts to your Mom!

[Harley PoMMom]

It is very important to give the Lysodren with some fatty food, such as peanut butter or cream cheese, is this being done?

[Missy G.]

I usually give him the pill in cheese and make sure that he has just had dinner before I give him the pill!

[Harley PoMMom]

I usually give him the pill in cheese and make sure that he has just had dinner before I give him the pill!

Yep, that is the correct way...good job! ;)