Cushings, allergies and seizures

[Lainey]

Hi all

I'm new to the forums but unfortunately not new to Cushings. This is going to be a long post so apologies in advance for those who are prepared to read on! ;) Our almost 14yo daschund x ? Radar was diagnosed with pituatary dependent Cushings about 18 months ago but looking back he'd had it for some time with nobody joining the dots. It finally came about when they ran some tests with a view to putting him on anti-inflammatories.

He's struggled with non-specific allergies most of his life, had an ACL repair about 6 years ago and has been less active ever since. At that time he was also on Prednisone for the allergies so when his appetite and weight ballooned nobody thought much of it.

He's been on Trilostane for the Cushings which has been successful for the cortisol. All stim tests have given good results and the cortisol is under control, but the reduced cortisol has caused his allergies to worsen. He's on antihistamines which relax him for a time but he's often itchy and we struggle with ongoing skin infections. We had him on cyclosporine for a long time which helped but once we started the Trilostane it was completely ineffective. He's been treated with Rilexine or Cephalexin for the skin infections on and off for the last year but, as soon as he comes off, the patches come back. We use a chlorhexadine wash as well.

A few weeks ago the vet gave him Amoxycillin as an alternative (Radar hates the taste of Rilexine). A week into the treatment he had a seizure, and another 24 hours later. Once we removed the Amoxycillin, the seizures stopped (although it took days for the spasms to settle). The poor chap then had his teeth cleaned and two removed, followed by a course of antibiotics which all went fine (apart from the anaesthetic hangover). We all thought the seizures were just a reaction to the Amoxycillin. He then went back onto Rilexine for his skin infections. 3 days later and he's had another seizure last night. This time he lost control of his bowel and bladder so it was worse than the earlier two for all of us! We've now stopped the Rilexine and waiting to see if the seizures also stop.

So we're in a pickle! Treating the Cushings makes his allergy symptoms unbearable (we have a soft cone on him most of the time to stop him chewing his paws to bits). Treating his skin infections seems to bring on seizures at night which are terrible for all of us and have our old Jack Russell Shandy scared of bedtime! The poor boy is on a cocktail of meds - Trilostane, Vivitonin, Clomicalm, Iramine, Previcox and antibiotics periodically.

Has anyone experienced Cushings and allergies together? Or had a dog respond to antibiotics with seizures? We'd love to hear some other people's experiences before heading back to the vet. He's very experienced and thorough, but we don't want to keep intervening if we can't improve Radar's quality of life day to day. Between all of his problems, he's a sweet happy boy who loves his walks and visits with his doggy and human friends. So we're thinking it may soon be time to stop the Trilostane and give him some happy, itch free days before he leaves us :(

Thanks very much to anyone who is still reading! x

[LauraA]

I know quite a few Cushing parents have used Apoquel with great results for allergies. I would definitely look into using it. I am assuming you have tried Zyrtec to see if that has helped give him any relief.

[Lainey]

We have tried Zyrtec but opted for Iramine because it also makes him a little drowsy at bedtime. I haven't heard of the other one though, I will look into it, thanks :)

[LauraA]

We tried the Iramine stuff as well at first but apparently studies back then (a few years back now) showed it to not be as effective as first thought. With the Zyrtec you do need to give it a good 2 weeks to see if it is going to be effective. We were looking into the Apoquel but found my girl had kidney issues as well so it was ruled out for us.

I see you are in Perth as well!! Hope you have had a chance to enjoy some of the lovely sunshine today :)

[Lainey]

Thanks very much for the info. Radar's kidney function is fine so I might chat to the vet about it when I go back. Failing that we only used the Zyrtec for a short while so it might be worth trying again. I'd love to make him more comfortable.

We're in the east, near Midland. Wasn't it a lovely day! I managed to get my washing dry, that was about it. I hope you had it better :) The next 2 days should be awesome so I'm bummed I'll be working. Love this time of year :)

[LauraA]

I am in Greenmount!! At the bottom of the Hill.

Cushing pups are prone to all sorts of infections which can make it quite challenging that's for sure.

[Lainey]

Oh wow so close! We're Viveash. We see Wayne at Midland Vet Hospital on Morrison Rd. I never thought I'd be chatting to someone just down the road when I found this forum!

So what's your puppy dog's story? Is he/she doing well?

[molly muffin]

Apoquel is a new allergy drug. Hard to get because everyone wants it but supposedly works miracles on allergies and okay for Cush pups. Worth trying to find it.

Welcome to the forum. I do hope the seizures stop. It's very mysterious what is causing the seizures.

[LauraA]

Hi Lainey
My girl had an attack of pancreatitis a couple of years back now and all the Cushings symptoms kind of came on suddenly right after she finished her antibiotics. Looking back though she had the panting and roaming episodes for a year to 18 months before and would have days when she would drink a lot as well as dry flaky skin problems. Her skin always looked quite bruised, especially after her walks. She was on Vetoryl for about 7 months and then we changed her to trilostane (compounded form of Vetoryl) which she has been on ever since. We use Maylands Compounding Pharmacy as that is the one my vet has the most confidence in, and it nice to be able to save some money on the drugs so hubby isn't complaining too much hehe.

She has had one big seizure in her life, about 5 years ago now. It was scary and lasted for a good 5 minutes. Could find no reason for it and fortunately she has never had another one.

I go to Mundaring Vet Hopsital on Bailey Road, though thought I would be able to have some time away from them till my other dog got really sick and so I am on twice weekly visits with her for the past 6 weeks. If it isn't one dog it is the other hehe.

[StarDeb55]

http://www.dermatologyforanimals.com/faq-03/

Hi, Lainey. Here's a very late welcome from me. I saw your thread title & knew I had to respond. First of all, the above link is from the Derm Clinic for animals. Dr. Lewis, who is the founder, has treated 2 of my boys for severe allergies, including my first Cushpup, Barkley. The link gives you a lot of treatment information which you may already know. The things I want to point out are disregard any of the discussion about steroid containing medication, obviously, with Cushings, that's a big no-no.

Now, the things I want to point out are the use of cyclosporin. Barkley was on cyclosporin for years. Fatty acid supplementation for the skin is essential. When it comes to over the counter antihistamines, Dr. Lewis gave me a long list. His instructions were to use one for 2 weeks before deciding that it's not working. B was on a kid's Benadryl for years. Barkley was also on a limited ingredient diet which I believe was fish & potato. His allergies manifested as severe ear infections which occurred 4-5 times a year. With this treatment, the ear infections were cut down to about twice a year. Dr. Lewis told me up front that he did not feel that B was a candidate for skin testing because of his Cushings. When Dr. Lewis was treating my second boy, he made the comment about Barkley that, "if hindsight is 20/20, I should have gone ahead with skin testing for Barkley."

I don't want to talk your ear off, & I hope you find this information helpful. If I or any of the other members, can help you, don't hesitate to ask. Keep us posted.

Debbie

[Lainey]

Thanks Sharlene & Molly Muffin :)
We were seizure free again last night so fingers crossed the antibiotics were the trigger and we won't see any more, at least for now.

[Lainey]

I know what you mean! Although our Jack Russell's problems are a breeze compared to Radar. I hope your other dog is well on the way to good health again. :)

I'm pleased for you that it was only the one seizure with yours but 5 minutes must have seemed like forever! Radar's have been shorter but left him acting weird afterwards and the spasms seem to last for days, poor lad. One second he's sitting or standing, and next he lands on his face when his front legs go!

So with your Trilostane, do you get it direct from the pharmacy? I think I know the place you mean. I'm getting mine through the vet. They're now using a compounding place in QLD which is cheaper than before but still very expensive. My hubby thinks he's only working to medicate the dog too haha. Can I ask what the dosage is and how much they cost (if you don't mind)? If there's a way I could get it cheaper that would be great!

[Lainey]

Thanks Debbie, I'll have a read through that. :)

We had Radar on Cyclosporin for several years, including the first year of his Cushings treatment, but it became ineffective once his cortisol was controlled. He stopped using the steroidal drugs when we started the cyclosporin so they've been out for a long time. Although they stopped the itch, they never agreed with his stomach so we don't miss them!

We excluded red meats from his diet several years ago as that definitely makes him worse. We've discovered oily fish drives him mad with itching so we've had to leave that off the menu. Chicken was always the best meat for him although we're now considering excluding it given it's got a reputation for causing allergies and he's so much worse than he used to be. Sadly for him that won't leave many soft food options unfortunately!

He used to have a lot of ear infections too but since the cushings was diagnosed and we started treatment they have been much less frequent - now it's his skin we struggle with.

It's so hard to know what to try next and if you're doing the right thing so it's great to hear what other people have been through. Thanks :)

[LauraA]

Yes the Vet sends a prescription through to the pharmacy and they make it up. She is on 30mg (I am lucky she responds well to once a day dosing) and I get 100 tablets at a time. It costs me $165 for them. Mundaring Compounding Pharmacy (which is Amcal) is cheaper at $150 per 100 30mg tablets, but they are relatively new and my Vet hasn't heard much about how effective they are there at this stage.

[Lainey]

OMG! Radar's on exactly the same dose and it costs us double that! Thank you so much for the info Laura. I'll be having words with our vet about that, or I'll be changing vets I think! So the pharmacy is the one on Guildford Rd? Can I ask your vet's name too please? :D

[LauraA]

My vet has actually gone on Maternity leave for an indefinite period of time (Kate) with her first baby being due very soon. I have been dealing with another of the vets with my other dog and she actually just put my order through (with a bit of a stuff up hehe). You just need to get your vet to ring through or fax the prescription through to them. They are at 181 Guildford Road - not far from the Pet cafe I frequently visit :) You can actually ring them yourself or just get your Vet to ring them if you want to get the ins and outs, they are very helpful. Or even email them.
(08) 9370 4410

[SasAndYunah]

Hi Lainey,

welcome from me as well to you and Radar :) First of all, I am from The Netherlands so you may find my English somewhat peculiar at times...or even downright impossible to understand at times :D

Anyway, I currently have (also a Dachshund mix) a very allergic dog, atopic in her case. Atopic meaning she is allergic to all sorts of inhalants, kind of like hayfever in humans.

I have learned that in order to be able to treat any allergy, whether it's food, inhalants or otherwise, you have to find the cause of the allergie. Because they all recquire a different treatment and even within the same kind of allergies, the treament options can vary a lot, depending on the individual case. For example, an allergie for mites (dustmites, storagemites, haymites...any kind of mite) can manifest in many different ways in different dogs. Some dogs get recurrent earinfections, others get skininfections, others have itchy paws and others have a combination of all of the above symptoms. Each manifestation has its own treatment protocol. So, as Debbie also mentioned, in my opinion Radar would benefit hugely if you could take him to a specialised dermatologist. But I am also very aware of all the costs these things bring with them and that it is not always possible unfortunately. But I do have learned that it is not necessary for an allergic dog to be constant itchy and scratching and chewing and have infections of all kinds....there is treatment possible.

Also, once you know what the exact allergens are, you can take other measures to help your dog...apart from medication. (cleaning, washing at certain temperatures, getting rid of rugs, antimite covers, etc...depending on what Radar would be allergic too. Also in the area of shampoo's and topicals there can be a huge profit, treatment wise. For example, my dog is amongst other things allergic to all sorts of mites including the ones living on her skin and very prone to bacterial skininfections, therefor I bath her with a shampoo that adresses bacteria and molds. Her monthly topical flea/tick treatment I have replaced with a flea/tick treatment that also adresses mites... She is also very prone to earinfections and I clean her ears every other day to help remove the wax that her "damaged/atopic" skin can't remove by itself. So you see, there is a lot one can do to help but you have to know what exactly Radar is allergic to :)

Apart from a skintest, there is also a bloodtest available. My dermatologist did both since either one of these tests could miss a specific allergy.

Hope this will help in some way...

Our best to you and Radar,

Saskia and Quincy :)

[Lainey]

Thanks Saskia & Quincy. Allergy testing is something we may consider going forward, once we've gotten to the bottom of these seizures. He's one expensive best friend :)

Laura thanks so much for your help today, I'm so glad you replied to my post. Is that the Pet Lover's Cafe you go to, the one that moved from Guildford? I follow the page on FB but haven't been there yet. I'm not sure my two have the social graces of cafe dogs! They used to go to doggy day care at the Pampered Pooch when they were younger but they're not so tolerant in their old age ;)

[LauraA]

Yes Lainey that is the Cafe :) They have great treats that are locally made and not too high in fat. My two particularly like the dried sardines. I take Maggie (non Cushing's dog) but leave the old and grumpy Bulger girl at home. She isn't as 'social' as Maggie lol. I get my pellets from their as they are low in fat and protein and have no preservatives or bad stuff (and again are Australian made).