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biscandzoesmom
09-26-2015, 09:55 AM
Hey y'all, just wanted to introduce ourselves. Biscuit is my 12 year old terrier mix - she's absolutely mommy's princess, likes to have at least 2 pillows to sleep on, can't bear to have rain fall on her, and loves pampering like getting brushed & having her nails painted. Well, she doesn't like the smell of the polish, but she likes me petting and holding her paw & then she adores all the attention she gets. She can also be a ruff & rowdy girl, wrestling with her labrador sister & running up & down the beach like a mad woman. I adopted her at about 5 weeks old & she & sister Zoe own my heart.

February of 2014 I began noticing that Scootie (Biscuit's nickname) was drinking a lot of water. With two dogs it was hard to measure, but was very obvious to see that scoot was at the bowl at least three times as often/long as Zoe. We checked a urine- her specific gravity was like 1.004, so dilute. We checked an Chem - cushings suggested in I think the liver values being slightly up. Did an ACTH - negative. Did some test with three urines in a row - all fine just dilute. Ultrasound - everything normal except a small 7 cm roundish cyst type thing that they couldn't see where it was attached to. Didn't look like cancer, wasn't pushing anything out of the way, just was. Rechecked ultrasound in October - cyst still there, no change in size, again everything else normal. Biscuit still drinking lots, but seems that she may just be a big drinker... I drink a ton of water/crystal light and on days when I'm driving Mountain Dew (ah caffeine), so I understood that she might just be like me.
Fast forward to annual appointments in June - urine still dilute, otherwise fine, chem shows liver values up further, and her t4 is slightly low. Doc realizes that thyroid not checked last year & says aha! Maybe this is the answer! Low thyroid would explain wonky liver values, drinking - case closed. So we send blood out for complete thyroid check to nachreiner/msu & wait for results. Nope, they say her thyroid is normal. Small hair pulling session later, ok let's check an ultrasound. Doc had heard a small heart murmur at annual, so we can check it all out. We use a traveling ultrasound doc who is also an internal medicine specialist, so she knows her stuff. Scootie's heart is ok - small area where her heart is correcting the problem itself (phew!). Liver looks good, weird cyst thing from last year still really unchanged, small "I don't want to call it a tumor but there's something" on part of her adrenal gland, us doc says gotta be cushings. Wants a blood pressure, urine culture, and low dose dex suppression test. Blood pressure slightly high - I think it averaged around 165/90. Culture negative, but ua showed she's dumping too much protein in her urine, so we have a UPC out. And according to the message I got last night, her ldds test came back "screaming cushings."

Before I go in in Monday to talk meds & next steps, I wanted to ask y'all for advice. I know the meds can be scary, and I remember reading that only one of them (i think the vetoryl? Something like that? ) treats both problems coming for the pituitary gland which most doggies have as well as problems coming from the adrenal glands themselves. Since Scootie has that "not a tumor thing" on her adrenal gland, I think she would probably fall into this category? I don't want to put my baby at risk, but I want to treat what's right. Other question - she's currently eating the royal cabin satiety diet to try & keep her weight down. She is a food hound & a few weeks ago climbed through a window & broke a glass canister to get te treats inside; cut on tongue = murder scene. She had been hovering around 59-61 pounds but this last weight check dropped down to 56. I saw weight loss can be a side effect of cushings treatments - should I be changing her food in anticipation that she won't be so ravished anymore & won't be stealing treats on her own? Or is the weight loss not just from being less starved bc of cortisol levels, but some other effect?

Sorry this is so disjointed and crazy sounding. And also sorry I don't have her value results & numbers with me - they are at the vet clinic, where even though we've moved & the commute is now around 90 miles I still work one day a week because I love my coworkers & also (thank dog) still get a staff discount on bloodwork and products. So I can give specifics on Monday night if it helps. Thanks for an advice for me & my baby girl as I try to help her feel better.

Harley PoMMom
09-26-2015, 03:12 PM
Hi and welcome to you and Biscuit!

I have only a moment to post but I wanted to stop by to welcome you both. I am sure the others will be by to offer their advice and support, I will try to get back later.

Hugs, Lori

Harley PoMMom
09-26-2015, 10:20 PM
Ok, I'm back! :eek:;)

Yep, getting copies of all those tests and posting the abnormal values with the reference ranges and their reporting units would be a big help to us in providing you with more meaningful feedback. The test that required 3 urine sample was this the urine cortisol:creatinine ratio (UC:CR), and if so, when was this done? Does Biscuit have any underlying health issue, and if so, what is it and what medications is she taking?

So, if I'm getting this right, ultrasound found no abnormalities with the other organs expect that "thingy" on her adrenal gland, is this the left or right adrenal gland?

Lysodren/Mitotane and Vetoryl/Trilostane are generally the two medications used to treat both the adrenal or pituitary type of Cushing's. Both can have adverse side effects and one is no safer than the other. Lysodren has been around for many, many years and for decades it has been used, off label, for Cushing's and still is. Trilostane/Vetoryl was FDA approved for the treatment for Canine Cushing's in 2008. However, when a dog does have the adrenal type of Cushing's, Vetoryl/Trilostane may be a better option than of Lysodren because adrenal tumors are resistant to Lysodren and higher than normal doses are required for adrenal suppression.

The key to facilitating safe and effective treatment is an experienced vet and an educated pet owner. It is when one or both is missing that dogs get into trouble. So the best advice I can give you is to do your research on Cushing's, the treatment protocols, and how it is diagnosed. I am providing a link to our Resource forum which has a wealth of information regarding Cushing's and also includes articles written by some of the most renown veterinarians that specialize in endocrinology http://www.k9cushings.com/forum/forumdisplay.php?f=10

Please know we are here to help in any way we can, and do not hesitate to ask all the questions you want.

Hugs, Lori

molly muffin
09-28-2015, 05:01 PM
The "thingee" could just be a nodule on the adrenal gland, so you would want to monitor that with periodic ultrasounds to make sure it isn't growing or spreading.

As Lori mentioned it would be good to see what her tests results are so we can give you better feedback.