Muscle wastage, Arthritis Help???

[Marshal]

Hi guys, not been on here for a good while, have been posting on the facebook page!
Marshal has developed arthritis now and has lost most the muscle mass in his hind legs, he collapsed over a week ago and spent the weekend in ER on a glucose drip as his levels were dangerously low! :(
Anyhow, he's picked up again but is very reluctant to go on even small walks now, seems very weak on his back legs! I give him joint supplements, salmon oil and plenty of massages and the vet gave us some Tramadol but I only give him that if he's having a really bad day!
Is there anything else i can do to help the muscle loss and arthritis? Tried hydrotherapy but my insurance doesnt pay out for that (long story) I work a minimum wage job and can just about afford to live day by day, everything gets spent on Marshal, I just want to help him as much as i can!
Any advice/suggestions would be more than welcome!

[labblab]

Hello and welcome to you and Marshal! I see you've been a member for a couple of years, but I believe this is your first post? I apologize in advance for asking several questions, but your answers will help us supply our best feedback. First off, can you tell us more about Marshal's Cushing's history -- when was he diagnosed, what testing was done, what symptoms did he exhibit, any other major health problems?

Secondly, is he currently being treated for his Cushing's? If so, for how long, which medication, at what dose, results of monitoring lab testing?

The reason why this info is important is because it can help us better judge whether the muscle wasting is inevitable or whether it can be reversed with more effective Cushing's treatment. Also, am I correct in understanding that his ER visit was due to an episode of low glucose? What do the vets believe caused that, because it is not typical of Cushing's. So I am curious as to what else may have been going on. Were his levels normal for his cortisol, potassium and sodium during that ER visit?

Another really important question is Marshal's age. NSAIDS would be even more effective than tramadol in relieving both the pain and inflammation from arthritis, but there are risks to the liver, kidneys, and GI system. Depending on Marshal's age, however, immediate quality of life issues may "trump" these risks, however. I am currently facing that same question with my aging arthritic non-Cushpup.

OK, enough questions from me! I'll be watching for your answers, and once again, welcome!
Marianne

[Marshal]

Hello and welcome to you and Marshal! I see you've been a member for a couple of years, but I believe this is your first post? I apologize in advance for asking several questions, but your answers will help us supply our best feedback. First off, can you tell us more about Marshal's Cushing's history -- when was he diagnosed, what testing was done, what symptoms did he exhibit, any other major health problems?

Secondly, is he currently being treated for his Cushing's? If so, for how long, which medication, at what dose, results of monitoring lab testing?

The reason why this info is important is because it can help us better judge whether the muscle wasting is inevitable or whether it can be reversed with more effective Cushing's treatment. Also, am I correct in understanding that his ER visit was due to an episode of low glucose? What do the vets believe caused that, because it is not typical of Cushing's. So I am curious as to what else may have been going on. Were his levels normal for his cortisol, potassium and sodium during that ER visit?

Another really important question is Marshal's age. NSAIDS would be even more effective than tramadol in relieving both the pain and inflammation from arthritis, but there are risks to the liver, kidneys, and GI system. Depending on Marshal's age, however, immediate quality of life issues may "trump" these risks, however. I am currently facing that same question with my aging arthritic non-Cushpup.

OK, enough questions from me! I'll be watching for your answers, and once again, welcome!
Marianne

Hi Marianne and thank you for your reply! :)
Marshal has been treated for cushings for the last 2 years now, he's an 11 year old Bullmastiff so very old for his breed (life expectancy 8-10 years)
He's been on vetoryl 30mg for most of the treatment after a few tweaks in the beginning!
His symptoms were drinking lots and peeing more, that's what took us the vet, ACTH tests and urine gave the cushings diagnosis!

He's been ok ever since the meds, alway kept his weight in check, fed him good food etc, probably why he's still going! However about 6 months ago the vet noticed his lymph nodes were enlarged, because of age, cost etc chemo wasn't really an option, he was never actually tested though for lymphoma, just the enlarged nodes!
I must first say he is under a charity vets practice, he is my mums dog who is retired and disabled, so there is only so much they will do because of costs etc! I help out as much as i can and have been Marshals main carer the last few years because of ill health with my mum! I' only work a low paid job myself so couldn't afford a private vets which I have already looked into!
They don't give us test results etc so I couldn't say what his cortisol levels were at or anything like that!

In regards to the collapse it was just over a week ago, I walked him in the park on his leash, he was fine one minute then next his back legs just gave way and he fell on the floor, I picked him up and carried him back to the house, ER vet said it was his arthritis and gave him a pain shot, got back home and he got worse, eyes went black, he didnt know who we were! Rushed him back to ER, they took a quick blood sample and said he would have to stay in as his glucose levels have dropped dangerously low and he would have died if we didnt take him back when we did! :(
Kept in over the weekend on a drip, pulled through and came home, he has picked up a lot but isnt very willing to exercise now, still quite wobbly on his back legs! Vet said it could of been an Addisons crisis so sent off bloods to check electrolytes? all came back fine, told to stay off vetoryl for a week or 2 then start again and see how he goes! We asked about another ATCH tets before we start again incase his dose needs changing but again, it all comes down to money, mum is ringing again tomorrow and telling them that I will pay for the test if that what it takes!
He's not really shown any cush symptoms since hes been off the meds, just this muscle weakness! I know he's old as well but apart from all this he's other wise fit! Kills me to see him like this! :(
He has Tramadol for pain relief but it doesn't seem to be doing much for him!
Sorry for the really long reply, Just wanted to give you an insight as to where we are with him now!

[labblab]

Thank you so much for your reply and the helpful info -- it wasn't too long a reply at all! I am guessing you are in the U.K., so unfortunately what with time zone differences, it will probably be tomorrow morning for me (I think that's tomorrow afternoon for you...) before I can write a more complete reply. But I will definitely write more then. We have been told by many others that it is not common practice for test numbers to be given out there, so it may take some doing to get that info. And we also surely understand that the cost of treatment/monitoring can be excessively high. But it is very clear from what you have written that Marshal is well-loved and well cared for, so we shall do our very best to make the most economically-reasonable suggestions that we can! More to come a bit later...

Marianne

[Marshal]

Thanks again Marianne

Yes, I'm from the UK, we have a charity vets here called the PDSA
It runs on contributions and government funding for low incomes etc!
They are very good but obviously because of fundings they don't really perform very in depth tests! They have been marvelous with Marshal over the last 2 years!
We went back this morning still concerned with this leg weakness, he can walk but quite stiff and gets a bit wobbly sometimes!
Anyhow, after some proprioceptive positioning testing, he was much slower returning his back paws to to normal position when she bent them under, the front ones were normal, they now think it's probably a form of degenerative disease with his age! Said there is no actual cure, just got to try little walks a few times a day to keep the strength in his legs,
i have also contacted a K9 Hydrotherapist to help keep some flexibility etc! This isn't with the PDSA so have to pay but I'll do anything if it helps him!
She doesn't seem to think it's cushing related after all!

[molly muffin]

Hi and welcome, it is possible that it isn't cushing related, but something else. The low glucose is a worry of course cause that can come on fast if something is going on with that.
Does he have problems with getting stuck in corners, rubbing his head against things, not wanting to put his head down? The reason I ask is because there is also the slight chance of a macro tumor, which is when the pituitary tumor causing cushings starts to grow and puts pressure on the various area of the brain causing neurological problems, which the feet not responding correctly could also be a sign of.
It is also possible as mentioned that it could be a degenerative disease, disc, etc.
When they checked the electrolytes did they also do a baseline cortisol test? Sometimes in the UK they do this along with the electrolytes but don't do the full ACTH. Still if you ask them about that and if the baseline was high enough, it would be doubtful if it where a Addison crisis too.