Mastiff with Cushings

[Tarahlynn]

Hi there, I adopted my mastiff Diesel about four years ago and, at the time, the lady I adopted him from thought he was about three. So, all best guesses say that he is seven. Since I got him we've been dealing with an Anaplasmosis flair up just about every spring and treating that with doxycycline for two weeks. Otherwise, he has been on no medication. This last winter we were living in a tiny home with no doggie door and his weight just ballooned. Now, we have moved to a big house with a doggie door and a massive fenced in yard. However, when we moved this late summer (just two months ago) he didn't react like I thought he would and he seemed more down then usual. Diesel is a big lazy lovable dog and always has been but he just wasn't himself. He was hugely overweight, incredibly hungry all the time with no desire to do anything. So, I took him to the vet, assumed it was all caused by another Anaplasmosis flair up. She gave my doxy and some pain meds (I'm sorry I don't know the name - I'm only giving him 1/4 of what they suggested and sometimes none at all if he's doing ok) and within two days of getting him on them he was back to his happy bouncy self, however, she wanted me to bring him back for the all day cushings test so we agreed.
She just called me that he needs to be put on Vetoryl for a month then go back to her for another all day test and then probably back to Vetoryl for the rest of his life. Honestly, its all very expensive but, much more importantly, he doesn't act sick. Overweight and lazy, yes, but not sick, not like he hurts or anything like that, he acts not much more different then the happy dog I adopted, older maybe, but not like he's hurting or sick. I want to help him lose weight and his ravenous appetite makes me feel awful for him (we're going for walks every day now and I'm moving to switch him entirely to a home made diet). Is there anything I could do naturally in this case? Thank you guys so much!

[Harley PoMMom]

Hi and welcome to you and Diesel!

I have manually approved your membership so now all your posts will be seen right away. Also, please just disregard the validation email that was sent to you from k9cushings.

I was wondering if you could tell us more about your boy? We usually ask a lot of questions to our new members but that's only to gain information about the pup so we can provide better feedback, ok? So here it goes! What symptoms is Diesel displaying that led the vet to test him for Cushing's in the first place? Does Diesel have pituitary or the adrenal form of Cushing's? How much does he weigh? Has he had a CBC/ Chemistry blood panel done recently, and if so, could you post any abnormalities that are listed with the reference ranges and units of measurement? What dose of Vetoryl has been prescribed for Diesel?

Sounds like he had the LDDS (low dose dexomethasone) test performed as it does take all day, if you could get a copy of those results and post them here that would be great. Unfortunately the LDDS test has a higher chance in resulting of a false positive when any underlying issue or even stress is present and since Diesel's LDDS test was performed when the Anaplasmosis was occurring I am a bit concerned with the positive result from that LDDS test. The LDDS test is a diagnostic test, it can not be used to monitor a dog that is being treated for Cushing's, only the ACTH stimulation test is used to do the monitoring.

Frozen green beans and carrots can be given to help curb the hungriness.

Sorry that this will be short, I only have a moment to post, I'll try to get later with some more of my thoughts, I am sure that in the meantime other members will be along to welcome you and to offer their advice.

Hugs, Lori

[Tarahlynn]

Lori, thank you so much for your kind and fast reply!

I will answer what I can, the rest of the questions I just emailed on to my vet!

Diesel weighs 140 pounds right now and I don't believe anything over 110 would be healthy for him. The majority of the weight he gained over the last winter before we moved to the new house and the big yard. This last summer he started acting like he was having an anaplasmosis flair up (and I was suspicious that he may have been having a flair up for awhile and the resulting aching joints were what slowed him down and poured on his weight gain) he started limping on one fore leg and then would switch. Then, he stopped limping and started acting like himself again and I kept on believing that the tiny house with the tiny yard we were living in was the entire cause of his lethargy and weight gain.

We moved to our farm now (and will be here forever) and he has a doggie door, big farm house and a big yard. It was the move that made me realize he was definitely more down than I had realized and it wasn't just the small house that was the problem. The old Diesel would have galloped around the yard like a puppy... not so much. So I took him to the vet figuring it was probably an anaplasmosis flair up that I should have taken him in for much sooner *kicking self*. The vet agreed with me and prescribed him with an anti inflamatory plus doxycycline but because of his incredible weight gain she wanted to do x-rays (they showed a fat but healthy dog) then from there she took a urine sample and sent it off to test for Cushings. I need to make a note here that I found this excessive but I agreed to it.

The results of that test made her call and ask us to bring him in for an entire day of testing. Ok, I was entirely convinced that this seemed excessive now and actually argued with her. Once I started Diesel on the doxy and the anti inflammatory it was like he was a new dog again and, except for being really hungry, he was absolutely symptom free so I couldn't understand why she wanted him for a whole day of testing. Diesel was bouncy, happy, his old self again and I was taking him for walks and was pretty darned convinced it was all an anaplasmosis flair up. But I agreed because I love my dog.

Then the results of that day of testing came back and she called me and wanted me to order a month supply of Vetoryl and then bring him back in at the end of his month and have him tested for an entire day again. So, I talked to Diesel about it and he seems perfectly healthy besides being fat and, quite frankly, he seems quite happy being fat too.

As far as symptoms go she kept asking me if his thirst is up and it just isn't. Diesel is very picky about his water (he needs it fresh and cold or he won't drink it at all) so I know he's not drinking in excess because I'm washing out and filling his bowl every time he wants a drink. Other then his lethargy and weight gain, he had no other symptoms.

Thank you so much again!

[Tarahlynn]

Hi there! Ok here is what I just received from my vet:

The test results for Diesel's Low Dose Dexamethasone test were as follows. I decided to do this test since his urine cortisol: creatine ratio, used to rule out Cushing's came back positive, therefore we were unable to rule-out Cushing's. Pre-Sample that is taken before the injection was 3.2ug/dL and the sample that was taken 4 hours post injection was unable to be used and the 8 hours post injection was 2.5ug/dL. Since the 4 hour sample was unusable I am unable to tell if he has the pituitary or adrenal form of Cushing's. Since his 8 hour post sample did not drop below 1.4ug/dL he has a diagnosis of Cushing's disease. The drug Vetoryl (trilostane) is approved to treat either form of Cushing's. We also have alternative treatment forms available if that is something that interest you. Diesel also has physical exam and history findings that are consistent with Cushing's including; lethargy, panting, weight gain, alopecia ( hair loss), hypotonic (thin) skin, mild hyperpigmentation (increased skin color) and polyphagia (increased hunger). It was hard to asses if he had increased drinking and urination. If you would like we can measure his water intake and see if it is an appropriate amount.

We did not perform a complete blood count (CBC) or chemistry. I would recommend that if you were going to pursue treatment or further diagnostics that we perform these tests.

[Renee]

While your vet is not being overly aggressive.... I am concerned that she does not appear to know cushings quite as well as she should.

Before a diagnosis, it is important to rule out other causes that can mimic the symptoms. Two very important: thyroid and diabetes. Without having done a blood panel (which is surprising, considering she spent your money on an LDDS!), you would not know if there are elevations in any thing that could point to issues other than cushings.

You are doing an excellent job of questioning things along the way and learning everything you can before making any treatment decisions. Being careful and cautious is the safest route when considering treatment for cushings. Overly aggressive treatment is a quick road to disaster.