At wits ends

[Wlkettle]

My 10 year old 64 pound boxer on July 9 we were told he had Cushing. In the beginning we were giving him 1 30 mg triostain pill twice a day.

All physical signs stop. Drinking pee hair was growing back ect.

On Oct 5 it was determined though all signs were good his blood levels were still high. So we increased his meds to 1 60 mg and 1 30 mg pill a day.

Everything went to shit, even though all level are now normal the drink and peeing have returned. No infection ultrasound is not showing anything.

I have tried changing out his food in case it was a allergy. Nothing.

Two weeks ago the vet decided even though his level were good on the 60 and 30 maybe he was still being overdosed and have returned him to two 30 pills. Nothing has changed in 13 days

Has anyone have any insight the vet has no idea where to go. Do we just need to wait a little longer with the two 30 mg pills

It has been suggested to try and limit his water intake. Ya that does not work either. Tried it. We are once again up every two hours at night.

Anything suggesting please.

[Harley PoMMom]

Hi and welcome to you and your boy!

We're a nosy bunch here and we would really appreciate it if you could tell us some more about your boy's treatment history, in this way we can provide you with better feedback, ok? One crucial thing is that one can not restrict water from a dog that has Cushing's so I am very relieved that is no longer being done.

Dogs with Cushing's usually have dilute urine and low urine specific gravity. A urine culture and sensitivity test should be done as the urine is diluted out and a normal urinalysis will not pick up the real number of white cells nor identify the type of bacteria in order to determine an appropriate antibiotic, so if this test wasn't done it could be that your boy does indeed have an UTI.

Could you please round up all copies of the testing that was done to diagnose your boy and post the results here. With respect to the blood chemistry and CBC, you need only post the highs and lows and please include the normal reference ranges. We are especially interested in seeing those monitoring ACTH stimulation test results, so please post them here too. What symptoms did your furbaby display that led you or your vet to test for Cushing's in the first place? Was he diagnosed with the adrenal or pituitary type of Cushing's? Does your boy have any underlying illness that he is taking medication for, and if so, what is it and what is the medication? Is your boy getting his Trilostane with food and are those ACTH stimulation tests being performed 4-6 hours after the Trilostane is given?

I am a firm believer that a dog's dosage increases should not be based solely on those ACTH stimulation numbers, how a dog is feeling and symptom control have to be taken in account too.

I am sorry that your boy's treatment has hit a snag right now but hopefully once we get answers to those questions I asked we will be able to help you help your sweet boy.

Hugs, Lori

[molly muffin]

Checking to see how your boy is doing?

Did they do a culture to check for a possible UTI and also a blood test to rule out that diabetes hasn't come on?

[Wlkettle]

No infections what so ever. No improvement what so ever.
They also checked for diabetics also negative.
Beyond tired I am up every 2 to 3 hours.

[mytil]

Well there is certainly something abnormal going on here.

Are there any other symptoms your boy is exhibiting? Is he still eating normally? Any vomiting and acting lethargic?

Has your vet mentioned kidney problems and maybe they are not functioning normally. Excessive peeing is a symptom of this. If you had a blood test performed (complete blood panel) check to see the levels of blood urea nitrogen (BUN) and blood creatinine - high in both indicate kidney troubles.

Please post the numbers of the ACTH test so we all can see them here.

Keep us posted
Terry

[Wlkettle]

We are on vacation so I will tell you what I know.

He is eating 4 to 3 cups a day which is normal. The vet said all kidney functions are normal. We have had a complete blood panel done. No vomiting no he does not have a lot of energy but I am assuming this is because he is not sleeping.

There is no colour to his pee.

[labblab]

There is a remote chance that your boy may be suffering from an uncommon condition known as diabetes insipidus. This has nothing to do with blood sugar and the much more common disease of diabetes mellitis, but it is an ailment that also causes excessive thirst and urination. The test involves an undesirable water deprivation process which can actually be dangerous to a dog. So when the disease is suspected, many vets just start the dog on a trial run of the treatment medication. If the symptoms resolve, great! And you can then assume the disease has been the cause. Your vet may not be familiar with this disease, but it may be worth asking him to research it when you return home from your holiday. Dogs with pituitary tumors that are causing their Cushing's may also be vulnerable to a disruption in the production of the pituitary hormone that can be responsible for diabetes insipidus. Here's a link that tells a bit more:

http://healthypets.mercola.com/sites/healthypets/archive/2012/12/24/diabetes-insipidus.aspx

Marianne

[molly muffin]

Did the blood panel show anything?

Maybe an acth test to see where his levels actually are.

[Wlkettle]

So the latest blood test came back and his ATCH levels are 141. He is now on 2, 40 ml triostane pills a days. He is still drinking and pee like crazy.

The vet has no idea what is going on since all other symptoms are now gone. We are going to treat him for diabetes insipidus next week.

[Marleys_Mom]

There is a remote chance that your boy may be suffering from an uncommon condition known as diabetes insipidus. This has nothing to do with blood sugar and the much more common disease of diabetes mellitis, but it is an ailment that also causes excessive thirst and urination. The test involves an undesirable water deprivation process which can actually be dangerous to a dog. So when the disease is suspected, many vets just start the dog on a trial run of the treatment medication. If the symptoms resolve, great! And you can then assume the disease has been the cause. Your vet may not be familiar with this disease, but it may be worth asking him to research it when you return home from your holiday. Dogs with pituitary tumors that are causing their Cushing's may also be vulnerable to a disruption in the production of the pituitary hormone that can be responsible for diabetes insipidus. Here's a link that tells a bit more:

http://healthypets.mercola.com/sites/healthypets/archive/2012/12/24/diabetes-insipidus.aspx

Marianne

How is diabetes insipidus diagnosed? Is it possible to misdiagnose Cushing's when it is really diabetes insipidus?

[molly muffin]

Usually what vets do is start them on medication which I believe is eye drops and if they respond then you are pretty much guaranteed that it is diabetes insipidus.