Breathing problems when sleaping

[thapsus]

Hi. I have a 10 years old Boston terrier girl that started to have serious problems with breathing when sleeping. She could not get any air. Condition was treated as normal brachycephalia. She had several surgeries but it did not help. I how ever found out she needs a pillow that leaves her throat clear so she can sleep. In that point she also had some hair loss and bulging tummy.

Few days ago I read about cushings and thought I want to test that. And I was right, she has cushings, maybe hypothyroidism also. I found this forum and saw some posts about dogs having same kind of problems.

The question is, has anyone's dog had any help from medication for this problem?

Thank You.

[labblab]

Hello and welcome to you and your girl! You're right, we have had some other members who have been troubled with breathing problems, and I'm hoping they will soon be stopping by to add their thoughts.

In the meantime, though, can you tell us whether your dog exhibits any other health problems or any overt symptoms that are consistent with Cushing's? One of the problems with the Cushing's-specific blood tests is that they can return "false positives" when problems other than Cushing's are actively present in a dog's body. So when a diagnosis of Cushing's is considered, we are usually looking for common symptoms such as excessive thirst/urination/appetite, dilute urine, skin/coat problems, excessive panting, heat intolerance, etc. There are also certain lab abnormalities that frequently accompany Cushing's.

So if you could tell us more about your girl's overall health and also post the actual numbers for any abnormal test results, that would be a great help to us going forward.

Once again, welcome!
Marianne

[molly muffin]

I just want to also say hello and welcome to the forum.

I don't know of any specific medication for breathing problems, but maybe someone else has an idea.

Marianne asked a good question, are there any other health issues? Have they done a CT or Scan of the nasal passages, throat? Anything to let you know for sure what might be going on? You said surgeries where done, what kind of surgery and for what?

[thapsus]

Thank You for answering. And I apologize if I write funny, english is not my mother language.

She does not drink that much. More than before, but that much. She is very very hungry all the time. I thought it was because I've been trying to slim her down, but it's been weird. She has always being so obedient and humble. Never taken anything without permission. Now she is stealing everything. And has not lost any weight and has bulging tummy. Vet said her back line look normal weight.

She had brachycephalic surgeries in october. She had widened nostrils, soft palete was shortened and everted laryngeal saccules removed. When that did not help, she had her nostrils drilled open. That is first surgery of that kind in my country so I'm not sure if that went great or not. She got anemia after that, but recovered quickly. I asked doctor to check her trachea and larynx for abnormalities or paralysis, but doctor said there was nothing wrong. I asked for collapsed trachea but doctor said it can't be that and she is not coughing. No CT or such but lots of x-rays in second surgery.

After that she has been doing ok. She can sleep with cushion and is not tired daytime at all. But before she was like puppy, and now she is not. Of course, she is soon to be 11 but anyway.

For surgereries she had some hair clipped. She is still bold in those places. And has some bold spots in her legs too and thinning fur in tummy. Her skin is very thin looking in tummy. She has been in diet to lose some weight but I have been giving her vitamins A, D, E, and zink, fish oil and vitamin mixture.

She is not as strong as she was before but can climb upstairs and jump to the table to steel food... We haven't been exercising much since whole month has been so cold, -20-30C. And before that she had to rest after surgeries.

I don't have the test results, vet called them to me, can surely get them later. Test was ACTH (only possible to do at that time of the day?). First value was 103 so not that high, but second was over 700. She also had higher liver values, something was 600 if I remember right. Also her thyroid value was only 2, something, so very very low. Other values were good, no anemia anymore.

Also. I now wen't to our own vet, good, but not specialized to brachycephalic. Surgeries was made in reputable brachy clinic by very experienced vet.

Edit. Forgot to say. She has been given 20 mg Vetoryl for two days now.

[labblab]

Thank you so much for all this additional information. And there is no need at all to apologize for your English -- you write very, very well indeed :)! There is no way at all that I would be able write a reply in any language other than my own. So I think you are doing a wonderful job.

I am afraid that I do not have any knowledge about the brachycephalic surgery, but it sounds as though you have done your very best to try to aid your girl's breathing.

As far as the Cushing's, yes, it does sound as though she has several symptoms that are consistent with the disease. So I will really be hoping that the Vetoryl will help her. May I ask how much she weighs? When first starting out, the most current dosing recommendations are not to exceed a daily dose of 1 mg. per pound (or 2.2 mg. per kg.). So I am hoping your girl weighs no more than 20 pounds (or 10 mg.). Also, do you have a monitoring ACTH test scheduled? The official recommendation is to have a repeat ACTH performed 10-14 days after starting on the drug. If not that soon, the test should at least be done by one month's time on the drug.

As far as her thyroid, we will hope that her thyroid level will normalize once her cortisol is controlled by the Vetoryl. That does take place for many dogs after they have been successfully treated for the Cushing's. But you will want to keep an eye on that, because some dogs suffer from low thyroid long-term, even after the Cushing's has been treated. If so, then thyroid supplementation is necessary alongside the Vetoryl.

Please do keep us updated as to how she is doing on the Vetoryl, OK?

Marianne

[thapsus]

Thank You! :)

She weights 9,8kg. Or did last wednesday. Few weeks ago she was 9,5 kg.

Next ACTH test is scheduled to February first.

[Wuchi]

Hi

My chihuahua had some similar symptoms. Turned out most were caused by Cushings. She fortunately did not get to the point of not breathing but sometimes her nose was so congested that it sounded like it. I don't remember her snoring before getting Cushings. Might be something to do with the muscle weakening due to the extra
Cortisone in the body. Once she stabilized on Trilostine/Vetoryl it calmed down some (so did the fast breathing) took many months to get her on the right dose so don't try to rush it every dog is different.

In regards to the other symptoms... My dog was running around on the beach last June and a couple month later she barely had the energy to walk. Cushings is aweful and it can really take ahold of your dog. Looking back I think she had it for about 6-8 months before being diagnosed: excessive eating then thirst...

My 2 cents (not a doctor): their muscles are week so be careful with letting your dog jump around and do stairs just make sure they take it easy, they will injur easily and it takes a bit longer for them to recover. I'm feeding my dog high protein (home cooked lamb and pork) to help with muscle regeneration -- don't recommend holding back food or water - food is needed to keep up with the over production of cortisone -- water is needed to flush out system - once the meds kick in thirst and food intake will go down.

To help with rebuilding her muscles (back legs sometimes get impacted the most) I'm taking her to a dog accupuncturist and she does cold laser therapy too (same vet). Has really helped my dog -- she injured her front leg jumping off couch when Cushings was at worst and it's completely healed up, back legs are taking a bit longer.

She also has thinner skin on belly think I read that skin/fur stuff takes a little longer (months/year) to get better. Have been using coconut oil (only use organic, virgin oil) on her belly and that helps some -- and she likes the belly massage too. On the forum i think it mentioned it takes 4months or more for stomach muscles to start coming back -- FYI my dogs new belly is from an enlarged liver and the stomach muscles going. So check with your vet before putting your dog on a diet -- might not be their tummy hanging low and might regulate itself after the cortisone goes down.

As far as exercise goes we can relate -- winter time -- if you are not already doing so play inside as much as possible, keep them moving helps with inflammation and helps drain the adrenal glands, if you can take them someplace -- pet store or hardware store that lets them walk some will also perk them up -- my vet recommends small outings with the dog (weekend at the beach) to help cheer them up -- it's hard on them too. If can't get dog to move then make sure you are physically moving/rotating their legs/joints around (tip from vet) to help keep things moving so the joints stay healthy and to try to cut down on muscle loss.

Best of luck on your journey!

[thapsus]

Thank You Wuchi.

Got my Väpä's control values finally today. She has been doing good. No problems. Luckily. Values though were so low that we are going to stay off meds for a week and continue after that with 10 mg Vetoryl (has been given 20 mg).

Test was ACTH (I don't know if it's same in English). Väpä's first test's first value was 103 (normal 10-100), now it was 14. Second test after 1,5 hours was originally 737 (normal 200-600), now it was 36.

[Harley PoMMom]

Hi and a belated welcome to you and Väpä from me as well!

Väpä's ACTH stimulation test results would be too low for my comfort, especially since her cortisol dropped so low so fast: her pre was ~ 103 nmol/L to 14 nmol/L, converted to ug/dl is 3.73 ug/dl to 0.51 ug/dl; and her post was ~ 737 nmol/L to 36 nmol/L, and converted is 26.7 ug/dl to 1.31 ug/dl.

If this were me I would with hold the Vetoryl until: 1) an ACTH stimulation test shows that her adrenal glands are producing enough cortisol for her body to function properly; and 2) her Cushing's symptoms have rebounded. Dechra, the makers of Vetoryl, recommend this too, this is stated in their product insert:
If the ACTH stimulation test is < 1.45 μg/dL (< 40 nmol/L) and/or if electrolyte imbalances characteristic of hypoadrenocorticism (hyperkalemia and hyponatremia) are found, VETORYL Capsules should be temporarily discontinued until recurrence of clinical signs consistent with hyperadrenocorticism and ACTH stimulation test results return to normal (1.45-9.1 μg/dL or 40-250 nmol/L). VETORYL Capsules may then be re-introduced at a lower dose. Dechra's U.S. Product Insert (http://www.dechra-us.com/Admin/Public/Download.aspx?file=Files%2fFiles%2fProductDownload s%2fus%2fvetoryl-5mg-pack-insert.pdf)

I also suggest to have Väpä's electrolytes checked to make sure that they are within the normal limits.

How is Väpä's acting? Does she still have a good appetite? Is she drinking/urinating normally? Any diarrhea?

Hugs, Lori

[molly muffin]

Wow that is way too low. I too would wait for some symptoms to come back and then verify that the cortisol is indeed rising with an acth before starting back on vetroyl. That can sometimes take a week, sometimes it takes much longer, which is why it is best to verify prior to starting back.

[thapsus]

Thank You. I will wait for a week and see what happens. If there is no symptoms I will definitely not start meds. I need to consult vet again. I sure don't wan't Addisons. I'm not rich though, quite opposite. But everything necessary will of course be done.

Need also speak to the vet about 5mg Vetoryl. I'm pretty sure she does not know that is available nowadays. Or if it is, but why wouldn't it be available in every country.

Väpä has been doing good. Active, good apetite, drinking and urinating normally. Had little bit runny poop (but no need to go more often), but that was expected because she got quite big chuck of fish skin from grandpa...

Väpä's electrolytes was checked and they were normal.

[molly muffin]

Okay, let us know how she is doing. That was a big drop, very fast, so at the very least, even when you do start back, it would be a reduced dose, if you do.