Pomeranian with cushings

[lisako]

Hi There!

My name is Lisa and I have a pomeranian, Teddy that was diagnosed with both regular and atypical cushings through the University of Tennessee (I think that's what it was) panel about 3 months ago. He had just turned three at the time of his diagnosis.

I'm familiar with cushings, as I had another pomeranian who passed last summer who had cushings and she had gotten really bad before she was diagnosed with atypical cushings by means of the same panel a few years ago. By the time she was diagnosed she had last almost ALL of her hair and skin was completely black. She was treated with lysodrine and pretty much all of her hair grew back quickly with a full force! Her hair was also much thicker than it was before she started showing any cushings symptoms (with exception of tail and back of hind legs).

Getting back to Teddy, the dermatologist decided to treat him with vetoryl. He was on 5mg/day which seemed to be the correct dosage the first time his blood was drawn, but on the 6 week check up it was not enough so now we have him up to 10mg/day, which seems to be the correct dosage for him. He had been gradually losing hair over the past year or so. It seems like since he's been on the vetoryl he has lost a lot more! Where he had just lost patches before, he is now bald on his entire underside, neck, sides, and tail, butt. Is this normal??? I understand it could take 3-6 months to grow back and he might have to shed his hair first, but it seems strange that he is going completely bald...

I will also mention he has allergies to something and always scratches his belly. We have done many trials of restricting his diet etc. or administering allergy medicine and nothing worked for this.

He is also on proin for incontinence, and has been since he was about 9 months old.

Thanks for any responses!:o

[Wuchi]

Welcome Lisa and Teddy :) this is a great forum and it's helped me and my chihuahua a lot. There are a bunch of experts that can provide more info on the meds and Cushings.

In regards to diet and allergies, what are you currently feeding Teddy for meals and snacks? I know it's challenging to figure out what they are allergic too. My chihuahua took the Dodds allergy test which helped figure out some of the main culprits -- Chicken was a big one (her allergies were mainly food related with some environmental) but she still licks her paws every now and then (seems to be when her stomach is upset).

[DoxieMama]

Welcome, Lisa and Teddy. I'm new here as well, waiting on confirmation of diagnosis for my little guy. My mom has had pomeranians for years.. so adorable. Hope Teddy's hair issues resolve in time.

[lisako]

Thanks! He is currently on natural balance, duck and potato. We had him on a couple trials with just the natural balance fish one and then the duck one and only potato treats, but nothing ever changed for him so we gave up. The dermatologist said we can do an allergy test, just haven't gotten to that point yet. I didn't know licking paws was a sign of allergies or stomach upset! Teddy does that too!

[lisako]

I love pomeranians too! They seem to have a lot of health problems though. Your pup is so cute!

[judymaggie]

Hi, Lisa & Teddy! You have given us lots of good information about Teddy but, as you will soon discover, we like details, details and more details. Having had my first Cush pup evaluated by UTenn, I know you will have received a print-out with the results of Teddy's tests and their recommendations for treatment. Please post those here so we can take a look at them. The results will include pre and post numbers as well as the normal range and we would all that info. If Teddy has also had blood chemistry and CBC tests, please post the highs and lows as well as the normal reference ranges. If a urinalysis has been done, please provide those results as well. Is Teddy taking any other herbs/supplements/medications? Does he have any other underlying illness?

A dog who has been diagnosed as "atypical" does not have elevated cortisol. If the cortisol, in addition to the other hormones, is elevated, then the diagnosis is "regular" Cushing's so am curious what the exact diagnosis was by UTenn.

Also, as I recall, UTenn used to recommend treatment with Lysodren if both cortisol and other hormones are elevated so will be interested to see what they recommend for treatment.

I am assuming you have had ACTH tests since the UTenn testing since Teddy's Vetoryl dose has been changed. Please provide us with both the pre- and post- ACTH results.

With regard to the hair loss, it is not uncommon for a Cushing's pup to lose their coat. Often, when the hair comes back, it is a different consistency than the original coat. Others who have more experience than I do with the hair loss will be along to offer their thoughts.

[Harley PoMMom]

Hi Lisa,

Welcome to you and Teddy! Pomeranians hold a special place in my heart, I've just recently adopted a 9 year pom. named Marvin!

If you could tell us more about sweet Teddy it would help us to provide you with better feedback, so here are some questions that I have.

Could you get copies of all tests that were done on Teddy and post any abnormalities that are listed? With respect to the blood chemistry and complete blood count (CBC), you need only post the highs and lows and please include the normal reference ranges. How much does Teddy weigh? What symptoms led you or the vet to test him for Cushing's in the first place? Does he have the pituitary or adrenal form of Cushing's? Does Teddy have any underlying illness that he is taking medication for? And if so, what is it and what is the medication? What tests were performed that diagnosed his Cushing's, and could you post those results too? Could you post the results of the UTK adrenal panel and what their treatment recommendations are?

Judy is correct that if Teddy's cortisol is elevated than he does have the conventional type of Cushing's. Is the hair loss the only symptom Teddy has? If so, Poms are a Nordic breed and are famous for hormonal imbalances and it's not always caused by a tumor, it's in their DNA. :( With them being a Nordic breed they can be prone to Alopecia X (Black Skin Disease) which is a hair cycle abnormality and sometimes their skin can become hyperpigmented.

One study was done to test the efficacy of Trilostane in growing hair on dogs with Alopecia X, treatment with Trilostane resulted in complete hair re-growth in 14 of the 16 Pomeranians. Link to this study: https://www.researchgate.net/publication/8217628_Treatment_of_canine_Alopecia_X_with_trilos tane One of our Administrators had a Pom named Lulu and despite being successfully treated with both Lysodren and Trilostane over the course of eight years, she never regained her coat so she just wore some very cute sweaters. ;)

I am sorry that you are going through this journey again but know we are here to help in any way we can.

Hugs, Lori

[lisako]

Thanks! I'm not sure if I have those (the numbers didn't mean much to me at the time), but I will look or get them from my vet. The only supplement that Teddy is on is glucosamine (luxating patellas). He does not have any other underlying illnesses that I'm aware of. The reason why I said he has both typical and atypical cushings is because both his cortisol levels and the hormones that are associated with atypical cushings are both off - I used that term my self but it could just be 'cushings' . I'm curious to see what UTenn recommended as well, the dermatologist just said that one is not better than the other and we decided to try vetoryl since they make it in smaller dosages. Teddy is about 6 pounds so I would have to do a suspension to administer lysodrine. I know hair loss is associated with cushings, but I was shocked at how much he lost after he had been treated - wasn't sure how much was normal!

[lisako]

Hi Lori! I will try to get the test results and post them. Teddy weighs about 6 pounds. The symptoms that let him to be tested were hair loss, the hair not growing back where it was trimmed, and skin infections (this was very similar to my older pomeranian that just passed that was diagnosed). The dermatologist was wary that it was cushings because he was so young, so we just ended up skipping the regular cushings test and going for the UTenn test, which I was fine with. The only other medication he is taking is proin for incontinence.

Thank you for the information related directly to pomeranians - that is very helpful! They are such a beautiful and fun breed but I guess like most pure breed dogs seem to have a lot of problems! Teddy has been wearing a lot of sweaters too, but it would be nice if he could get his coat back since we live in Alaska. If not, that's fine too though as long as he is healthy otherwise!

[Renee]

Hi there,

Where in Alaska are you (I'm in Anchorage)? I assume that the dermatologist you saw was Dr Preziosi? Is she managing Teddy's cushings as well, or just helped with the diagnosis because of the skin problems?

We are very interested in seeing those test results, so post them when you can!

[lisako]

Yes! I am in anchorage too! I love Dr Preziosi! She is managing as well- I already knew her from when I had problems with my older Pom so we went straight to her this time. I will call on Monday about the results!

[Renee]

That's interesting that Dr P is managing Teddy's cushings (never thought of a dermatologist managing an endocrine disorder!). My vet consulted with her when we were determining my girl's CC, but I never actually went to see her. Of course, we do have rescues that have gone to her, so I know her well enough in that sense, and I've been into VSOA many times for various reasons.

It's unfortunate we no longer have an IMS available here, but we are getting access to specialists more and more and I am hopeful with how vet medicine in Anchorage is progressing.

[lisako]

It started out at our regular vet with my older Pom, and she was consulting Doctor Preziosi, but she had such bad skin problems they ended up just having us go direct to her and she's been great!

[Renee]

Lisa, I'm very interested to know what VSOA is charging for the ACTH testing, if you don't mind sharing.

[lisako]

I think it was around 180?

[Renee]

I think it was around 180?

Hmm, that's a good price. I pay $110 for the test itself, and purchase my own cortrosyn for $325 which gets me 5 doses. Breaks down to $175. But, that is only because I buy the entire bottle of cortrosyn. If I didn't, then they would charge $250 per test.

Always good to have options and know that I could get a stim test somewhere else if needed!