Sugar Has Cushings

[My Baby Sugar]

Hello, my name is Debbie. My baby is Sugar. She is 14 1/2 and has had cushings for over 5 years. She is on trilostane, blood pressure medicine and several natural supplements. For the first years she did very well. A couple of urinary infections and skin issues .Doing very good. But in the last year and a half she has declined quite a lot. Hair has become very thin and she has hearing loss. At times she seems to forget were she is at in the house. The most concerning is her loss of muscle in her hindquarter and hindlegs. From her ribs to her tail is very narrow. She can no longer stand. Lots of weakness. I use a harness to help her walk. She has also lost 4 pounds in the year and a half. My vet thinks the muscle issues and weight loss are from long standing Cushings. He said Sugar is his longest living Cushing dog. Most live only 2 to 3 years. Is he right. Is this type of muscle issues from the Cushings. He did say that there is a small possibility that she has an issue in the head or base of neck. But an mri or cat scan would not be an option for her because of age and health issues. His advise is to keep her comfortable as long as possible. I knew this day would come, but it is heartbreaking. Sure could use some advise. From me and Sugar, thank you.

[labblab]

Welcome to you and Sugar! I'm sorry I have only a moment to post right now, but I wanted to let you know that I've moved your thread here, to our main Questions/Discussion forum. This way, our members will be more likely to see your thread and have the chance to respond to you. ;)

We're really glad you've found us, and I'll try to return, myself, before long.
Marianne

[My Baby Sugar]

I appreciate that Marianne. And for the warm welcome. I realize that Sugar is probably nearing the end of her journey with cushings. When she leaves, I hope I can say I did everything possible for her. That is why I am here. I hope I am not missing anything that perhaps could help her. Her bloodwork is still good. Only thing she has is a low albumin which the vet does not seem concerned with. Debbie

[molly muffin]

Hello and welcome from me too. :) aI think if she has lived with cushings for several years, then you are doing an excellent job for Sugar and have definitely given her a good life and done all you can for her.

How long a dog lives with cushings, mostly depends on age they are diagnosed and the normal life span of the breed, and other health issues. We've had dogs not survive very long and others go for years and years, I think 8 years is one of the longer ones I know of from the forum.

It is true that cushings often does lead to muscle loss in the hind legs, so does age. My dog is 13 and she has problems with the rear legs (also has luxating petulla), but on this last grooming I too noticed how thin she has gotten from ribs back. I think it is maybe some cushings and maybe some age related. She too is on blood pressure medication.

It's hard when they get older, whether they have cushings or not and we Never want to lose them.

So the albumin is low. Is it always low, and is it grossly low or just a bit low? I'm guessing a bit maybe if the vet doesn't seem to be concerned?

Low abumin can go along with several disease, such as kidney, liver, pancreatis, etc. If it is very low it can be a problem, if it is just a one off barely low then maybe not so much. You basically want to see if it is trending downwards on a continuous basis.

[My Baby Sugar]

What a kind thing to say Sharlene. Thank you. I truly hope I have done the best I can for Sugar. It is sad to see her struggle to walk. I do not let her see me cry as I know there will be plenty of time for that when she is gone. I have asked my vet if she will in time lose use of her front legs. He really does not give me a direct answer. So, Does cushings in time take all muscles and use of all legs. I have not read that as a part of the disease. At 14 1/2 would any one this site attempt to do a cat scan or mri. Her albumin is a 2.1 with normal 2.4 - 3.6 range. Your Molly is so adorable and I hope the best for you and her. .

[Whiskey's Mom]

Hi, I'm new here too. I'm sorry about your sweet baby Sugar. But I also wondered about Cushings and the use of the legs. When my boy tore his ACL in Oct., the xray was the least expensive option, and we were afraid of surgery at his age. My vetsaid his hips were good but the ligaments in his legs were weak from the Cushings. So he gets laser therapy on BOTH legs. But I do notice muscle loss in his body, and I can feel his spine & hip bones. He has been on limited activity since the injury, but I need to let him have some fun and stop being so overprotective. We have a vet appointment today, so I will ask about the use of his legs. We have not done cat scans, MRI or ultrasound, because the end result would not change how we treat his disease. We feel the money is put to better use on his Denamarin and Vetoryl, laser therapy and his favorite treats of course! Love to Sugar from Whiskey

[DoxieMama]

Hi Debbie,

What a great mom you are to Sugar, taking care of her with Cushing's for 5 years! I am sorry she is having a rough time now. What kind of dog is she?

Shana

[molly muffin]

Usually the muscle weakness is in the rear legs from what I can tell from being on the forum and seeing any number of cases throughout the years. If you start to see front leg weakness, then possibly an xray would be able to show if there are any spine issues.
Would I do an MRI or Ct Scan at Sugars age, doubtful. If you aren't going to do surgery or extensive treatments, then I don't know that is would be the best use of money for Sugar.

[My Baby Sugar]

Thanks to Whiskey's mom and Shana. Both of your babies are darling. Love the names. I hope Whiskey will continue to do well.. Sugar sends her love back to Whiskey. Shana. Thank you for saying I am a great mom. I truly hope so. I still wonder if I could have changed something in terms of her leg weakness. She is a maltese and as her name indicates, she is white. She use to weigh 8 pounds but weighs a little over 4 pounds. Very skinny looking. Probably a pound was her hair. She use to have tons of hair. . And Sharlene, I will watch for front leg weakness. Debbie

[Whiskey's Mom]

Please don't be too hard on yourself. You love your pup and she loves you that's the important thing.

[DoxieMama]

Aww, she's a tiny little pup! Sounds like her name is very appropriate. And I agree with Whiskey's Mom wholeheartedly! Be kind to yourself and love on that little one. You are doing great.

Shana

[lulusmom]

So, Does cushings in time take all muscles and use of all legs. I have not read that as a part of the disease.

If Sugar's cortisol was stabilized and effective control was confirmed by appropriate acth stimulation tests, muscle wasting should have been arrested. Otherwise healthy senior dogs experience muscle wasting, especially those who are inactive. My tiny cushdog, Lulu, was diagnosed at only three years old and by age 9 she had noticeable muscle wasting but was still walking and running in circles at dinner time. :D She was a little tubby when diagnosed and weighed in at 5 lbs. She maintained her normal weight or 4.0 to 4.5 lbs after starting treatment but she started to lose weight in the last year of her life. She was down to a bit under 3.5 lbs when she passed. She was having a very difficult time walking, not due to muscle wasting, but severe osteoporosis. I believe the combination of nine years of thyroid supplementation and delayed cushing's diagnosis had a horrible effect on her bones which were disintegrating.

I know how difficult and heartbreaking it is to watch our senior babies decline. They bring us so much love and joy which can make it so incredibly difficult when we come to that "quality of life" crossroads. I suspect your are at that crossroads now. We can only do so much for our pups and please know that we're here to help you in any way we can to try to give Sugar a better quality of life if at all possible. You've done a tremendous job in getting her to 14 1/2 so congratulations on being an excellent and most loving advocate. It would really be helpful if you could fill in some blanks for us so that we have a better idea as to Sugar's cushing's treatment history. Did you have her acth stim tests done every quarter, every six months or less? What dose of trilostane is Sugar receiving and is it once a day or twice a day? When is the last time your vet did an acth stimulation test and can you please share the results of that test with us? Can you also tell us when the last blood labs were done and if you have copies of those results, can you share the high and low values with us, including the normal reference ranges?

I am so sorry for the reasons that brought you here but I'm very glad you found us. You and Sugar have been on quite a journey and I thank you for letting us be a part of your journey now.

Glynda

[My Baby Sugar]

Thank you Glynda, I thought Sugar was tiny but your baby was so tiny and just adorable. . I am confused as to what you are saying. Are you saying back legs and hindquarter weakness is not a part of cushing disease if cortisol levels are under control. I just accepted my vets reasoning that all the muscle issues are from long standing cushings. Are you saying it could be osteoporosis. After 5 years of treating there are so many acth test, bloodwork etc. I will give the latest of everything done. It will be a year in May since her last acth test. We just started to do the year acth test because Sugar gets under a lot of stress now and does not like being poked . The last was a Pre - 2.7 And a Post - 6.7 . Her bloodwork was done Dec 2015. Her blood Urea was a 39 with normal 5 - 29. Her albumin was low at 2.1 .Normal 2.4 -3.6 . The strange thing is Sugar use to have elevated alkaline phos. but now it is only 72. I do find that strange. Actually all but the two mentioned are in normal range. And urine test are always good. She get 5 mg trilostane in morning and 5 mg at night. If there is anything I can do to help her please suggest. Debbie

[My Baby Sugar]

Yes, wanting to know if there is anything else I can do for Sugar. I use a harness that was made especially for her to help her walk. She has acupuncture treatments every week and glucosamie for her joints along with other body supplements. She sees a chiropractor once a month. She did not do well on water treatments. I can not think of anything else to try but perhaps someone else might have a suggestion. Debbie

[molly muffin]

maybe laser treatment on her back legs? I know some have tried it.

Really I think that you are doing everything that any of us would try already.

[My Baby Sugar]

Thank you Sharlene. Before I throw in the towel and look in the mirror and say ,Debbie, you did everything you could for Sugar, I have lingering questions. I can understand the thin hair, the hearing loss, confusion at times and the tiredness could be long standing Cushings or older age. But I wonder about the extreme hindquarter and hindleg weakness. Also the extreme weight loss. Until I came to this site, I did believe my vet who contributed these issues to the Cushings. But Glynda got me thinking. Is it really from the disease? Did my vet and myself overlook something ? Is it to late to do anything to help Sugar ? Will I have to let her go all because of the weakness. I am tormented by all these questions. Please help.

[Whiskey's Mom]

Whiskey has some weakness in his back legs too and had torn his ACL. The laser therapy really helped him, but we can see that his legs are a bit wobbly at times. We use a harness to help him get in the car & now just sometimes going up steps. He was always a jumper & did the stairs a million times a day, so I know how hard it is to see a pet struggle. :( I'm sorry you and Sugar are going through this. Maybe your vet can advise you if laser therapy would be helpful.

[labblab]

If I am understanding you correctly, it has been almost a year since Sugar's last ACTH test, and at that point the results were 2.7/6.7? If that is true, I really think the first thing you need to do is have another ACTH done. The thing is, those results at that time would be considered fine as long as all Cushing's symptoms were satisfactorily resolved. But if not, with a "post" of 6.7, most clinicians would recommend a dosing increase in order to gain better control of the cortisol. Since it's now been a year, Sugar's cortisol may have been running even higher for a significant amount of time.

Given Sugar's age, there may be trade-offs to increasing her dose (and I understand why you want to spare her any unnecessary stress from blood draws), but I still think it is important for you to have this info in hand. If her cortisol has been continuing at the same level or even higher throughout this past year, that could definitely be contributing to ongoing loss of muscle mass and strength. And it is even possible that the reverse may have occurred -- her cortisol may have dropped too low and that is affecting her strength and energy level.

Marianne

[My Baby Sugar]

Whiskeys mom, thank you for the suggestion for laser treatment. We have tried the laser but they do it basically along the whole spine. Marianne, I will schedule an acth test. The reason we started doing it once a year because every time we do any bloodwork Sugar starts to squeal and whine even before the blood is drawning. I guess the vet thinks it is to stressful for her. We do bloodwork every 6 months. I think the vet and staff thinks she is an old girl, so why put her through so much. Deb

[My Baby Sugar]

Here are the results of Sugars` acth test. The pre was 2.9. Post 7.9. Because of her age and the stress of repeated bloodwork , vet wants to keep her trilostane the same and recheck about 6 months if I want to. He also said her bloodwork and urine test that was done in Dec. 2015 were both pretty good. Thank you for any suggestions. Happy Mothers Day to all the moms. Debbie

[molly muffin]

I might want to recheck her sooner than 6 months, but I probably would leave her at this as long as her symptoms are controlled. :)

Happy Mothers day

[My Baby Sugar]

Thank you Sharlene. I think at this time that's about all that can be done for Sugar. It`s sad to see her struggle to walk and she seems to be really tired. I give her lots of supplements but I guess they can only do so much. She does not like her hindquarter harness at all and refuses to walk. I`m looking to find a stroller for her. Hopefully to get her out more. Cushings or old age or both ? .Sigh, so sad. Debbie

[Sadielove]

Welcome to the forum. I hate that it is under these circumstances. We are all cherish our Cush pups and want the best for them. I worry daily since I am new here as well. My baby has been on trilostane for 30+ days. You are an excellent mom taking care of her daily. Hugs to sugar and you.

[My Baby Sugar]

Sadielove ,I always appreciate someone telling me I did a good job. Its nice to be reassured. Sometimes I`m not for sure. Best luck to you on your baby. Now, I wonder since Sugar has been on trilostane for over 5 years and her back hindquarter and hindlegs continue to weaken along with hairloss, with tiredness and more frequent confusion, would it be best to take her tired and frail little body off of the drug. Perhaps in time after 5 years ,I wonder if the drug can its self become toxic. Just thinking. If I take her off , maybe she would not be as tired and also she would not have to do any more ACTH test. She just does not want to be bothered anymore. . Or by taking her off, would that make things worse. Can predisone. help ? Sometimes I can not decide what is best for Sugar. My sweet, sweet baby. Debbie

[Whiskey's Mom]

Debbie, Sugar is so very lucky to have a loving Mom like you. We agonize over making the right decisions for our sweet babies. . Everything we do for them is out of pure love. I honestly don't know what I would do in your situation, but I don't think any choice you make would be wrong. Hugs from us.
Annie and Whiskey

[My Baby Sugar]

Hi Annie ,thanks for your understanding. Love to you and Whiskey. At this time I am lucky that I can bring Sugar to work with me 2 days a week. A super understanding boss. Two days I leave her at my vet and on Mondays, my husband is home. I am so afraid to leave her alone. Its sad but when Sugar was young ,people would stop me and say how adorable she is. Now, I get a lots of looks that say, poor little thing, maybe she should be put down. I know Sugar is not real happy any more but now and than I see a spark in her. Debbie.

[My sweet Ginger]

Hi, at first I thought Sugar's cortisol level might've gone too low since her last ACTH was one year ago but this latest results show that's not the case. My baby was almost 14 when she was diagnosed with Cushings and soon after with dementia. She lived to be 16 yrs and a few months. Towards the end she lost almost a half of her body weight, went deaf, sparks in her eyes long gone, got incredibly frail and completely detached from everyone and everything. She was on 5-6 different kinds of meds but she kept getting up and would walk around, aimlessly for hours many times a day. Family members would make comments like 'I would put her to sleep. She has no quality of life.' I'd ignore those comments until one day the thought ' Am I really doing right by her? ' pops in my head. Then I'd ask our specialist and he'd say 'I think she's doing pretty good considering everything she's got going on.' Backed with his assurance I'd then be able to ignore those comments again and stayed the course. What others were saying didn't really matter so much to me but there were a couple of times I wasn't sure whether I was just being selfish by keeping her with me. So his professional opinion mattered.

You mentioned Sugar being confused. I wonder if she is developing a dementia as did my Ginger. If you don't mind adding one more pill and with your vet's approval you might want to try 'Novifit' if she has CCD.
We never found out what made Ginger to lose so much weight especially in the last few months despite she was eating pretty good on her own. Also by then we didn't really go by the rules or recommendations that much. She ate and did whatever she wanted and stayed away from frequent testings as much as possible while staying on necessary medications religiously and periodic BP and overall check ups.

As sad and hard as it was watching my baby declining right in front of my eyes, to this date I'm glad she stayed with us as long as she did and that I was there for her but in the end it is what you feel is right for your baby.
Give her extra hugs and kisses and her favorite treats and just enjoy every day you have with her while making precious memories together. Hugs. Song.

[My Baby Sugar]

Dear Song, thank you so much for sharing that part of Ginger`s life with me..I realize it was painful for you. It touched my heart and the tears just flowed. Through the tears I could see the other side. A sweet little baby that fought hard and along side of her a loving and devoted mom. You have gave me the strength to do what I think is best for Sugar no matter what others say or the looks that say it all. Sugar is often confused or dazed so I will ask the vet about Novifit. Hopefully that might help. Its worth a try. Sugar has also has lost a lot of weight .They think it is from the Cushings that is causing muscle loss. I try to get her to walk more, but she will not. She still likes to eat. I will cherish the time we have left, extra kisses and lots of treats. Whether a day or are several months. . Love, Debbie

[Joan2517]

Song is right, enjoy every moment with her. Sugar knows she is loved and you know best what her quality of life is...

[My Baby Sugar]

Thank you Joan for your kind support. It means a lot to me. I read that a lot of cushing babies have hindleg weakness. The longer a dog has cushings, the worse it gets. Is that correct ? This is what my vet has made me believe. I still wonder about that. She`s had xrays and they showed some arthritis. Debbie

[Joan2517]

I'm not an expert, Debbie, and wasn't on the Cushing's journey long, but Lena's back legs definitely got weaker over the years before we even knew she was sick...just thought it was old age. I can't remember when she stopped doing stairs, but it had been a while. The last month before she died she started stumbling a lot...she was so small, we just picked her up and carried her to wherever she wanted to go...she couldn't do the deck stairs anymore at all and we always had to help her up and down. I still look out the kitchen window and expect to see her little face watching me waiting for me to come out and help her up. If I took too long, she would bark and start swaying back and forth until I came to get her.

It's 3 months today and I miss her terribly. I would give anything to have her back to hug, hold and love. Hug Sugar for me....

[My Baby Sugar]

Oh Joan, your baby was very pretty.I did read part of your post and I can tell you loved her very much. You really tried to do the best you knew how for your baby. Well, I guess I am ready to throw in the towel and assume the back hind and leg weakness is from long standing cushings as my vet told me. So sad. I will keep her as long as I possibly can. Hopefully no other problems will arise at this time. My journey to the site is over. I wish I could have got a little more insight from the seniors members .

[DoxieMama]

It's always so difficult to know what is going on with our little ones. If only they could talk to us and tell us when it hurts, or how they really feel.

As for Sugar's weakness, it could be from aging or something else. If her cortisol levels are under control, then I'm don't know if it has anything to do with her Cushing's diagnosis or not.

Please keep us updated on how she is doing. We are here to support you and Sugar as best we can.

Hugs...
Shana

[Joan2517]

The journey to this site is never over...come back whenever you need to, we are always here. You don't know how long Sugar will still be with you. Who knows...

Lena was almost 15, but she was so tiny that she never seemed to get old until all of a sudden the Cushing's just did her in. I think that's what has been so hard for me, she never seemed old. She still looked like a puppy and she never, ever complained.

I wish you and Sugar all the best, Debbie.

[molly muffin]

There is no reason to leave the site, and it can be comforting to talk to others who are going through and have been going through the same thing.

High cortisol can have an effect of weaking tendons and ligaments, this is generally what I think causes the muscles to weaken and some of them don't really recover well from it, some do. I think probably the longer undiagnosed the weaker they will be.

That just means it is harder for them to do stairs. I carry mine up and down the steps now and have baby gates to keep her from going up or down. I'm more careful about making sure I have a steady hand on her harness when she is on grass or uneven ground, so in case I need to give her a lift if she steps wrong.

We just each do the best we can and find our way to what works with our furbaby.

[labblab]

I agree 100% with the others -- you need never leave us, because our focus is totally on the dogs themselves, no matter how they are doing or exactly what may be causing the problems.

My heart especially resonates with you this morning, because I am facing the same issue of hind-end weakness with my elderly non-Cushpup Lab. It has truly become a quality-of-life issue for us right now, too. Since our girl does not have Cushing's but is experiencing the same problems, I have to agree with Shana that Sugar's weakness may have as much to do with aging as with Cushing's. It is probably impossible to separate the two influences at this stage in Sugar's life, and either way, the greatest challenge is to find a way to make her daily life as comfortable as possible. If you are like me, this means some tears are shed along the way. And that's why we will always welcome you to remain with us. We can't change what's happening, but we can walk alongside you in this journey. I know that for me, the support of our family here means the world. :o

Marianne

[Whiskey's Mom]

I agree too. Just post when you need caring and support from people who love their dogs and understand your feelings. No judgements here. And I too have known dogs that had hind leg weakness as they got older but not Cushings. :-( hugs and love to Sugar and to you.

[kanga]

Sending love, support, and good vibes your way. Hope you and yours do okay. :(

[Tammysmom]

Debbie, just want to say you are a great mom and doing a great job taking care of little Sugar. Seems like you are doing everything possible for her. My thoughts are with you both. Brianna

[My Baby Sugar]

Thank you everyone for the words of comfort and support. I truly appreciated each and everyone who replied. . I am sorry if I sounded rude or ungrateful in my last post. Sometimes I just feel so hopeless. And at times so exhausted. Marianne , I am so very sorry for your baby girl. Dealing with this type of weakness is so hard. I also shed a lot of tears. I shed a few for you to. . I think I am driving my vet nuts. I can`t let it go. He said it is possible that Sugar has developed an additional problem in the brain or base of neck area and that could be causing some of the weakness along with confusion and tiredness. Even tho he still sticks to the long standing cushing thing. He said it would be way to risky to do an mri or cat scan at her age. My job requires that I am out of town for a week twice a year. I would be leaving in June and I don`t think anyone can watch Sugar.. But now I feel so much like a bad mom. So at this time I feel so stressed. Debbie

[My Baby Sugar]

Want to add that I have ordered novifit for Sugar. Hope it helps. Thank you Song.

[molly muffin]

Let us know if the novofit helps at all! I do hope so

[My Baby Sugar]

My job requires I go out of town twice a year. In June I will be gone 3 days. Usually a little longer. I really don`t think anyone knows how to watch Sugar. Anyone been in that situation. Any ideas. I also wanted to ask if a cushings dog will stop barking. Sugar always liked to bark at everything. Kids, bikes, rolling trash cans , lawn mowers. . . I really didn`t notice the bark change until my husband mentioned it. She probably has not barked in 6 months or more. if I remember. She does have hearing loss. She still has good vision in one eye and a inmature cataract in the other. Maybe ? Debbie

[Whiskey's Mom]

Sorry you'll have to leave your baby. Wish I had an answer for you. Last week Whiskey went on his first sleepover without us since being diagnosed with Cushings. We had a hard time leaving him but he did well. Had a great time with his canine cousins. :) hope you can find someone to care for Sugar, or maybe you can be excused from going.

[My Baby Sugar]

Annie, I am glad Whiskey is doing good. And enjoyed his sleepover. That's cute. The trip was really for a week but my boss said we could do it in 3 days. Cutting out the fun. It`s important. A buying trip for Christmas. Today when I picked Sugar up at the vet, they said when they took her out she whined. Looks like the sun hurt her eyes. Getting kinda stressed. I think I will have to talk to my boss. Sugar really needs me. Debbie

[My Baby Sugar]

I am so thankful that I had almost 15 years with Baby Sugar. However, I have run out of options for my little sweetie. I came here hoping to get a few suggestions and support. I am grateful to the few who responded. I have taken her off the trilo as I see no use for it. She fought a long battle and I will forever miss my love, my joy. She taught me the meaning of life.

[DoxieMama]

Debbie, I am so sorry.

[Whiskey's Mom]

I am so very sorry. Praying for strength and comfort for you and Sugar.
Much love. Annie and Whiskey

[Aunt Jana]

I'm so sorry about Sugar. Don't give up. Ask your vet about your days away in June, maybe they will have some suggestions. Do you have a groomer? They always have connections too.

I know the feeling of not knowing what to do next. It will come to you.

Take care

[Joan2517]

I'm sorry, Debbie...cherish the time left with her. If I had it to do over, that's what I would do with Lena. My heart goes out to you....