senior greyhound with Cushings

[greyhound lady]

Thank you for accepting me to this forum. I need a little help. My 11yr. old male greyhound, Oz, was diagnosed with Cushings in April this year. I have an excellent vet who put him on Vetoryl (trilostane) 60mg. After follow up testing, he needed an increased dose. We increased the dose to 75mg but it had to be compounded. After scheduled testing, his level was very high. He was put back on Vetoryl but 70mg. He was recently tested and his levels are normal. A blood chem panel was done and also electrolytes were checked; all were normal. His problem is episodes of shaking/trembling in his upper body around 9pm each night while lying on his side at rest. The episodes last about 20min. He doesn't seem in pain. After the episode, he stretches. It is very similar to a seizure but not as dramatic since the trembling is like quivering from being cold.
I hope this makes sense. If any greyhound owner has a grey with Cushings or any other owner with a Cushing's dog that has had this happen, please enlighten me. I have adopted retired racers for 25yrs. and this is my first Cushing's dog. I'm seeking any help. Thank you.

[Harley PoMMom]

Hi and welcome to you and Oz!

It would help us a great deal if you could share more information about your boy, in this way we can provide you with our best possible feedback and we get this information through a ton of questions so here goes some of mine. :eek:;) Could you get copies of all tests that were done on your boy and post those values that are abnormal. 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. If you could give us more specifics about the testing that has led to the Cushing's diagnosis and the monitoring ACTH stimulation test results, that would be very helpful too.

We have had numerous reports of unexplained tremoring and "shivering" episodes throughout our years on the forum, tremors are listed as a side effect of Vetoryl/Trilostane.

I'm sorry this post is so short, I'm at work :eek: Please know we will help in any way we can.

Hugs, Lori

[greyhound lady]

Thanks for the reply. I'll gather reports as soon as possible. I don't have all copies here. I had a consult with my vet about Vetoryl this week and we discussed that the quivering/shaking has been listed as a side effect of the drug. I read this info in the insert of the Vetoryl. My vet called the drug co., Dechra but didn't get much information. There was no co. vet to speak with. My vet left her name and number so their vet could call to explain side effects, etc.
Tonight, Oz hasn't had an episode so far. Of course, I can't watch him 24-7 so he could be having issues during the night. His rear left leg is very weak and I understand rear leg weakness is a symptom of Cushings. At this point, if the quivering is not causing pain, I'm ok with that and accept it as an on-going side effect to be expected. I'm hoping Oz will get stronger as time goes along. At his age, quality of life is important. Thank you again for your reply and after posting his info, I hope you can share some knowledge on this challenging disease.

[labblab]

Hello and welcome from me, too! I just want to "second" what Lori has said above: through the years, we have had other members who have worried over unexplained tremoring episodes. My own Cushpup, a Lab, suffered from intermittent involuntary tremoring episodes across his shoulder blades that made him look as though he was shivering. For him, the episodes happened most often when he was sitting down or at rest -- even when he was sleeping. Sometimes he would jerk himself awake, they were that severe. But just as is true for your boy, he would usually just stretch afterwards and never seemed to be in any particular pain or discomfort. The tremors began before he started trilostane treatment, worsened significantly when he first started the drug, and then ended up stopping entirely a few months down the road.

We never did figure out what caused them. Through the years, other members here have reported similar issues with their dogs under a variety of circumstances: some using trilostane, some using Lysodren (another medication), and also dogs not yet being treated at all. For this reason, it has been hard to point to a single "trigger." It is true that tremors are now listed as a possible side effect of trilostane. But I've always wondered whether such tremors more often just somehow relate to rapidly changing cortisol levels. But the good news is that they didn't really seem to bother my dog at all -- it was ME who was going crazy trying to figure them out!

Marianne

[greyhound lady]

Thank you, Marianne for giving me hope that the quivering/shaking will subside. And, yes, like you, it's ME who is bothered by this, more so than Oz. If the Vetoryl doesn't cause permanent problems or pain, then I can deal with a little quivering.
You've given me hope that things will get better. Thanks!!
Cynthia

[judymaggie]

Hi, Cynthia! I wanted to add my "welcome" to you and Oz. Huge kudos to you for adopting greyhounds for so many years -- you are obviously a caring parent and I bet they have thrived in your home.

We often say that the best outcomes of Cushing's treatment is a well-informed pet parent and a vet who is knowledgeable or, at the least, is willing to learn. It sounds like Oz has both in his corner!

[greyhound lady]

It's been a while since I've posted. In Aug. Oz's cortisol snap test result was 3.9, normal range. He is tolerating Vetoryl 70mg once a day well. He'll be retested in Nov. In my last post, I mentioned Oz's weakness in his left rear leg. This condition has worsened so much. His leg hangs when he gets up from his bed. I massage his leg and he will eventually put his foot down at times, limping at all times. There is much muscle wasting and his other leg is supporting his body when walking for the most part. My vet thinks he could have degenerative myelopathy, eliminating LS and other conditions with exam. Oz has been put on gabapentin 100mg once a day.
My question is.....could this be DM or just Cushing's?? Odd that it is just in one leg. Any thoughts or suggestions are appreciated.

[labblab]

In Aug. Oz's cortisol snap test result was 3.9, normal range. He is tolerating Vetoryl 70mg once a day well. He'll be retested in Nov.

Hello and welcome back! Before addressing Oz's muscle weakness, I just want to clarify his test results. Does that 3.9 represent the second, or "post" number of an ACTH stimulation test, or is that simply a baseline cortisol reading? If it's the former, that's great. If it's the latter -- simply a baseline reading -- that is not so good. Even though it may indeed fall within the normal range for a dog without Cushing's, from that number alone, we cannot assess whether or not Oz's cortisol level is being adequately controlled for a dog being treated with trilostane. The baseline cortisol reading alone is just too variable. So let us know about the testing and we'll go from there.

Marianne

[greyhound lady]

Sorry about not clarifying results.....his 3.9 was post. The Vetoryl seems to be doing its job. Previously, the compounded drug did not; post results for it was >10. That prompted the change to Vetoryl. Oz's symptoms have improved; no TT accidents in the house and less panting. The panting he has now is when he needs to go out for a bathroom break. His quivering episodes have gradually subsided and is sleeping well. Overall, he seems better except for this leg issue.
Hope this info helps. Thanks.

[labblab]

Whew! Thanks for the clarification. ;)

OK, then, this is probably a dumb question, but I assume that ligament damage has been ruled out in that leg? If Oz does not want to put any weight on that leg, I'm wondering whether there's an undiagnosed knee issue going on? Unfortunately, Cushpups are vulnerable to cruciate ligament damage due to the effects of high cortisol on ligaments and tendons.

[greyhound lady]

I neglected to say that xrays were done a week ago. (my poor brain!)I know they do not show all damage. My vet said that Oz's joints, hip and leg, looked like a much younger dog. She removed a corn from a pad on that affected leg but that wasn't the problem since he has continued to limp since the procedure. My vet examined his legs and couldn't feel anything unusual. Again, exam cannot eliminate some issues. I know that DM is not a disease that affects greys normally, but who knows. My vet is very open to any suggestions or questioning from me since we have known each other for years. So, any questions I can ask her or any other conditions you can think of that I can mention to her would be appreciated. Thanks for your help.

[judymaggie]

Cynthia--one suggestion would be to have Oz examined by a veterinary chiropractor. My beagle, Abbie, has been going once a week for treatments to manage intervertebral disc disease and I have been very impressed with her knowledge of how muscles, joints, etc. work together. Not sure where you live but, hopefully, you could find this resource in your area.

[greyhound lady]

Thank you for the suggestion. I live in Alexandria, LA. I don't know if there is a chiropractor near us, but I will certainly ask my vet. My vet did mention that maybe acupuncture could help and is checking out a dr. in a city about 90miles away.
Thank you for taking the time to reply.
Cynthia

[judymaggie]

Cynthia--I did try acupuncture with Abbie but she couldn't tolerate the needles, probably because of nerve inflammation. This could certainly be a good option for Oz.

[lala22]

Hello Greyhound Lady, just wanted to say 'Hey', as i just joined this group on Friday after my greyhound was diagnosed this past week.

Ziggy is our first greyhound, but we've fostered off the track on and off over the past 4 years or so.

Nice to 'meet' you.

[greyhound lady]

Nice to meet you, too. Sorry your Ziggy has been diagnosed. This forum helps a lot. I've been adopting greys for 25yrs. and think they are super. My Cush-boy, Oz, is 11yrs. old today!!! We will be celebrating him today. Good luck to you and Ziggy!!

[judymaggie]

Happy 11th Birthday, Oz!

[greyhound lady]

Thank you! Oz is having a better day today. He got a McDonald's hamburger for a treat which he loved! Of course, his two "sisters", one another grey, had to have one, too. Ha!

[Squirt's Mom]

Happy 11th Birthday, Oz!

[Harley PoMMom]

Happy 11th Birthday, Oz!

[molly muffin]

Happy Birthday Oz!!

They didn't see any signs of arthritis in the joint? Did they also xray the spine? If that is all good then the other possibility is nerve. Did the ylocate any aea or movement that seems to cause pain?

Will he sit for treats? small ones.. If so one excercise suggested to me was sit give treat, walk to you, sit treat, walk to you and just keep progressing across, yard, room. It's like doggie squats to help strengthen muscle, but you don't want to over work the joint/leg, you just want to slowly build muscle, so start slow is key and see how he handles that.

[greyhound lady]

Thanks for all the Happy Birthday posts. Oz has been having some better days. My vet and I feel as if the gabapentin has started to work. He shows no pain in any area but continues to have the muscle wasting and poor strength in his rear leg. He will put it down to walk but limps. Thanks for the exercise suggestions. With the improvement in his attitude and being able to get up and down better, I feel we can start with some exercise soon. As with any disease, we take it a day at a time and enjoy any slight improvement.

[molly muffin]

So seems like if the gabapentin is working, then it wasn't a cushings related issue but a nerve for example or something along those lines. I hope that he continues to improve every single day.

[greyhound lady]

Yes, my vet feels Oz has a neurological problem, probably degenerative myelopathy. The gabapentin helps but with such an issue, Oz has good days and bad. I feel fortunate that the Cushing's is being controlled at this point with Vetoryl. Thanks for your reply and interest.