Cushings and weight loss

[Meli]

Hi. I just joined. My name is Melissa and my 6 year old Newfoundland Dog Bailey was diagnosed with Cushings in August this year. I seen a few posts with the same symptoms but didnt see any resolve so was wondering of similarities. Bailey started off at 147lbs at disgnoses a weight hes been at for years. The vet put him on 180mg of trilostane once a day. 1 month later he had lost 10lb. Vet blew off my concern. Next check up a month after that he was at 120lbs. Vet still not concerned. Now in december hes at 103lbs and is nothing but bones. He eats just as much as he always did. Vets have already tested all major illnesses like kidney failure, uti, liver, diabetes, thyroid etc. Only thing standing out was the cortisol so the cushings so just shrugging at his weight loss. So doing my own research. I came across EPI. Pancreatic insufficiency. The vets here wont even look at it because its not something theyre familiar with is my guess. But i ordered enzyme medication regardless. Cant hurt to try especially if hes going to die from weight loss soon anyway. Wondering if anybody had dogs that got this after getting Cushings or starting Trilostane? Can trilostane cause it or cushings itself? I cant find any real ties but these problems didnt start until the same time as the cushing diagnosis and starting of trilostane. Any ideas?

[judymaggie]

Hi, Melissa -- welcome to you and Bailey! Bailey's weight loss is truly dramatic and I can certainly understand why you are so concerned -- I am also appalled that your vet is so nonchalant about it. Giving him the benefit of the doubt, maybe he is just stumped as to why it is occurring. I do not have personal experience with EPI but there have been some discussions here about it.

There is a condition called corticosteroid withdrawal syndrome which is described as occurring from acute withdrawal of circulating cortisol -- clinical signs include weakness, lethargy, anorexia and weight loss. This is distinguished from Addison's based on electrolyte and ACTH results. With the withdrawal syndrome, the Vetoryl would be stopped and then restarted at a lower dose. From what you have described, Bailey does not have anorexia and you didn't mention any lethargy/weakness.

It would help us greatly if you could provide some background with regard to the Cushing's diagnosis. Your responses will help us guide you. What symptoms was Bailey displaying which led you (or your vet) to consider a Cushing's diagnosis? What Cushing's diagnostic tests were done? If an ACTH, please post the "pre" and "post" numbers. If an LDDS, there are three numbers to post. Was an ultrasound performed (either initially or during the last few months)? If so, were there any irregularities in any organs noted? Were both adrenal glands visualized? I am assuming a chem panel was done -- please post any highs or lows along with the range (i.e., ALT 65 (range, 18-45). Was a urinalysis performed? If so, what was the specific gravity and was there any protein in the urine?

The dose that Bailey was prescribed is higher than the manufacturer of Vetoryl (brand name of trilostane) recommends, i.e., 1 mg/lb. Were monitoring ACTH tests done at the 14 day and 30 day mark? If so, what were those results? Has an ACTH been done since then?

Are you still giving Bailey the trilostane? Have you tried stopping it to see if he gains any weight when off it?

You said that "the vets" have tested for other diseases. Have you had any consults with an internist?

It will most likely be quiet here this weekend but, hopefully, others will be along to add their thoughts.

[Harley PoMMom]

Hi Melissa,

Welcome to you and Bailey! Sorry that your sweet boy is having issues with keeping weight on and I see why you are so worried. EPI sure sounds like it could be a possibility and weight loss despite having a healthy appetite is one of the most common symptom, also their stools are generally a greasy voluminous yellowish or grayish cow-plop shape. Has there been a change in appearance of Bailey's Stool?

Could you post Bailey's most recent ACTH stimulation test results? What symptoms did Bailey display that led you or the vet to test for Cushing's? The recommended starting dose for Trilostane is 1 mg per pound of the dog's weight so for Bailey that would be a dose of no higher than 140 mg. So I'm a bit concerned with his 180 mg starting dose of Trilostane which is why I'm very interested in seeing those ACTH stimulation test results.

I've been a member here for 7 years and have not seen any correlation between Cushing's disease or Trilostane and EPI. Chronic pancreatitis can be a cause for EPI, does Bailey have a history of pancreatitis?

I am sorry for the reasons that brought you here but so glad you found us and we will help in any way we can.

Hugs, Lori

[Meli]

Thank you for the reply. I was just looking over Baileys records. I should note that i live primarily in the Arctic and there is only 1 vet and limited supplies. Meaning they didnt have an ultrasound big enough to check which type of cushings Bailey has for a dog his size. Giant breed. But moved recently and had the same reaction with new vets who think i need to put him on vet food to gain weight.

It started over the summer in May when he started drinking excessively and became unable to control his pee. He also became smelly from his skin in general and itchy licking his paws and belly a lot. General bloodwork was in normal limits so it was named allergies and getting old. So i was trying to find the source of the smell and discovered he had a broken molar. So june 10 i took him in. Thought this was the problem and had his molar removed. Bw showed normal range again and weight is listed at 60.8kg. Heart check good.

August 16 i took him back again. Peeing and drinking out of control. Fur from bloodwork on tooth extraction never grew back. Urinalysis was done. Ph was 8.0 but everything was within normal limits except it had low specific gravity. No sign of diabetes or other illness. Kidney and liver check were fine. Weight is now 55.10kg. LN is within normal limits. Heart check is good. No abdominal pain from what they can tell BSC 3/5
Diabetes is ruled out, renal failure ruled out, thyroid ruled out, heart problem ruled out

I returned for ACTH test august 19. Weight is. Result was Cort06 >828nmol/LH and started on trilostane. 180mg. 1 box at 120mg and 1 box at 60mg. To make the 180mg.

SEPT 8 follow up acth testing. Vet said was boarderline. Results on the records i have say cort08= 146 nmol/L weight is 50.6

Ive been continuing since with the medication but vet will only say poor bailey and that shes at a loss to his weight loss. No better results from new vets now that i am moved. Now over the last month. Ive had him weighed he was 103 lbs. Hes lost his entire undercoat. The smell that covers his body is bad. Still drinks and pees a lot but nobody seems concerned with his weight loss because he still eats just as much if not more and still plays and is active. His body under the bushy top coat of fur is bones. Its like hes starving to death yet still eating everything.

[Meli]

In response. Baileys stool is a mix. 25% its like a orangey green cow paddy. 50% like diarrhea of many colors and 25% normal. Also hes had no history of pancreatitis. Also i can see on his records where it says they took bloodwork. But there are no results listed like with all the other tests. Dont know if they left it out or what the deal is. I nevrr noticed until now the blood labs arent there.

[molly muffin]

Hello and welcome from me to. Newfoundland dogs are just beautiful. I use to have one living down the street from me. Lovely teddy bears. I can see where the concern would be with that amount of weight loss so quickly.

I'd definitely ask them to email you the lab results as they were missing. My next question is whether there are any specialist where you are now, such as a dermatoloty specialist. Take some skin scrappings and see if there is any underlying bacterial infection anywhere in the skin area.

There must be something going on and it can sure be hard to find with a newfy and all that hair.

[Harley PoMMom]

I'm posting this reply from one of our Moderators, Leslie, which includes some recipes for weight gain:
Some recipes for Satin Balls, and other food ideas, designed to help pups gain weight -


Satin Balls - (Cat's recipe)

1 lb ground lamb, turkey or venison (or combination)

1 8 oz package of ricotta cheese

2 ounces almond butter

2 ounces coconut oil

4 ounces ground flaxseed

1 dozen egg yolks

2 cups rice cereal cooked

Other things to try include green tripe, sardines(canned in water and
drained) scrambled eggs, novelty meats like ostrich and rabbit, and certain
types of baby food. Baked treats can be good too, if the meat content is high
enough to get them interested. Don't OD on protein (as you know) with
Cushing's.

Kathy’s recipe
TO ADD WEIGHT - SATIN BALLS

20 pounds ground 70/30 beef or lamb
2 pounds beef or chicken livers pureed in the blender (gross I know)
12 eggs pureed in the blender
1-pound bag of cranberries pureed in the blender with the eggs
2 containers high fat ricotta cheese
2 cans jack mackerel or Salmon - drained
2 big cans spinach drained
1 box total cereal
1 jar wheat germ
1 big round box oatmeal
1 can of pumpkin
2 cups unsweetened applesauce
Bake at 350 like a meatloaf.

[Meli]

Hi again. In response . He has had skin svrsppungs done and has had yeast infections in the past but nothing has showed up in the last year for skin. Tests have been negative.
Also thanks for the recipes but as I already mentioned the problem is that no matter how much he eats or what it is. He continues to lose weight. Right now he eats 3 to 4 meals at 2 cups of food per meal a day plus treats and still loses.

[molly muffin]

hmm, okay so no infections of the skin and still losing weight.
Did you ever get the blood tests results to see if they showed anything going on internally?

the next option if all tests are normal would be an ultrasound to take a look at internal organs. maybe get a look at the pancrease?

[Harley PoMMom]

Another thought I have is making sure there are no parasites as our dogs can easily get them.