Piper, 8 yr old Boston Terrier with Cushing's

[Sailorchick]

Hi there. I found this site while searching for info on Calcinosis Cutis and Vetoryl. Our Boston Terrier Piper was diagnosed with Cushings 2 years ago (January 2015). She had a terrible case of Calcinosis Cutis at the time, in addition to the standard cushings symptoms- pot belly, excessive thirst/hunger, incontinence. She had also lost almost all her fur.

We had all the testing done and my vet confirmed she had cushings and prescribed Vetoryl. She's now been on Vetoryl (30mg 2x daily) for 2 years and is doing incredibly well. She's only 17 lbs, so I believe she's on a very high dosage of Vetoryl, but it seems to be working for her and she's had no real side effects. We did start at a lower dosage (30 mg 1x daily) but after the repeat testing at 4 weeks post treatment my vet upped it to the 30 mg 2x daily, which is the dosage she's been on ever since. Her blood work/ACH Stim tests always come back looking good at that dosage so we haven't changed anything, and all her cushings symptoms seem to be well controlled. She looks fit & healthy, has a good amount of energy, does not seem overly hungry, has no incontinence issues and drinks an appropriate amount of water. Overall we're very happy with how she's doing on her current treatment plan.

The only issue we are now having, and the reason I'm posting here, is that her coat has grown back in almost too thick & course. She used to have a very short, smooth coat, and never shed. It took about 6 months for her hair to start to grow back, but now the hairs are about twice as long as they were before she got sick, and much much denser. Over the past year her coat has just continued to get thicker and thicker and the shedding has gotten very bad. She looks a bit like a woolly mammoth sometimes, her coat is so thick & course. As her coat has gotten courser and denser, she's now started scratching relentlessly. She gets an Omega 3-6-9 capsule in her breakfast each morning (she's on a grain free diet & does not consume any "people" food), but it doesn't seem to help with the scratching. Nothing seems to help really, she just constantly scratches at her self. She's actually drawn blood scratching at her ears, though thankfully no where else.

In addition, in the last few months I can feel some new bumps around her neck and on her back, under her coat, similar to what the calcinosis cutis lesions used to feel like, though these new hard, scaly bumps are not open lesions like before, and the hair is definitely not falling out around them. You have to really dig through her coat to even see them, and even then you cannot see the whole bump due to all the hair.

Has anyone experienced anything like this with their dogs who have been on a cushings treatment for a few years? Has anyone elses dog's coat grown back excessively thick once the calcinosis cutis cleared? Has anyone experienced Calcinosis lesions returning even though other cushings symptoms are well controlled?

My vet swears the bumps I'm feeling are scar tissue from her initial bout of open lesions, but I really think these are new.

Just wondering if anyone else has been through something like this... TIA

[judymaggie]

Hi and welcome to you and Piper! Super kudos on managing Piper's Cushing's. I don't have any personal experience with the coat issues you are experiencing with Piper although some members have reported coat changes after their dog has lost their typical coat. Have you tried any allergy medications and/or special shampoos?

Others will be along--I just didn't want you to feel ignored.

[Sailorchick]

Thanks Judy!

I'm really curious to hear what other have to say, especially about the apparent return of the CC, though with no hair loss, even though all other symptoms seem well in check.

We haven't tried any allergy meds yet, not sure about mixing Benadryl & Vetoryl? We do bathe her in a colloidal oatmeal shampoo, which is supposed to help. We can't give her a bath too often though, because in addition to Cushings, poor Piper was born with an ingrown tail, and we have to keep the pocket dry to avoid tail fold dermatitis.

[judymaggie]

Hi -- I wanted to provide you with a link to our "in-house" expert on CC, Renee. Her thread is long but would be worth reading through.

http://www.k9cushings.com/forum/showthread.php?t=5908

FYI, one can give Benedryl to a dog on Vetoryl. I used Benedry for a long time with my Abbie and now give her Zyrtec.

Has your vet done a scraping and/or biopsy on the new bumps you are seeing? It might be worth going down that road to find out exactly what you are dealing with so that you can tailor treatment accordingly.

[Squirt's Mom]

I can't help with the CC but it's not uncommon for a dog on Vetoryl (Trilostane) to blow their original coat then regrow a new one that is completely different. I have used the example of a Boston with red curly hair for some time now and lo & behold here she is! :D

[labblab]

Hello and welcome from me, too, although I'm sorry that Piper is so uncomfortable with her itchiness! First, regarding her coat, I have to "second" (or "third" ;)) what Judy and Leslie have said -- many members have reported changes in the nature and/or color of their dogs' coats after starting Cushing's treatment. I don't know whether this is primarily a result of the hormonal/endocrinologist changes, or side effects of the medications' actions on the hair follicles, but it is not uncommon. I guess it may be a similar phenomenon to changes in human cancer patients' hair regrowth after completing chemotherapeutic treatment.

As far as the skin bumps, I have to wonder whether they may be allergic in origin as opposed to a return of CC. As Judy has suggested, you might consider a biopsy in order to truly get a handle on what's going on, or at least a doggie dermatologist's evaluation and opinion. We suffered through itchiness and allergies with my non-Cushpup Lab throughout her entire life, and I can really resonate with your frustration. Have you tried altering Piper's food? Food sensitivity may not be an issue for her at all, but it can develop in a dog at any time and giving a try at a novel protein and limited ingredient food is something you can at least do on your own.

I know people are really sold on the notion of grainfree food as a superior option, but I do question whether peas/lentils/potatoes are any more "natural" or really more healthful for a dog than are oats/barley/rice. I do feed my own remaining girl (not the allergic one) a grainfree food, but my choice is really more about the quality of the manufacturer than thinking that grainfree is truly healthier or less likely to trigger allergies. The truth is, I have found that many high-quality grainfree foods are loaded with a myriad of different ingredients that could seemingly trigger a food sensitivity. My "allergy girl" never stopped itching when fed grainfree foods, but finally was better when she was fed an extremely limited ingredient chicken-and-rice food. So the point of this saga is just that a very limited ingredient food may be worth a try, even if it contains grain, and I believe there are a few fairly limited ingredient grainfree products, as well. I've just now switched my girl to a duck-and-lentil combo that has a fairly short list of ingredients ("PureVita"). Too many peas seem to trigger GI issues for her, and it can be hard to find grainfree kibbles that don't have a lot of peas in them.

Anyway, that's just one thought and food may make no difference whatsoever. But in combination with the itchiness, I do wonder whether the skin bumps may be related to an allergic response.

Marianne

[Budsters Mom]

Hi and welcome,

Benadryl and Vetoryl and safe to use together, although I didn't dose them together. I dosed it with a small amount of food. Benadryl is safe in dosages of 1mg. per pound of dog's weight. It can be dosed every 8 hours, Three times per day. It can cause drowiness or completely wire them. My cush pup/allergy boy would drop like he'd taken a sleeping pill. My allergy girl gets completely wacko and acts like she's been given a steroid. I give her Zyrtec, which is much more effective. I DO NOT KNOW IF ZYREC IS SAFE FOR CUSH PUPS! MY ALLERGY GIRL IS NOT A CUSH PUP. Please check with your vet before adding any medications. Benadryl became less effective in time with my Cushpup. I didn't try any other allergy meds with him due to other more serious issues that had priority.

Piper's bumps could be microscopic mites. Those little critters can attack the skin causing huge patches of hair to fall out. My little allergy girl is extremely allergic to all types of mites. Many of us have dust mites in our homes. It is pratically unavoidable. Vacuumning, cleaning, washing bedding often is crucial is controlling mites. Everywhere your dog has been has to be kept clean and hopefully mite free. Bathing often is essential for mite control. That is difficult with Piper's ingrown tail.:o

Please get a skin scraping done if at all possible. You want to be sure what is causing Piper's skin issues before attacking them head on. It might not be a recurrence of CC at all.

Please keep us posted.
Kathy



We haven't tried any allergy meds yet, not sure about mixing Benadryl & Vetoryl? We do bathe her in a colloidal oatmeal shampoo, which is supposed to help. We can't give her a bath too often though, because in addition to Cushings, poor Piper was born with an ingrown tail, and we have to keep the pocket dry to avoid tail fold dermatitis.

[Sailorchick]

Thanks all! I've scheduled an appt with my vet for him to look at the bumps on her neck. We'll see what he thinks. This is a new vet, as the vet we've been with for the last few years sold her practice and moved to FL! So far I like the new vet that bought the practice, hopefully he's up to speed on Cushings.

I definitely don't think they are mite bites, as some are fairly large (bigger than a pencil eraser), and very irregularly shaped, just like the CC lesions used to be.

I will look into finding a food with a smaller ingredient list, that's a good place to start.

[molly muffin]

hello and welcome from me too. I'm curious, you said the ACTH results have been really good, do you know what the pre and post numbers on the ACTH have been or currently are?

Someone else mentioned Renee our cc expert and she is the expert because she has been dealing with it for so long. One of the keys that we have noticed on the forum is that with cc the post should be under 5.0ug for best responses. Even a bit of upward moving on the post cortisol can have the cc showing up again.

I'm glad that you are going to check out the bumps and see if they are the same or not. I wonder if the new thicker coat isn't also an aggravation to her skin, in a breed not normally having long, thick coats. That is a total speculation and curiosity on my part.

[Sailorchick]

Her last stim test was in September and I believe the numbers were pre: 2.3/post 3.8. We'rescheduled to do another one in February, though I'm thinking we'll be moving that up.

[molly muffin]

I just went back to Renee's thread and her dog got cc for the second time, when the cortisol went up to 6.6 after being controlled for a long time.
The second time of cc, didn't erupt like the first one, the hair didn't come out right away and they were hard and flaky as opposed to open, weeping like the first go round.
So now the question is whether or not, the cortisol has gone up just enough perhaps to cause the latest outbreak of cc.
They did eventually turn red, just the beginning was different the second time.
http://www.k9cushings.com/forum/showthread.php?t=5908&page=78