Gracie's journey with Cushings - collapsing trachea

[IsabelleGracie]

Hello,
In April 2017, I noticed that Gracie (14 year old mini poodle with Cushings) was snoring while sleeping and had developed a goose like cough. She was hacking a bit too when she coughed. The first visit to the vet was a diagnosis of kennel cough, because of the time of year and a spike in kennel cough in our area. She was prescribed cough medicine and an antibiotic, although I'm pretty sure an antibiotic is not used to treat kennel cough. After 10 days, we went back to the vet because she was not any better. During the 10 days, I had done some research and discovered that she most likely had a collapsing trachea due to Cushings. A collapsing trachea is described as breathing through a straw. The vet agreed with me that it could be a collapsing trachea and prescribed Vanectyl-P for a short period of time. We used the new med and she did get better, not perfect but much better. She was weaned off Vanectyl-P and then the cough came back. After more discussions with the vet, it was decided that she should go on 2.5 mg of Prednisone once a day. This was a hard decision because Prednisone would increase cortisol and cause Gracie's symptoms to increase, which they have, and possibly advance the disease. I am still struggling with the decision but I know Gracie's quality of life has improved even though she is drinking and peeing almost all the time now. She has to wear diapers now because she can't control the peeing anymore. She doesn't seem to mind the diapers and it has made a big difference to our household.

My question is: Has anyone else had this issue with their Cushings pet and if so, was there another therapy used?

I would appreciate any feedback or sharing of experiences.
Thank you,
Isabelle

[molly muffin]

Hello Isabelle, welcome to you and Gracie.

It is true that with prednisone, which mimics the action of cortisol, symptoms will continue to get worse, but with the trachea collapse that has to be the first concern. You are making the choice for what she needs most at this point and that is to treat the trachea collapse.

Are you seeing a specialist or your GP vet? I did a bit of reading and some say antibiotics is sometimes used, "cough suppressants, bronchodilators, corticosteroids (to control inflammation), and/or antibiotics. In obese patients, weight loss helps decrease respiratory effort." That was from petmd

I don't know what other medication might be available for collapsed trachea when cushings is already an issue, but some of the others might know.

It seems to be quiet on here this weekend, but others will be along who might have some experience better ideas.

I did want to welcome you to the forum though. :)

[labblab]

Hello and welcome from me, too! Gosh, I'm sorry to hear about Gracie's problems, but like Sharlene, it seems to me that treatment for her trachea has to take priority. Unfortunately, I don't have any great suggestions to add into the mix. This is not a problem that has been discussed recently (if much at all...) on the forum :o.

However, especially given her age, I absolutely agree that treating her trachea takes top priority in terms of quality of life. Hopefully, some of our members may indeed have had some experience with this issue and will be stopping in to offer their thoughts. In the meantime, we'll be anxious to hear updates as to how little Gracie is doing.

Marianne

[IsabelleGracie]

Thank you Sharlene and Marianne.
I am seeing our GP vet not a specialist. Initially I wanted to take Gracie to see a specialist but since they are in another province, it was cost prohibitive and I was very concerned how Gracie would react. Again, a balancing act as you well know.

At this time, Prednisone seems to be the only option because I can't allow her to suffer with a collapsing trachea. We did have her on the cough suppressant when she was taking the antibiotics initially. I don't think it really helped her much. Her back legs are now shaking and she seems to be losing the use of them a bit at a time. Last weekend, I noticed she "lost her legs" twice - she kind of wiped out a bit. I am sure that this is from the effects of the Prednisone.

In any case, she seems content. She has two brothers to play with, one year old puppies who love her, and she is devoted to me as I am to her. Everyday is a reassessment of her condition and the choices I am making for her.

If any other member sees this thread and are able to provide advice or experience, I would be so grateful!

Thanks to you for this forum and the kind words.
Isabelle and Gracie

[DoxieMama]

Hi Isabelle, welcome to you and Gracie. I do not have anything more to add but wanted to add my welcome to the others. I look forward to your updates. Any time you want to share, we will be here for you both.

Shana

[IsabelleGracie]

Thank you, Shana. What a wonderful group this is - so many kind people willing to share all their knowledge.

[Harley PoMMom]

Hi Isabelle,

Welcome to you and Gracie from me as well! My non-cush pom, Marvin, has a collapsed trachea and it is being medically managed with Hydrocodone. Also, one of our staff members, Leslie, had posted that Adequan could possibly help and although I couldn't find any concrete studies regarding the success of this treatment for a collapsed trachea I decided to try it for Marvin, and it has definitely made a difference.

Before the Adequan injections Marvin had to take his Hydrocodone every 4-6 hours, now that it down to every 12. We just recently started this treatment in June and his vet had me bring him in for the Adequan shot twice a week for the whole month of June. After this series of shots he'll get one on a monthly basis if needed.

Hugs, Lori

[IsabelleGracie]

Hi Lori,
Thank you for this information. I haven't heard of either of those drugs before and I will ask my vet about them. I did a little Google search on hydrocodone and Adequan and I'm not sure if I have enough information on them compared to Prednisone, some of the websites are overwhelming.....

I really appreciate that you were able to give me another option to research - it could be better for Gracie and her quality of life :)

Take care,
Isabelle and Gracie

[Squirt's Mom]

Hi Isabelle and welcome to you and Gracie! :)

Leslie here, the one Lori mentioned. You may not find much on Adequan and collapsing trachea out there. There is a vet in Little Rock, Arkansas - Dr. Earl Smith, now retired, formerly with Shackleford Vet Clinic in Little Rock - who told me about this, saying he had used Adequan on several small breed dogs with success. Sadly the pup we were working with turned out to have a tumor not collapsing trachea so I don't have first hand experience....but other I have shared that info with have tried it and most had success. Your vet may be able to get in touch with Dr. Smith but either way it is worth a shot for your baby!

Hugs,
Leslie and the gang

[lulusmom]

Hi Isabelle and welcome to you and your precious Gracie.

I am very familiar with tracheal collapse as my two Maltese boys were diagnosed with it after being diagnosed with congestive heart failure. Coughing is common in both disorders. Neither of my two cushdogs, both Pomeranians, had that problem. Miniature Poodles and Maltese are on the top ten list of breeds that seem to be genetically predisposed. Fortunately my boys did not need steroids as theophilline, a bronchodilator which can also act have an anti-inflammatory effect, proved to be very effective. I have provided a link below which includes this drug as an appropriate treatment. You may want to speak to your vet about giving that a try as well as doing the diagnostic procedures mentioned in the article so that you have an idea as to the severity of the problem. Steroids should be a last resort for a dog with cushing's so I personally would exhaust every other avenue first.

Aminophylline is also a brochodilator but neither of my boys did well on it. They completely stopped eating, which is a common side effect. We switched them to theophylline and it was very, very effective. Sometimes we have to walk a tightrope with our pups whether they have cushing's or not but cushing's most certainly throws a monkey wrench into the works.

Dogs with cushing's have muscle wasting which affects the respiratory muscle system, plus they almost always have a redeposition of fat to the thoracic area and an enlarged liver, all of which places a good deal of stress on the diaphragm making breathing more labored. If a dog is at all overweight, this makes it worse for a cushdog and a whole lot worse for a dog with a collapsing trachea. If Gracie is overweight, focus should immediately be on weight reduction.

If all else fails and prednisone is ultimately needed to give Gracie a quality of life, it is going to be a delicate balancing act which would best be directed by an internal medicine specialist (IMS). You may want to consider consulting with an IMS sooner than later. If this is something you would consider, let us know your city and state and hopefully one of our members might be able to provide a name. Your vet may know one as most gp vets refers patients to specialists. You would probably need to ask for a referral anyway. You can also search for a specialist in your area at http://find.vetspecialists.com/ You will need to check a few boxes so fyi, the specialty is "internal medicine" for "small animals".

Yorkies are at the very top of the list of breeds effected with collapsing trachea and if you google collapsing trachea, you will see Yorkies all over the place. Joining a Yorkie group may be beneficial as I am sure there are many who have first hand experience with this disorder and have tried everything in and out of the box. I hope this helps.

http://veterinarynews.dvm360.com/tracheal-collapse-frustrating-minimally-invasive-tehniques-promising

P.S. I am not familiar with Adequan as an effective treatment but it is most certainly worth investigating.

[IsabelleGracie]

Hello again,
Thanks for the support and the advice. I am very happy to have other options to discuss with my vet. I actually live in Halifax, Nova Scotia. We have a wonderful vet college in a neighboring province called the Atlantic Veterinary College that would be the closest to a specialist that I could access. The College is about 3 hours away. I had asked that Gracie be referred there when Cushings was suspected but the cost was prohibitive. Gracie is not overweight, she has never been. I weighed her five days ago at the vet and she is 13.6 lbs, which is in normal range for a mini-poodle. Since she has developed Cushings, she is very food motivated but I try to keep that at bay with baby carrots. She does pant quite a bit now but I am blaming the Prednisone for that. I would like to get her off that drug so I am going to investigate all the options that you have given me and I will update you as I go.

Gracie's last checkup was mostly positive. She has a strong heart without a murmur, which the vet thought was rare for her age. Her eyes and her ears are a bit weak but she can still find her way to the fridge!

To complicate things a bit, I am going to be changing her vet. I will make a list of the suggestions I now have and present them to the new vet, maybe I will be able to find something that works better for her.

HUGS to you all! Even though I don't know anyone who has contributed to this thread, my heart is full of gratitude for all your time and expertise to help Gracie. Even a suggestion that may not seem to fit is a hope for me to pursue. All of our pups are so special to us and it is difficult to put into words how much this support from strangers means to me.

Thank you!
Isabelle and Gracie.

[molly muffin]

I do hope they can find another option than prednison as the symptoms should get much better if she can get off that.

I'm hopeful One of the options will work and they are all worth trying.

[IsabelleGracie]

Hi Sharlene,
I have an appointment July 20 with another vet to discuss the options that this group has provided me. I do hope I can get Gracie off the Prednisone, although it has helped her the last couple of months. I have a list of options and questions to present so I am hopeful.

I will update when I have more news. :)


Thank you!
Isabelle and Gracie

[molly muffin]

Oh I do hope they can find some other drug that will allow the prednisone to be gotten off it. It would make it so much better to not have to deal with cushing symptoms along with the trachea. Let us know what they say!

[IsabelleGracie]

Hello!
Belated update on my dear little Gracie. My new vet agreed that she should not be on Prednisone and so she is now weaned off it. The best part is that she has been off it for a couple of weeks and the cough has not returned so I am suspecting that she doesn't have a collapsing trachea. If the cough returns, we will do some investigating into the cause and try treatments other than prednisone. I mentioned the suggestions that were brought up to me in this thread and we will keep them in mind if we need to. I am hoping that we don't need to, that her cough will not return.

Thank you all for your support - it means so much!
Isabelle and Gracie.

[molly muffin]

That's great news! So glad you were able to get off the pred. I hope the coughing never comes back.

They did rule out kennel cough right?

My dog when she was young got kennel cough, even though vaccinated against it and we almost lost her. If so, then it could have cleared up and that will be that.