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Mako’s Mom
10-22-2017, 07:51 PM
Hi All,

I have been following this forum for nearly 6 months, but this is the first time posting. The resources and support provided are inspiring, and I have found myself returning time and time again to read all your stories. I thought it’s time for me to post mine, and to provide support to others.

Mako has been the love of my life for the past 9 years. A 10 pound ball of black and white fluff, she has always been known to have a big personality. Around May of 2016, my little fur baby began exhibiting the signs of Cushing’s, though at the time, I didn’t know better. She had just come back from an annual visit to the vet, with a clean bill of health, and I was happy that she was in such “good condition.” Shortly thereafter, the voracious appetite emerged, the pot belly, excessive thirst - symptoms we all know too well. In July, I brought her to the vet related to other symptoms suggestive of a urinary tract infection, and an X-ray of her abdomen revealed an enlarged liver. The Cushing’s was discovered incidentally, and thereafter started the barrage of tests to confirm the diagnosis.

It took a long time for Mako to be stabilized on trilostane (15 mg), and in the interim, she developed symptoms that my vet kept insisting were atypical. White spots developed underneath her tongue that looked like little white zits (not a pleasant thing to see). We ended up at the vet’s office for a biopsy on New Year’s Eve to determine what these were, as my vet had never encountered something like this before. The result: calcinosis cutis in her mouth. It was not serious thankfully as the little “zits” would burst and disappear after about a week. Shortly after the new year, Mako seemingly threw her back out and we ended up at the vet once again. She was also diagnosed with hypothyroidism.

Finally, in April of this year, Mako was deemed stable, and there was such a sense of relief within my family. Her symptoms improved, and she seems happier...but not for long. Within a matter of a few weeks, neurological symptoms emerged. They were subtle, at first, and it was hard to discern whether her symptoms were actually neurological or behavioral, as there was facade work being conducted on my apartment building, and the noise levels were frightening all the dogs on my floor. Over time, though, the symptoms progressed, and I just knew that the little tumor in her pituitary was enlarging. She had many of the neurological symptoms that those of you with macro cushpups have observed - circling, star gazing, staring at her water bowl but not drinking. I made an appointment with a neurologist to confirm my suspicion of a macro tumor, and he agreed. I opted to forego the MRI, not just because of the cost, but also because I felt like I would just be confirming what I thought was a death sentence. I already knew that I would not choose the route of radiation treatment. I couldn’t put my little fur baby through all of that; she had been through enough.

The prognosis was that Mako would live until the end of the summer. I removed her from the deafening noise of my apartment, and temporarily moved into my parent’s home where she could live out the rest of her life in peace and surrounded by love.

Month by month, her condition deteriorated, both physically and cognitively. It was as if every 2 weeks was a marker, with some new change occurring. The week before Labor Day, she developed seizures, and I knew this signaled that the end was near. We went through periods of cluster seizures, for which her prescription of Keppra did not seem to be helping. My vet recommended that she take omeprazole as well, since there has been some literature indicating that it can inhibit cerebrospinal fluid (CSF) production, thereby decreasing intracranial pressure. She had been on quite the concoction of meds. There have been several scary moments where I thought I would lose her. But in between, she seemed to hang in there, and I could tell that it was not her time to leave us.

It is now nearing the end of October, and Mako is miraculously still here. She has her good days and bad days, but what is most amazing is that her seizures have become sporadic. Whereas before, she was having at least one seizure each day, she can now go several days without one. Unfortunately, she has become more symptomatic in terms of her Cushing’s. But in a way, that’s not a bad thing. She has begun eating again and put on some weight. I was wondering, has anyone else had this experience? I was thinking, something akin to Nelson’s syndrome...

Well, that is my very long story. :) Thank you for letting me post this.

Mako’s Mom

Harley PoMMom
10-22-2017, 08:38 PM
Hi and welcome to you and Mako!

I am so glad you have come out of the shadows and created a thread for your precious girl. You are such a wonderful Mom to sweet Mako, your love and devotion to her is very evident in your post.

I am so sorry that Mako is showing signs of a macro and I know how worried you must be about your girl. We do have members that are going through the same thing with their precious pups and I am sure they will be by to share their advice and support.

Please know we are here for you both and will help in any way we can.

Hugs, Lori

molly muffin
10-22-2017, 08:58 PM
Hello and welcome to the forum, in a speaking capacity that is as you have been here for awhile. We're very happy that you came decided to create a thread for your girl.

Yes macros are very scary to deal with, probably one of the most awful possibilities tied to cushings that there is. Kudo's to you for all you have done for your girl and for being so brave for her. It isn't easy at all, as we know to handle both cushings and a macro tumor, as the treatment can be opposite for each.

Is she still on trilostane?

Poor dear to get cc under her tongue. Normally we see it more on the torso, but we have seen it in the internal organs and other soft tissue spots.

I read your post practically holding my breath till the end. I suppose that is how you are living each day though.

I think that normally, with a macro it is expected that there is a deterioration as you expected to have occurred by the end of summer, so this rebound is really a very good thing. Do the vets think it is the combo of the anti seisure medicine and the omeprazole that has given the good results?

Again welcome to the forum. :)

Mako’s Mom
10-22-2017, 11:40 PM
Thanks so much for your kind words and support!

Mako is still on trilostane (15 mg each morning), as well as thyrozine, omeprazole, and levetiracetam (Keppra). Whether the anticonvulsant is working, I don’t know. I was told that the first and preferred line of treatment for seizures is phenobarbital, but since it’s so harsh on the liver, it really isn’t an option for our cushpups. The neurologist was on board with the omeprazole, largely as it has few, if any, side effects or drug interactions. So, it didn’t hurt to add it in as a precautionary measure. When Mako threw her back out in January, it’s now thought that her tumor was already large enough where it was causing increased pressure within her brain, which was then pressing on her spinal cord and causing discomfort in her back - not the pinched nerve or slipped disc as initially hypothesized. My vet thought the omeprazole might help prevent that from happening again....and it hasn’t. Who would have thought that an over-the-counter heartburn medication would have such an effect on the brain?

I’m planning on getting in touch with my vet this week about the change in seizure frequency. It almost seems too good to be true. Certainly, she has other neurological symptoms (lots of restlessness, lethargy, persistent tremor in her hind leg), but the seizures were by far the worst to experience. Coincidentally, they stopped around the same time as her Cushing’s symptoms re-emerged...

molly muffin
10-29-2017, 07:52 PM
Did you get a chance to talk to the vet about the seizures? If so what did he say?

Crossing fingers for continued good days