Kali Newly diagnosed-shes anxious-wont sleep-upset tummy-I need help!

[maria98335]

Hello, my name is Maria, first off let me say I am so thankful I found this website! Ive been floundering through the internet trying to figure out what to do for my baby girl and am getting desperate so Im glad to have found a place where I can talk to other parents of cushings dogs. My baby girl Kali is a 13 year old female rat terrier. For the past 9 months or so I have watched her appetite go crazy like she is never satisfied however she constantly wants food but sometimes its a chore to get her to eat it as she has been constantly fighting pancreatitis. Her anxiety has ramped up, especially when guests come over its like shes bouncing off the walls, I cant say she drinks a ton of water anymore than she normally has because she has always drank lots of water and she is a very thin dog and doesnt have the pot belly that I have heard most cushings dogs, and for awhile just her back legs were shaking but now her whole body trembles. She whimpers alot but at times runs around the house and plays with her toys? I kept looking up her symptoms and talking to the vet and he said she looked healthy but I finally just took a morning urine sample in and asked him to check it and he said her cortisol was slightly high so we did the next text which he said shows she is in the gray level of cushings, not too bad. We have not done the test that shows which type of cushings she has because frankly right now her tummy issues are horrible and Im trying to make her feel better which is what brought me to you. He doesnt want to treat her with prescription medications for cushings because of her stomach issues. My vet isnt great with diet information and she is allergic to alot of foods so he put her on Royal Canin hydrolyzed protein diet but I feel like since shes been on that everything has gotten worse and I dont know what to do for her, Ive asked about giving her supplements and he is unfamiliar with them and says their all "quackery" Ive looked into lingnans and tried melatonin but that upsets her stomach. I have multiple medical issues myself and another toy rat terrier with thyroid issues so my life is crazy and I am overwhelmed but I cannot face it without my furbabies, please help us! Maria

[Squirt's Mom]

Hi Maria, welcome to you and Kali! :)

Personally, I would seek an IMS asap to see Kali. It sounds like she has several issues going on. Does she have diarrhea, vomiting, or both? Can you describe her digestive issues to us?

What test did he do that put her in the "gray area" for Cushing's? There are two blood tests used to diagnose Cushing's - the LDDS which is an all day test and the ACTH which takes a couple of hours. If you would get copies of that test and any others the vet did, like the urine test pr wellness check which shows things like BUN & CHOL, and post those results here that would be great. Please include all the normal ranges for each value and the little letters that appear with the numbers. Any comments would be great as well. One test I strongly recommend she have now is an abdominal ultrasound performed on a high resolution machine.

I've had a couple of babies with allergies and both did very well on a frozen raw diet...and I am NOT a proponent of raw diets so it was a last resort for me. I use Basic Instinct frozen raw bites (both were small dogs). You want to get a novel protein...ie most foods contain chicken, turkey, beef, or lamb so look for rabbit, duck, venison or another protein Kali has NOT eaten. You will need to give the diet(s) at least 6 weeks to see if they help. Long process but so worth it when it works!

I also recommend you talk to the vet about an injection called Cytopoint for the allergies. It has been a miracle for my little Chihuahua. She had scratched her belly raw and was actually yanking hair out of her legs she was itching so much...and that was on bi-weekly injections of prednisone. The Cytopoint stopped her itching within a few hours of the first shot, she had to have another shot 4 weeks later but has now gone almost 2 months without needing another injection. She is eating the Instinct Raw Duck bites (PetCo stopped carrying the rabbit I used with my other baby, a Pom mix :( ). But she is doing well on the duck so I won't complain!

I am sure others will be along soon to chat with you as well and probably ask more questions. We LOVE details so the more you can tell us the better. I'm glad you found us and look forward to learning more as time passes.

Hugs,
Leslie

[maria98335]

Leslie,

As I am new to this website and forum I hope I am going about answering this post correctly, Im in the process of getting Kali's numbers for you. So Kali is 13 years old and all her life she has been a picky eater, only eating when she was starving and then if she had an empty tummy she would vomit yellow bile so I tried very hard to get her to eat on a regular schedule but being so picky it was very difficult. I went around and around with her vets, I had a good holistic vet about 3 years ago but then she packed up and moved. She was great with diet and supplements however I live in a very small town so the vet I have now is very old school English medicine and feels that supplements and such are just a waste of money and if you try to discuss them with him he just answers he knows nothing about them. He also isnt very good with diet and Im concerned about what she is being fed especially when it comes to cushings. When I had the holistic vet we did the oral swab food allergy test because she was having so many diarrhea issues with her food, but my current vet says thats all hogwash. I still try not to feed her anything that she responded to negatively on that list. I for over a year was even cooking her food, and then the holistic vet convinced me to feed her raw but then she moved away Kali got pancreatitis and the new vet said NOT to feed her raw, that it was the worse thing for her! IM AM SO CONFUSED. The vet only wants her to eat (nasty) canned Royal Canin prescription Hydrolyzed diet food but its first ingredient is pea starch and it seems that since she has been eating that food her anxiety, appetite etc has increased. When I say she has tummy issues I mean that about every couple of weeks she will have a day or two of vomiting lots of fluid, and her poor tummy is always grumbling and makes noise all the time. She is laying in a tote full of blankets behind me 4 feet and I can hear it grumbling. She also has occasional diarrhea. I am in the process of making her an appointment with an Internal Medicine specialist to get an ultrasound. The regular vet already did xrays etc and said her insides looked "healthy" but? When she is lying beside me she trembles and shakes and thats what concerns me as a mamma I just want to know she is not in pain. This is very hard for me as Kali is the older of my 2 dogs and I got her when I became ill 13 years ago, not my proudest moment but I had had about 5 operations in 6 months and tried to kill myself because I couldn't take the pain anymore so I got Kali and she has been here for me every step of my own medical issues. Both my furbabies have medical issues and it breaks my heart but her leaving me now is something I dont know I can take, Im sobbing...sorry Im a strong woman living on social security and have been through alot the past 13 years but this is difficult, the vet just doesn't seem to have any answers. As far as the tests for cushings goes she has only had the short 2 hour test done and he said her numbers were just slightly above normal. I wanted to wait for the other test because of her anxiety leaving her at the vet for a full day and wondered if getting the ultrasound first would be best. What I need help with is what can I do in the meantime?


Hi Maria, welcome to you and Kali! :)

Personally, I would seek an IMS asap to see Kali. It sounds like she has several issues going on. Does she have diarrhea, vomiting, or both? Can you describe her digestive issues to us?

What test did he do that put her in the "gray area" for Cushing's? There are two blood tests used to diagnose Cushing's - the LDDS which is an all day test and the ACTH which takes a couple of hours. If you would get copies of that test and any others the vet did, like the urine test pr wellness check which shows things like BUN & CHOL, and post those results here that would be great. Please include all the normal ranges for each value and the little letters that appear with the numbers. Any comments would be great as well. One test I strongly recommend she have now is an abdominal ultrasound performed on a high resolution machine.

I've had a couple of babies with allergies and both did very well on a frozen raw diet...and I am NOT a proponent of raw diets so it was a last resort for me. I use Basic Instinct frozen raw bites (both were small dogs). You want to get a novel protein...ie most foods contain chicken, turkey, beef, or lamb so look for rabbit, duck, venison or another protein Kali has NOT eaten. You will need to give the diet(s) at least 6 weeks to see if they help. Long process but so worth it when it works!

I also recommend you talk to the vet about an injection called Cytopoint for the allergies. It has been a miracle for my little Chihuahua. She had scratched her belly raw and was actually yanking hair out of her legs she was itching so much...and that was on bi-weekly injections of prednisone. The Cytopoint stopped her itching within a few hours of the first shot, she had to have another shot 4 weeks later but has now gone almost 2 months without needing another injection. She is eating the Instinct Raw Duck bites (PetCo stopped carrying the rabbit I used with my other baby, a Pom mix :( ). But she is doing well on the duck so I won't complain!

I am sure others will be along soon to chat with you as well and probably ask more questions. We LOVE details so the more you can tell us the better. I'm glad you found us and look forward to learning more as time passes.

Hugs,
Leslie

[labblab]

Dear Maria,

I just wanted to stop by to welcome you, as well. I apologize that I don’t have enough time available this evening to write a more comprehensive reply. I plan to return tomorrow to try to give you a better thought-out response. But I was so touched by reading about your special bond with Kali that I wanted very much to reach out to you tonight — to reassure you that you are no longer alone in this journey! I am so glad that you’ve found us, and we will remain right by your side as we jointly work to sort out the path forward.

Sending many hugs your way!
Marianne

[labblab]

Hi again, Maria! OK, I'm back this morning and I've had the chance to read through all the helpful information you've already given us thus far. I'm surely sorry that Kali is having a rough time right now -- I'm sorry that BOTH of you are having a rough time right now! Leslie has already provided a great introduction and useful thoughts about the allergy issues. As far as the Cushing's diagnosis, I do think I'd encourage you to push forward with an abdominal ultrasound right now, before proceeding with any more Cushing's-specific testing.

This is the reason why I suggest this. It does sound as though Kali has already had the 2-hour ACTH stimulation test, and it's the 8-hour LDDS test that awaits her. The worrisome part, though, is that both of those blood tests can return "false positives" even when a dog does not truly have Cushing's. Other stresses and illnesses can cause the body to produce excessive amounts of cortisol, so in the absence of definitive observable Cushing's symptoms, "positives" on those blood tests can be suspect. From what you've described thus far, Kali does not really sound like a typical Cushpup. She may indeed have Cushing's, but I would want to try to rule out other possible causes for her problems first. I do think the ultrasound would give you the most "bang for your buck" in terms of assessing the condition of her intestinal system and other internal organs in addition to her adrenal glands. You will get a good general assessment of her overall internal functioning, and I think that would be an important place to start.

Regardless of anything else, in this situation of GI disturbance, I agree with the vet's recommendation to hold off on starting any Cushing's medication at this point in time. It is really never wise to give any dog the medication if they are not eating properly or if they are experiencing episodes of vomiting or diarrhea. So I'm really in favor of proceeding with some more general diagnostics at this point, and I think the ultrasound is an excellent way to proceed.

Please do keep us updated!
Marianne

[Squirt's Mom]

Oh Maria,

I can SO relate to you. My adult daughter passed away suddenly in 2006 and my world came to a screeching halt. For over a year I don't know what happened or what I did - it is simply lost in grief. I am a fighter, a survivor even when I don't want to survive, but her loss just about did me in. Then my heart-n-soul dog, Squirt, was diagnosed with Cushing's and I woke up. Someone needed me again. Squirt literally saved my life at that point because I was having a very hard time finding a reason to keep going. But she needed me so I started living again for Squirt. My Sweet Bebe passed away in 2014, 7 years after her diagnosis, and all that pain from losing my child came roaring back in spades. The one who had given me a reason to live had joined my daughter. I have struggled since Squirt passed, pain being a constant companion both emotionally and physically. Since she left I have been diagnosed with cancer (no evidence of disease today 1 1/2 yrs later thankfully) and Lymphedema as a result of the cancer surgery on top of other diseases that had qualified me for disability in 2007. I finally talked to my doctor about some help for depression and anxiety and the drugs have made me very very sick. Hopefully I will adjust to the latest one soon and things will start to level out. I know what it is to feel such fear and anticipatory grief. I felt that for the last year of Squirt's life. I knew her time was coming soon, from old age and nothing else, so we talked every day. I walked around holding her as walking was hard for her by then. We talked about the places we had been, the people we knew and loved, and what the future held. I told her all the things I wanted her to take with her and hold in her heart til we were united once again. I still cry almost daily for Gia and Squirt as well as my other babies who have gone ahead. I know how tough and cruel life can be at times and am so sorry you are in such a tough place.

But I also want you to know that thanks to Cushing's I have found friends all across the globe who lift me up when I am in need. Who always have soft shoulders to lean on, warm hands to hold, who's tears fall with mine. I want you to know the same is here for you, too. You and Kali are part of our little family now and you will never be alone again. We will walk with you every step of the way and should it be that Kali does not have Cushing's, you still belong here as part of us from now on.

Hugs,
Leslie

[molly muffin]

Hi Maria and Kali.

I think I too would hold off a bit on starting any cushing medication as that GI issue could be related to the pancreatic episodes and you want to make sure that she is over that. Not only that but as she is just in a grey area right now, it could be the GI issue is affecting the cortisol, as that is a natural response. Did you ever get a chance to get to the Internal Specialist or is that something you want to look into in the new year?

How are you both doing?

[maria98335]

hi all, please bare with me as I am so new to forums and not real computer literate as well. I joined this forum back in December and have been having issues with my own health as I'm fighting my own cancer. I have 2 sick pups, my eldest girl Kali will be 14 in May, she is a 16lb female rat terrier. I had noticed the past several months that she had a ravenous appetite, like she always wants to eat, but a lot of the times even though shes begging for food she wont eat because she also has lots of tummy issues, diarrhea, pancreatitis, vomiting yellow bile when she doesn't eat. The vet prescribed Vetoryl 10mg 2 times a day for her but she was going through a spell of real bad diarrhea and not eating so they put her on antibiotics and told me to hold off until we get done which we almost are. So were about ready to start the Vetoryl and I'm scared to death. I need help with her nutrition which my vet knows nothing about, he says all he can recommend is to feed her low fat Royal Canin dog food but he doesn't realize my girl is super picky and only wants to eat chicken. I'm not opposed to cooking her food but I cant seem to find any real quality meal planning information for cushings anywhere so here I am, she also has hyperlipidemia, extremely high liver values and I'm told that goes hand in hand with cushings, so can anyone out there recommend any good companies to buy "real" food dogfood from or have any good recipes for food that's good for dogs with cushings and needs low fat diet? I was looking at "justfoodfordogs" but its super expensive and I'm living on a fixed income, I have another dog Bandit that I'm certain also has cushings but induced by long term pred use so I'm working on getting him off the pred for allergy skin issues. I'm overwhelmed and just want the best for my dogs but feeding them the right food is important to me so if you know of a good quality food, canned, home cooked or buy already cooked I'm open to suggestions, Maria

[molly muffin]

Hello maria and welcome to the forum.

Wow, so much going on. I'm sorry to hear about your own battle with cancer and trying to take care of two dogs that have health issues also. Do hope you are taking time for yourself as well.

One thing off the bat I'd say is that you don't want to start Kali on vetroyl unless she is eating (as meds need to be given with meal) and they need to not be sick when starting, as you have to watch for ill effects, like refusing to eat, throwing up, diarrhea, as those are signs of too much medication. Was she tested for cushings while sick? (as that can cause false positives)
Also based on her various medical conditions maybe starting lower would be better, like 10mg per day instead of 10mg 2 times a day. The recommended starting dose is 1mg per 1lb. So at 16lbs it may not be too much (the twice a day) but with her other health issues, I don't know. Discuss that with our vet I think.

Oh gosh, poor Bandit might also have introgenic cushings (caused by prednisone) Talk to your vet about a plan to decrease pred slowly to try and get him off it. There is some other good alergy meds out there now that might work better for him. I think leslie had a good one that is new, maybe she will pop in and can remember what it is called. That might be an alternative to the prednisone for Bandit.

As for food, any good quality protein, lower fat content food would be good. I'm trying to remember what all I used. I did have the prescription food and I also tried Merrik. My dog was really picky all the time, so finding what she liked and kept on liking was a lot of trial and error. She too like chicken.

The thing if you cook is to remember to add in the vitamins that they need so they get balanced meals. I didn't do the cooking but some others like Leslie did so she probably has better ideas about that than I do and I'll let some of the address the food option info.

I did want to say hello though and welcome.

[Squirt's Mom]

Hi Maria,

Good to hear from you again. I have merged your most recent post concerning diet into Kali's original thread. We like to keep all info in one place as it is easier to look back thru the history that way. This thread will also serve as a sort of diary of her cush journey for you as well. The title of her original thread is "Kali Newly diagnosed-shes anxious-wont sleep-upset tummy-I need help!". That will help you find it again when you need to chat. ;)

Diarrhea and loss of appetite are two of the hallmark signs the cortisol has dropped too low, which is a life-threatening condition. Her vet should have performed an ACTH when that happened to see where the cortisol was and if she needed intervention. Was an ACTH done? If so could you share those results? If not, you will want to talk to her vet to make sure they understand what should be done in the future should that be necessary. I also understand they may have been trying to save you some money but this is not the time for that measure. It is CRUCIAL to know where the cortisol is when nausea/vomiting, loose stool/diarrhea, loss of appetite and/or lethargy are seen in a pup on treatment. Once she is stable on treatment then the ACTHs can be skipped with less risk to Kali.

Nor do you want to restart the Vetoryl at the same dose. I would start no higher than 10mg personally and NOT AT ALL as long as she is not eating well or still has diarrhea or loose stools. Protocol with this drug also states that an ACTH should be done and should show the cortisol is high along with strong signs but I realize that may not be possible so you want to rely on her signs and make sure they are very strong before restarting....and NOT AT ALL as long as any sign remains that the cortisol could still be too low....ie nausea/vomiting, loose stool/diarrhea, loss of appetite and/or lethargy.

As for a cush diet - there is no one diet for our babies. The guideline is simply low fat. I used a canine nutritional consultant for several of my own babies - Monica Segal out of Canada. She will design a diet based on your babies health and other factors. The cost is around $280 plus any supplements needed to balance out the food. I have found the price well worth it. You can find Monica here - https://www.monicasegal.com/. She is also on Facebook here (but does consulting via her website) - https://www.facebook.com/Monica.Segal.Nutrition/ btw - the supplements last a LONG time. ;)

As for Bandit's allergies...there is a fairly new allergy shot called Cytopoint that has been lifesaver for my little Fox. She was scratching herself literally raw, biting and pulling at the skin on her legs til they were bloody and nothing was helping til we tried that injection last year. She had one shot and within hours had stopped itching altogether. She needed another one in 4 weeks but has not needed the third one yet....and it has been at least 4 months since the last injection. Talk to your vet about Cytopoint asap - I highly recommend it!

I pray you are doing as well as possible with your own challenges. Having faced my own cancer starting in the spring of 2016 I feel for you and understand a teeny bit of what you are going thru. Please know we are here for you as well as for your precious babies anytime you need to talk.
Hugs,
Leslie

[maria98335]

HI all, I finally figured out how to get to this thread and responses, thank you all for answering and for your well wishes and ideas. So this is what has and has not been done with Kali. I pushed hard to have her checked for cushings because she had been acting ravenous for months and months, extremely anxious and drinking tons of water, I took in a urine sample and her cortisol level was "slightly high" so they did the ACTH stim test and I was told she was in the "grey area" not too high but questionable for cushings. She does have extremely elevated liver enzymes. She shakes alot of the times when shes laying down. The vet said that elevated liver enzymes can cause the tummy to hurt. She doesnt have the pot belly like Bandit does but all she wants to do is eat and its getting to the point where I think she is even considering eating her poop URGH! I took her to an internal medicine doctor and had an abdominal ultrasound last month and said other than some slight liver edge abnormalities everything looked normal, her adrenals looked normal. Told me to try the Trilostane then we went through the no appetite and diarrhea stage so they had me put her on metronidazole for 2 weeks and told me to hold off on the trilostane. Shes back to normal poop and eating 5 times a day (more if Id let her) Im cooking her food feeding her steamed sweet potatoes, boiled free range chicken breast, with some green leafy veg, ground egg shells. Im considering "justfoodfordogs" Metabolic Food-has anyone used them for food? I know they had a recent recall which Im told is far from ordinary for them. Kali being so picky just doesn't want to eat canned food and has never been a kibble eater. I did try to give her a trilostane the other day and she didnt seem to respond well to it, she was more anxious than usual, she couldnt settle down, I gave her 5mg only half the dose they wanted to give her and she weighs 17lbs. I got nervous and was afraid to give it to her again, I wasnt goign to be home the next day as recently I have had so many doctor appointments that it worries me to start her on something that I cant be here to watch the side effects, it would be great if I was going to be home for 5 days straight to see how it went but it scares me, however if you all input that trilostane helped save your dogs and worked wonders then Im ready to give it a go because Im afraid this (the cushings) is getting worse and I cant loose her. Lately when she gets super excited or anxious and gets on a non carpeted floor she looses her footing and has done a couple of backflips, its likes she cant keep her paws on the ground all together or maybe lift her backs legs? seems to be having problems jumping on furniture at times. Ive considered lignans and melatonin but dont want to waste my time if that treatment doesnt really work and I should go straight to the trilostane, I guess what I need is that gentle push forward, this is so hard to deal with but I love this baby girl and she saved my life so Im not ready to give up on her yet, shes like a toddler all day long HELP!! I have the trilostane in 5mg capsules, the doctor prescribed 10mg twice a day, I thought perhaps giving her 5mg twice a day to see how she does if thats the consensus? Your thoughts? He said its not enough to effectively treat her but since shes borderline cushings how could it hurt? then we can see what the side effects are, this is a regular vet not an internal med doctor so? thanks again for all your help :-) sorry for rambling, Im so stressed out right now :-( I have no support system ,no one to talk to about this and the doctors just say give her the drugs. Thanks for being here for me Maria (will write about Bandit later)

[Squirt's Mom]

....but since shes borderline cushings how could it hurt?

To be blunt, it could kill her by making her cortisol go TOO low which is quickly life threatening. ;) Based on her reaction to the first time she tried the Trilostane I would NOT put her back on it right now. She would need another ACTH at the least. The fact that her adrenals are NORMAL on the ultrasound makes me doubtful she has Cushing's. A dog with Cushing's will have either one or both adrenal glands enlarged most of the time. So that along with her reaction to the Trilo really make me question if she does have Cushing's at all.

I would help us give you more meaningful feedback if you would get copies of the testing that has been done so far and post the actual results here. The ultrasound comments, the ACTH, the wellness screen that shows ALP, ALT, GGT, CHOL, BUN, and other values. This test looks at organ function. If the wellness screen (or whatever her vet calls it) has not been done I would have that done asap.

Personally, I would want an indepth check of the liver just based on the comment about the organ's edges. Kidney disease, liver disease and other conditions can mimic Cushing's so diagnosing Cushing's is as much about ruling out other possibilities as anything.

I hope you are well...and again do NOT restart the Trilostane at any dose right now. ;)

Hugs,
Leslie

[maria98335]

Thats how I feel Leslie, yet they keep pushing the Trilostane, I called the vet this morning, they said she could have Pituitary Cushings? They are supposed to be emailing me her bloodwork, I have a question as this is all new to me. They did the urine cortisol which they said was "slightly elevated" they did the ACTH which they said was "slightly elevated" they suggested the Low Dose Dex all day test but in her current condition, tummy constantly upset, extremely anxious, whining all the time, Im concerned about having her at the vet all day which increases her anxiety. Since you have all gone through this is the Low Dose Dex test hard on the dog? If this test will absolutely rule out Cushings without causing any damage or harm to Kali then Im willing to do it because at this point I cant get them to focus on anything else. They said her never ending need to eat and excessive water consumption indicate cushings with the even though its slight elevated cortisol, give her the drugs..drugs lets just push drugs, I hate them, I have bone cancer so I know how horrible they are, dont get me wrong if they will make her feel better Im happy to give them but I dont want to give her anything thats goign to make her feel worse or is not justified or indicated for her condition. Im at this stage where I love my baby so much, she saved my life when I found I was ill and I cannot imagine my world without her but Im afraid shes in pain and I cant let her be that way, Im crying as I write this because Im so frustrated and alone and I dont know what to do, I dont want to give up on her I just dont know where to go...

[DoxieMama]

Hi Maria,

First, take a deep breath. We are right here with you and will help you navigate the road ahead, whatever happens, OK? You're not alone anymore. We'll do our best to help you so you can reduce that frustration and anxiety you're feeling. Deep breaths will help. *hugs*

The urine cortisol and ACTH are "slightly elevated". Let's see what those numbers are when they email the results to you. The low dose dex test (LDDS) might be difficult, especially if she is anxious about being at the vet. My pup was not anxious at the vet so I'm not sure what to suggest. Others have had dogs like that too, hopefully they will stop by with ideas.

Her symptoms could indicate Cushing's but we'll cross the bridge when we know for sure. Reviewing those test results is the first step.

Sending many hugs your way...
Shana

[Squirt's Mom]

Ask her vet if she can stay with you between draws. Ya'll could go back home if close enough or to a park or mall, or just outside the clinic walking around. Sometimes that helps when the pup is stressed out. If the vet won't allow that, and some won't for some reason, bring one of her blankets or one of your shirts, etc. to put in her cage while she waits. That can also help calm them at times.

[Squirt's Mom]

How are you and Kali doing? Just popping in to check on the both of you.
Hugs,
Leslie