Golden newly diagnosed

[kwhit]

Hi. My name is Karen and my 13.5 year old Golden, Chance, was just diagnosed this past week. I'm so glad to have found this board. :)

He started trilostane on Friday, (30 mg/a day), and since then he has had really bad diarrhea. Is this just his body getting used to the drug? I'll be calling his vet tomorrow, but thought I would ask here, too. I have noticed that his panting has lessened, but the amount he's drinking hasn't changed nor has his appetite, (still huge). Should I see changes in those areas soon?

His vet also said he needs a dental with some extractions, (one being his upper canine), which she said was a difficult one to take out. :( He shows absolutely no signs of discomfort from his teeth at all, but I know they can be quite stoic where pain is concerned. He still asks for treats all the time and chews his dental treats with no issues. I'm very leery about the procedure because of his age, but is there any added risk with the surgery because of him having Cushing's?

Sorry for all the questions right off the bat, but I'm new to this and wanted to find out from those that have a lot more knowledge about this disease. TIA.

[labblab]

Hello Karen, and welcome to you and Chance. He looks like such a sweet boy!!

Yes, it is indeed possible that the trilostane may be causing his diarrhea, so it’s very good and very important that you discuss this with the vet today. I am assuming that Chance weighs more than 30 pounds, so a starting dose of 30 mg. is technically within the current dosing recommendations (starting dose not to exceed 1 mg. per pound). But having said that, our experience here is that larger dogs often end up needing relatively small doses of the drug to keep their cortisol levels under proper control. So it may turn out that even the 30 mg. is more than Chance requires. Or it just may be the case that it will take his body some time to adjust to what may be a rapid lowering of his cortisol level, and you may want to first start out with a lower dose before gradually working up higher. Either way, it’s important to report this side effect to your vet.

Until Chance’s cortisol does indeed drop within the desired therapeutic range, though, you will likely not see a noticeable improvement in observable symptoms. Right now, the best way of monitoring cortisol levels is via a blood test called an ACTH stimulation test. Has your vet spoken with you about this? If a dog is generally doing well, the first monitoring test is usually performed after the first 10-14 days of treatment, or at least no later than the first month. However, if dogs appear unwell, the test should be done sooner. Since Chance has had only a couple of doses of trilostane, I don’t know that I’d rush to perform an ACTH immediately. But if the diarrhea continues, I’m assuming your vet will advise you to halt the trilostane until the diarrhea ends, and then resume the trilostane at a lower dose.

You’ve mentioned excessive panting, thirst and hunger. Does Chance have any other Cushing’s symptoms, either in terms of observable issues or abnormal laboratory results? Can you tell us what tests were done to diagnose his condition? As far as surgical risks, you’ll need to talk with your vet more about that. I believe that elevated cortisol levels can delay healing. Also, if Chance suffers from kidney or liver dysfunction, there can be added risk to undergoing anesthesia. Lastly, there seems to be an increased risk for blood clots associated with uncontrolled Cushing’s. So everything being equal, it might be wise to hold off on the dental work until Chance’s cortisol level indeed comes down. But again, your vet should be in the best position to discuss the specific risks and benefits that apply to Chance.

So we’ll be anxious to get some additional info about your boy. And once again, we’re really glad you’ve found us!
Marianne

[Squirt's Mom]

Hi Karen, welcome to you and your sweet boy, Chance! :)

Marianne has gotten you off to a great start so I'm just popping in to welcome the both of you and tell you we are so glad you found us!

Hugs,
Leslie

[kwhit]

Thanks so much for your responses.

Chance has had elevated ALP for about a year, but no other symptoms at that time. It’s just been during the past 4-5 months I had been noticing the increase in his drinking and his appetite. Then in the past month he’s had accidents in the house which was totally unlike him. He has also had increasing muscle weakness, especially in his back legs. He couldn’t hold his stool until he got outside.

What really Got me worried, though, was his Precision PSL blood work levels in November, (he gets blood work every 3 to 6 months because he’s on Rimadyl. He has severe elbow dysplasia), extremely high. Top normal level was 140. Chance’s level was 1200. His ALP was at 900. Retested two weeks later and his ALP was the same and his PSL was 1100. Showed no signs at all of pancreatitis. Retested again in February and his ALP was at 600 and his PSL was over 2000. Decided to see a different vet that is on staff as an internist at UC Davis. She ordered an ultrasound, chest X-ray and the one hour Cushing’s test. Everything looked good except for some nodules on his liver and pancreas, but his doctor said that they didn’t look like anything suspicious and were pretty common in older dogs.

His Cushing’s test came back at 18 which his vet described as a grey zone. So he then had the 8 hour test which confirmed he had Pituitary Dependent Cushing’s. Oh, and his stool has firmed up as of this morning.

[molly muffin]

I just want to say hi and welcome to you and Chance.

It could be that just introducing a new medication into his body caused him to have some diarrhea. I'm basing that guess on it getting better.

When are you scheduled to have the first ACTH follow up test? At 18, I would expect that his cortisol should come down fairly easily but you don't know for sure until you see how his body is reacting. Staring low though is a good plan since as was mentioned earlier, some larger dogs end up needing smaller dose.

Welcome again

[kwhit]

Thanks so much for the warm welcome.

Chance’s doctor told me to discontinue his med for now and put him on a bland diet for a few days. After a few days we’ll see how he is and go from there.

I was also wondering if these symptoms could be a reaction to his new med or if it’s just a coincidence and it’s his natural age progression, (kind of hoping it could be the medication and not him getting worse from age��):

1. Increasing loss of muscle control, (I had a ramp built for him so he could go up and down the steps to the backyard on his own. More independence for him), and just in the past few days he has had a difficult time going down the ramp. His back legs give out.
2. Increasing anxiety. I think he has a touch of dementia. He would bark and whine at nothing. He would pace and get very agitated/couldn’t settle down at night. I started giving him CBD oil about 5 months ago and it worked perfectly...until he started the trilostane.

Could these two issues be due to a reaction to his new med?

[molly muffin]

Muscle loss and especially hind leg weakness is often a symptom with cushing. I used a ramp for my girl too, but I think with a larger dog that it is harder all around for them with the rear leg weakness. So that could be due to cushings.

So the CBD oil stopped working when given with the trilostane on the anxiety, dementia? Now that the trilostane has been stopped it will be interesting I think to see if the CBD oil start to work on those two issues once again.

Dementia, macro pituitary tumors, can cause some neuro symptoms, but it isn't known that he has a macro, so could also be age related. As could the back leg weakness.

This is one of the things that makes cushings so hard to diagnose because often age releated and cushings symptoms can mimic each other. The excess drinking, urination, hunger, accidents in house that didn't use to happen, those are most often associated with cushings rather than age.

I would personally see if the CBD works on the anxiety, nero symptoms again, and perhaps going forward try a smaller dose of the trilostane to see if he has the same reaction.

[kwhit]

Well, it looks like the CBD oil is working on his anxiety again. He fell asleep at his normal time, no barking, pacing or whining. Looks like it didn’t work because of the trilostane since this is the first day he didn’t get his dose of the med. I’ll let his vet know tomorrow and see what she says.

I’ll see if his mobility is better tomorrow, too.

[molly muffin]

hmmm, interesting that it is working on the restlessness without the trilostane. Yes, definitely let us know about the mobility too.

[kwhit]

Chance’s mobility is definitely better. It’s amazing that a medication can have such a drastically negative effect in such a short period of time. I’m very nervous about using it again, even at a lesser dose. Are there some cases where treatment is not given? What about a holistic approach? His urination amount is not that bad and I can deal with it. Would not treating be extremely detrimental to his health? I’m so torn as to how to approach this. I’ll be waiting one more day to email his doctor to give it more thought.

[Squirt's Mom]

Lysodren might be an option since it works differently from Vetoryl (Trilostane). Lyso works only on the adrenal glands while Vetoryl works on the loop between the hypothalamus, pituitary and adrenals, or the HPA axis.

[labblab]

Hi again, Karen. Leslie is right that Lysodren might be another prescription option for you to consider. However, in honesty, if he were mine I might not opt to resume treatment at all given Chance’s age. Rather than “reinvent the wheel” (HA!), I’m going to repeat here a reply that I have posted elsewhere. As you’ll see, I don’t feel as though treatment may always be the best option for an older dog.


Given her age, Gidget has now entered her senior years. That being the case, there may be pros-and-cons to Cushing's treatment that you'd want to think over. In my own mind, the decision whether or not to treat any dog depends on a number of factors: age of the dog, apparent discomfort, severity of symptoms (both external and internal), etc. Cushing's is typically a slowly developing syndrome, and the decision to actively treat may come sooner or later in the process. The primary goals of treament are to control the troublesome observable symptoms (things like excessive thirst, urination, hunger, panting, muscle wasting), and also to halt/delay silent internal damage. Untreated Cushing's can make dogs more vulnerable to things like high blood pressure, high cholesterol, protein-losing kidney disease, blindness (as a result of high blood pressure), pancreatitis, ligament damage and slow healing, chronic infections and skin issues, GI disturbance, etc. Not every dog will suffer from all or even many of these issues, but the disease can make them happen. For a younger dog, I would want to provide as many quality years of life that I could, and that would mean putting a stop to the development of the internal systemic damage as well as relieving the uncomfortable outward problems.

However, since the damage usually occurs over time, my own opinion is that I don't worry so much about the "silent" damage in a dog who is already elderly. Instead, my biggest concern for a senior dog is immediate quality of life. So if the overt symptoms are making the senior dog uncomfortable, I would treat. Otherwise, I might choose not to treat, especially if my senior dog suffers from inflammatory conditions like arthritis that may actually be soothed by the elevated cortisol level of Cushing's. Treatment also involves frequent vet visits and blood draws, especially at the beginning. So again, if vet visits are really stressful for a senior dog, I'd also factor that into my treatment decision.

Marianne
I know you have a lot to think over and to discuss with your vet. But I just wanted to let you know that I don’t think you’d be making an unreasonable decision if you delay resuming treatment, should you decide to resume at all.

Marianne

[kwhit]

Thank you so much for this. I just emailed his vet asking her about the possibility of not treating. Chance absolutely hates the car. Stresses so much that it can make him sick for days afterwards. My sister has 10 acres in the Santa Cruz mountains and it’s beautiful. But...Chance has never been there. He would never be able to take the car ride, (about 45 minutes). I took him to visit my daughter when she was attending UC Davis and he was sick with bloody diarrhea for days. So the vet visits alone would be miserable for him.

I’m just so confused. 😞 I just want him to be happy and content.

[Squirt's Mom]

My Squirt LOVED to ride! Any time she heard the keys jingle or saw me getting my purse she got so excited....then Cushing's came along and she became terrified of the car, any car. No matter how often I took her to fun places she was always scared it was another trip to the vet for another poke and prod. And we were on Lysodren which typically requires lots fewer trips to the vet. At 15 I stopped treatment and promised her no more vet visits unless absolutely necessary. She lived another year or so - we just enjoyed our time together as much as we could. It would be cool if they would come up with a way for us to test for cortisol at home like you can for diabetes. Maybe one day research will provide that equipment for us.

[kwhit]

Chance's vet just emailed me saying that if his quality of life is worse on the med. then I can absolutely choose to not treat. We are going to talk later this week to go over everything more thoroughly. We may try a lower dose, but I'm not sure that would be the best thing for him. I just want to make the best and most informed decision that I can. I just hope I make the right one...

[molly muffin]

If you have to take 17 to get to your sisters place then I can definitely see how that would make Chance ill. It makes me nauseous sometimes. hahahahah True it is beautiful though.
I would probably take Chance off the meds too. Quality of life is everything.

[Whiskey's Mom]

HI!
I don't get on the forum too much, but I read through your thread when I saw you have a Golden. I took my Whiskey off the Vetoryl and I don't regret it. Especially after seeing the how much he returned to his old self after being off it for just a few days. We will never know if he truly had Cushings, I still go over everything that happened and will always wonder. He never minded trips to the vet or the testing itself, so that wasn't an issue. Given his age, we just wanted him to feel his best and have as happy a life as possible. I hope Chance is doing well,, Goldens are so sweet and great family members.

[kwhit]

HI!
I don't get on the forum too much, but I read through your thread when I saw you have a Golden. I took my Whiskey off the Vetoryl and I don't regret it. Especially after seeing the how much he returned to his old self after being off it for just a few days. We will never know if he truly had Cushings, I still go over everything that happened and will always wonder. He never minded trips to the vet or the testing itself, so that wasn't an issue. Given his age, we just wanted him to feel his best and have as happy a life as possible. I hope Chance is doing well,, Goldens are so sweet and great family members.

They are the best, aren’t they? 😍 He’s my world.

[kwhit]

Ever since Chance took the trilostane, (March 2-5), he’s had diarrhea. Really, really bad diarrhea. His stools were great before that. Loose stools once in a great while, but not every day like it has been.

His dental surgery is scheduled for this coming Monday, but I’m wondering if I should cancel it. Is diarrhea a symptom of Cushing’s? If it’s a virus, then his immune system is compromised. Not the best thing when facing surgery. And is it true that they heal slower with Cushing’s?

[Joan2517]

Hi and welcome from me too. If he has diarrhea, please stop the Trilostane. It could be a sign that his cortisol is dropping too low, or the dose is too high for him. You should get him to the vet and get an ACTH test soon.

[Squirt's Mom]

Were Chance's electrolytes ever checked? If not, I would want that done as well as another ACTH asap...and personally I would not let the dental go ahead until those tests were done.

How is his appetite? Does he ever seem lethargic? Does he show any signs of nausea, or has he vomited?

Yes, Cushing's can make healing a bit slower especially if the cortisol is not well controlled but if his cortisol is too low as Joan suggested then the dental would not be a good idea. So talk to his vet about those tests and anything else that may need to be looked at like a parasite invasion or an infection.

Let us know what the vet says and how you decide to proceed!
Hugs,
Leslie

[kwhit]

Hi and welcome from me too. If he has diarrhea, please stop the Trilostane...

He only took the trilostane for 4 days, March 2nd through the 5th. I stopped it because he was falling down and his stool was beginning to get loose. He was on 30 mg. He weighs 95 lbs.

[kwhit]

Were Chance's electrolytes ever checked? If not, I would want that done as well as another ACTH asap...and personally I would not let the dental go ahead until those tests were done.

How is his appetite? Does he ever seem lethargic? Does he show any signs of nausea, or has he vomited?

Yes, Cushing's can make healing a bit slower especially if the cortisol is not well controlled but if his cortisol is too low as Joan suggested then the dental would not be a good idea. So talk to his vet about those tests and anything else that may need to be looked at like a parasite invasion or an infection.

Let us know what the vet says and how you decide to proceed!
Hugs,
Leslie

His appetite is still huge, his water intake is better, less than before. Not lethargic at all and no vomiting.

[molly muffin]

boy that sure does sound scary! How is he now?

[kwhit]

His vet wanted to see him so we went in this afternoon. She decided that postponing his dental until we get his diarrhea taken care of would be the best thing to do right now. She ran more blood work and I’ll get the results tomorrow. Right before we went into his vet’s office he pooped and it was the first normal bowel movement he’s has in over two weeks. So I was happy about that, but I’ll have to see how tomorrow’s is, (he had bad diarrhea just this morning). He’s back on a bland diet, but this time it’s whitefish, (I bought cod), and white potatoes. The rice and chicken went right through him. �� Hopefully his blood work is okay. She also prescribed metronidazole, (for his tooth and for his diarrhea).

[Squirt's Mom]

I had a Toy Poodle foster a few years back who couldn't keep anything in - she had explosive diarrhea with every food we tried. I finally started with single human foods until I hit on Salmon - and that she could digest. Slowly I tried adding rice then pasta then white potato - all caused her to go back to the diarrhea. But she could handle the sweet potato. So her diet consisted of salmon and sweet potato with NutriCal mixed in. Why the NutriCal didn't send her over the edge I have no idea but those three she could digest. It was a loooong process of finding that combination so I can empathize with you! I hope you find what works for your baby, too!

Hugs,
Leslie

[kwhit]

Chance just threw up his entire breakfast. I can’t remember the last time he threw up. I’m pretty sure it’s the metronidazole. He had it for the first time with his breakfast but maybe he’s sensitive to it. I emailed his doctor to let her know. All his blood work came back unchanged from last time. His resting cortisol level will be back tomorrow. She wanted to check that to be sure because he started having diarrhea while on trilostane.

[kwhit]

On the plus side, his stool this morning was perfect. :)

[Harley PoMMom]

Oh poor Chance and poor you, too :( That's great news that his stool is looking better...YYAAA!!! Keep us updated, please!

[kwhit]

I just heard from Chance's vet and his resting cortisol level was normal. He's not on any meds so does this mean he doesn't need them? Could he not have Cushing's or is resting cortisol level not a good indicator? I'll email his vet with questions tomorrow, (don't want to bother her on a Sunday), but thought I would ask here because this group is so knowledgeable and maybe you can help me with questions I should ask her. Thanks!

[labblab]

Can you find out the exact number for Chance’s resting cortisol level? Also, out of interest, do you know what is resting cortisol number was back when he had the diagnostic ACTH (when his post-ACTH number was 18)?

I think the bottom line is that a resting cortisol that falls within the normal range does not rule out Cushing’s for Chance, especially if he still exhibits outward symptoms of the disease. For diagnostic purposes for a dog not taking trilostane, it’s the post-ACTH value that carries the weight. However, it’s good to know that his resting cortisol has not fallen too low, since that helps rule out any fear that he’s suffering from insufficient cortisol production as a result of the few days that he was taking trilostane.

At this point, I know you’re weighing lots of variables and Chance may well remain better off without treating Cushing’s. For that reason, you may choose never to resume treatment regardless of his Cushing’s status. But a resting cortisol value alone will not tell you whether or not he suffers from the disease.

Marianne

[kwhit]

Thank you so much for this reply. It answers a lot of questions for me. I didn't get the numbers of his levels between the two tests. Since his level is normal would it be unwise to try again on the trilostane? His muscle control has getting much worse the past week and I don't know if it's from Cushing's or age progression. If it's from Cushing's I would like to treat him if it would help but don't want him to get worse. He couldn't tolerate 30 mg so maybe start with 10 mg and see how he does?

[labblab]

After having been off the trilostane for awhile, if Chance’s resting cortisol level is still within normal range, I don’t think I rush to start him back on any dose after all these GI problems. It still would help to know exactly what this recent reading was, though.

[kwhit]

Thanks. I'll find out the levels tomorrow and post them.

[kwhit]

I’m going through this with my Golden, Chance. Today has been the worst day. I couldn’t get him up. He didn’t want me even trying. I finally did get him up on his feet but he fell trying to walk just a few feet. Then he wet himself. I went to get a towel and water to clean him and when I got back to him, he had crawled out into the hallway so he wasn’t laying in his urine. I couldn’t stop crying, but then I didn’t want him to feel my stress so I stopped and cleaned him up. He fell asleep as I was blow drying him. He’s still in the hallway asleep. I know exactly how your feeling. Chance is my world and I’ve never been so scared as I am right now...

[labblab]

I just saw the reply you posted elsewhere yesterday, and I made a copy to place here in your own thread about Chance. This way, folks will be able to reply to you directly with their well wishes. Goodness, I’m so sorry for the rough time you guys are having! I so wish I had some great words of wisdom to offer, but I realize that most anything I have to say right now will be feeble comfort in the midst of your worry. Please just know that we remain right here by your side, and we are sending huge healing wishes to both you and your sweet boy. Do keep us updated, OK?

Giant hugs flying across the miles,
Marianne

[Squirt's Mom]

I am so sorry Charlie is struggling so and pray he regains a bit of strength soon. Please know we are here anytime you need to talk and that we are with you every minute.

Hugs,
Leslie

[kwhit]

Chance still can't walk on his own this morning. I have to help him with a towel a d he hates it. I think he has vestibular disease. The only thing is is that he doesn't have a head tilt, or one that is noticeable anyway, and he's still eating and drinking. I have to bring both to him, though.

Does that sound like a possibility?

[labblab]

I just don’t know, although I believe it’s possible for metronidazole to cause vestibular issues in vulnerable dogs. Look at this quote:


Metronidazole Toxicosis
Metronidazole toxicosis resulting in central vestibular disease can affect dogs and cats. It is usually seen in animals receiving high doses of the medication. However, because metronidazole undergoes hepatic metabolism, animals with liver dysfunction may develop signs of vestibular disease despite appropriate doses of metronidazole. Therefore, the history of any patient presenting with vestibular signs should be thoroughly reviewed to ensure the patient has not received this medication. Treatment with diazepam has been reported to speed recovery, although the exact mechanism of action is uncertain. I use a diazepam dose of 0.5 mg/kg q8h for at least 5 days or until a complete remission of clinical signs is obtained. Prognosis is very good if early intervention is achieved.

Is Chance still taking the metronidazole? Even if not, it sounds like something to ask the vet about.

Marianne

[kwhit]

I just don’t know, although I believe it’s possible for metronidazole to cause vestibular issues in vulnerable dogs. Look at this quote:



Is Chance still taking the metronidazole? Even if not, it sounds like something to ask the vet about.

Marianne

Oh, wow. That’s scary. Chance only took one dose of 250 mg. He threw up right away so I stopped it. I wonder if that small dose could have done anything to him. He’s obviously very sensitive to it.

As I’m typing this he just barked at the mailman. Makes my heart happy when he does something so normal even though he doesn’t feel well. Makes me believe he’ll get by this.

[Squirt's Mom]

My little Chi had vestibular and he circled to the left constantly - so much so he simply could not move forward to get anywhere. He was blind and his eyeballs were not normal so I didn't see any of the hallmark eye movement (rapid side to side movement). It took a while but he did improve. He continued to carry his head tilted to the left most of the time even after it passed but the circling did stop. I hope Charlie's barking is a sign he is getting better and you will see more signs very soon!

Hugs,
Leslie

[kwhit]

Chance is a lot better. He started getting up on his own and walking on his own last night. What’s odd is he never had a head tilt and he never quit eating or drinking. I’m thinking it might not have been vestibular, but then not sure what else it might have been. Do some dogs get over it in just over 24 hours?

[Harley PoMMom]

Neurologic disorders are listed as a side effect of metronidazole, although it is more typically seen with long term high doses, short low doses have been noted:
Neurotoxicity following prolonged therapy is most often related to cumulative dose and duration of treatment. Most canines who develop neurologic signs secondary to metronidazole administration have received weeks to months of therapy, but toxicity after short-term therapy at relatively low dosages (<60 mg/kg/day) has been reported. http://veterinarynews.dvm360.com/metronidazole-uses-toxicity-and-management-neurologic-sequllae

Glad to hear he is doing better!

[kwhit]

He just took the one dose, (250 mg), on the 23rd and showed these symptoms starting on the 27th and ending early last night. So I’m not sure if the metronidazole could have caused this, but you never know. I’m definitely bookmarking the article. I do know that he’ll never take it again.

[kwhit]

If it was vestibular, I wonder if the CBD oil I give him made a difference in how fast he got over it. If so, that’s pretty significant.

[molly muffin]

How is Chance doing now? Has the circling stopped completely? I hope to hear good things on our sweet boy.

[kwhit]

Chance is doing well. No effects left over from his episode, (not sure what else to call it), at all. He still has symptoms of Cushing’s, panting, alyways hungry, weak rear legs but, interestingly, his thirst is a lot less. Also, he hasn’t had any other accidents in the house.

I wanted to ask if drooling is a symptom of Cushing’s? He drools sometimes without it having anything to do with food. Just curious.

[Larinda]

my dog drools also. a lot! been doing it for years. mostly over food. none of my other labs ever did that. he has been symptomatic of cushings for over a year now and just recently confirmed and put on trilostane. I often wondered as well if that was something related to cushings or not.

[labblab]

That’s so interesting that you’ve written about this right now, because my nonCush yellow Lab is doing the same thing and we can’t figure out why. She’s almost ten now, and has had some widely intermittent drooling episodes throughout her life, but they’ve gotten a lot more frequent recently. Most often, it’ll happen in the middle of the day with no food involved, either. If she’s awake, I’ll hear her licking her lips and see drool dripping down. But a lot of times, she’ll do it while she’s napping and there’ll be a pool of drool under her head :-((((.

Our vet says there can be a lot of different causes for “hypersalivation,” but we’re stumped as to what’s going on with our Luna. Her labwork is all normal, her behavior is otherwise normal, appetite normal. So for right now, we’re just kinda monitoring it to see if we can figure out a “trigger.” And, um, we’ve put off replacing our ancient couch for the time being since that’s where she loves to nap...and drool...

Marianne

By the way, LOVE your new photos of Chance!!!

[Joan2517]

Gable has been doing this as well for the last few months. I hear him licking the floor where he's been laying and noticed that he seems to drool in his sleep or just when he's laying down, but really a lot more than he used to around food...and it's very slippery!

[kwhit]

...By the way, LOVE your new photos of Chance!!!

Thanks! :o

[M&Inu]

Chance is doing well. No effects left over from his episode, (not sure what else to call it), at all. He still has symptoms of Cushing’s, panting, alyways hungry, weak rear legs but, interestingly, his thirst is a lot less. Also, he hasn’t had any other accidents in the house.

I wanted to ask if drooling is a symptom of Cushing’s? He drools sometimes without it having anything to do with food. Just curious.

I am glad Chance is doing well. Love the pictures of him! I just wanted to tell you, that Inu started drooling a lot aproximadeteley a month ago. She also is panting more, but I can't decide if this is because its getting hotter here and with her condition its affecting her more.

[molly muffin]

Awww Chance is a handsome guy and looks very happy to me. :)

[kwhit]

Hope everyone is doing well. ��

Chance is doing pretty good, although on his last senior panel, taken on 07/12, he seems to be slightly anemic. His new vet, (she’s mobile and I really like her), said that it’s pretty typical for a dog with Cushing’s that is not being treated. Is this true? One good thing is that his Alk Phos is way down. I truly think this is due to the CBD oil he gets twice a day. It hasn’t been this low in at least 5 years.

So I just thought I’d ask you guys if anemia is common. Thanks!

P.S...if you need me to post his blood work from the 12th and also, for comparison, his blood work from March, I will.

[Harley PoMMom]

Anemia is generally not seen in dogs with Cushing's since elevated cortisol increases the amount of red blood cells. If you would post those previous abnormal lab values with the reference ranges that would be great! And glad to hear that Chance is doing well!!

[kwhit]

Thank you so much for your reply. Here is all of Chance's abnormal values, (in bold), from his 7/12 blood work:

RBC 4.94 5.39 - 8.7 M/µL L
Hematocrit 34.1 38.3 - 56.5 % L
Hemoglobin 11.5 13.4 - 20.7 g/dL

Glucose 59 63 - 114 mg/dL
Potassium 5.5 4.0 - 5.4 mmol/L H
Na: K Ratio 27 28 - 37 L
Albumin 2.6 2.7 - 3.9 g/dL
ALP 362 5 - 160 U/L

Here are his values from 3/23:

RBC 5.5 4.8-9.3
Hematocrit 41 36-60
Hemoglobin 14.4 12.1-20.3

Glucose 91 63-114
Potassium 5.4 4.0-5.4
K Ratio 28 28-37
Albumin 2.8 2.7-3.9
ALP 447 5-160 (His ALP was almost 1,000 in 11/17)

Thanks so much for your help.

[Harley PoMMom]

Thank you so much for your reply. Here is all of Chance's abnormal values, (in bold), from his 7/12 blood work:

RBC 4.94 5.39 - 8.7 M/µL L
Hematocrit 34.1 38.3 - 56.5 % L
Hemoglobin 11.5 13.4 - 20.7 g/dL

Glucose 59 63 - 114 mg/dL



The fact that these levels have consistently dropped is worrisome, that low glucose is what concerns me most though. Does the vet want to recheck these levels in a couple of weeks?

[kwhit]

His vet wasn't concerned at all. She said to have his blood checked in another 6 months. He's not being treated for his cushings because the meds made him very, very sick. He was on a super low dose, (trilostane 30 mg/day. He weighs 94 lbs.), so we decided not to treat. In fact, his symptoms have almost disappeared except for panting. Why is his glucose level so worrisome? I lost my female Golden to hemangiosarcoma and that's what scares me the most about his blood count.

Thanks for helping me and Chance out.

[kwhit]

Was just reading about low glucose. :( I was so concerned about his blood count, I didn't even think about his glucose.

Do you think it has anything to do with his diet? He eats 2 cans of ID canned/a day. Free fed Lotus Senior Dry and he gets 4 tablespoons of pumpkin a day. He also gets Charlie Bear treats. If I vary this up at all, he gets horrific diarrhea. If I keep on this regime, his stool is perfect.

[Budsters Mom]

In some dogs, BG (blood glucose) levels can dip dangerously low at times. They are not necessarily diabetic or hypoglycemic. However, they may have periods of episodic hypoglycemia. This is often not caught at the vet because the BG levels when tested may appear normal, or slightly below, causing no red flags to pop up. My dog is a picky eater. She never eats unless she's hungry and often skips meals all together. This can cause her BG levels to drop. When this occurs, she becomes restless, agitated and shakes. Rubbing a little Karo syrup on her gums, settles her almost immediately. This helps to normalize her BG level quickly. Honey on gums will do the same thing, but be careful if your dog has severe allergies. It is very easy to check a dog's BG level. You can use a standard human BG monitor. Instuctions are available on You-tube. My dog's hypoglycemic attacks are rare now due to careful monitoring. If she hasn't eaten by bedtime, I will check her BG level and feed her a small snack. If her level is low, I will mix a little karo syrup into her snack.

FWIW... Chance's BG level of 59 might be one a time thing, but I wouldn't feel comfortable waiting to test again in 6 months. I would get a monitor and test it myself, for my own peace of mind. It is not painful for my dog. She barely notices when I do it. It takes only seconds.

[Harley PoMMom]

I'm so glad that Kathy responded as she has a lot more experience and knowledge dealing with hypoglycemia in dogs than I do. As Kathy suggested, if testing Chance's BG at home is possible I'd do that, and if not, I'd have a blood panel (CBC/chemistry) performed in a couple of weeks to see where those levels are.

Since Chance is doing so well on his diet than I wouldn't change it up, normal stools are important. If you do decide to test his BG at home and it appears to spike down at certain times rubbing the kero or honey on his gums would be something I'd try.