Calcinosis Cutis Questions

[barcebr]

My 9-year-old Boston Terrier Henry was recently diagnosed with Cushing's after lesions appeared on his back and we went in for testing. He's got all the typical symptoms and the vet said he was a "poster child" for the disease after the LDDST test. He has been on Vetoryl 30mg for about 14 days now, and the second test to check whether he was at the right dose indicated that he was. However, his CC is only getting worse.

It started on the nape of his neck and has steadily been progressing down his body towards his tail and around his sides. His open wounds got infected at one point with an antibiotic resistant bacteria which required a culture and then Baytril to get under control. The original lesions in the center of his back seem to be getting better, and are seeming to dry out. But it seems like the plaques are continuing to extend in all direction and eventually are going to cover his whole body. They are weeping a clear fluid and smelly. I'm afraid they are getting infected, but he is still on Baytril so I find that hard to believe. We are also using a biohex shampoo 3x per week to keep everything clean.

I guess my question is: if the Cushing's is being managed properly with Vetoryl then how long will it take for the Calcinosis Cutis plaques to stop appearing and decimating his skin? How much worse can it get before it gets better? The vet shaved about 50% of his back, but the plaques now venture into unshaved areas. Should we shave his whole back?

He seems quite uncomfortable too. :(

Thanks for any advice!
Bryan

[labblab]

Hello Bryan! Welcome to you and Henry, although I’m surely sorry that he’s having to deal with CC. Calcinosis cutis is definitely one of the most troublesome of the Cushing’s symptoms, and unfortunately, apparently it can take quite a while to resolve even after cortisol levels have been reduced into therapeutic range. Calcium “clumps” that are buried under the skin still have to work their way to the surface before they can erupt and ultimately resolve.

I’m going to give you the link to a related informational thread on our “Everything Else” forum. Among other things, you’ll see that there is a Facebook group that is specifically dedicated to the treatment of CC. I’m not a Facebooker myself, so I’ve not had a chance to personally visit this group. But if you’re already on Facebook, I’d encourage you to check them out. For instance, there may be discussions there about various topical sprays that may offer additional relief in between baths.

https://www.k9cushings.com/forum/showthread.php?8909-Calcinosis-Cutis-treatment-thread

If you can, it’ll be helpful to us if you can get the actual numerical results for Henry’s last ACTH test. That way, we can help you gauge his progress as time goes on. Although it’s difficult to remain patient, it’s generally not recommended to increase trilostane doses until after the first month of treatment has passed. This is because cortisol levels tend to continue to drift downward during the first thirty days even when doses are left unchanged. But once again, it’ll help us to find out what his first monitoring levels actually were.

So do take a look at the related thread here, and we’ll also try to think of some additional tips to offer out to you. Once again, we’re very glad you’ve found us although we’re sorry for the reason that has brought you here.

Marianne

[reggiedog]

Hi Bryan

I'm definitely not as experienced as some of the others on this forum, but I thought I'd chime in with my dog's CC experience.

My 8 year old Staffordshire Bull Terrier also has cushings and calcinosis cutis. She was diagnosed maybe 2.5 months ago and the CC appeared around the time of her diagnoses. Unfortunately we still haven't quite got her Trilostane dosage right - her dosage was definitely too high and her cortisol levels dropped dangerously low for over a month and I'm still not 100% confident she has recovered. In that first month when she was diagnosed, first started treatmetnt, and her cortisol levels were dangerously low when her CC started and got much worse – it got very scabby, she kept scratching at them and making her wounds bleed. It also seemed to "spread" relatively quickly.

Once we got her first test results back, I was so confused – how can her CC be getting worse (which is a product of high cortisol) when her actual cortisol levels were low? :confused:

As Marianne already mentioned, the vet said the CC was getting worse because the cortisol levels in her system were high for so long pre-diagnosis. CC is slow to react to the changes in cortisol levels and the fact that her cortisol levels were low for 1 month wasn’t enough to counteract the high cortisol levels existing in her system.

It’s now been about 6 weeks of my dog being on and off a low dosage of Trilostane (but mostly off because we want to take the treatment very slowly given those test results after the first month). We started using DMSO (ordered off eBay) in the last month or so. Her CC has improved drastically in the last 6 weeks ago which makes me suspect her cortisol levels are still low / normal despite being mostly off the Trilostane for the last 6 weeks. Her skin is definitely not 100% back to normal and we still find her scratching against the fence and her kennel, but she’s not constantly scratching to the point where she’s bleeding. It’s a marked improvement from where we started. I think the DMSO has helped stopped the CC from being so itchy, but it's extended period of low coritsol levels which have actually made the CC go away.

There was defiantly a time when I though her CC would not get better, but we did start seeing results. It’s hard to be patient when you see your dog looking so poorly.

Putting a jacket on your dog may help him stop scratching as much (if it’s not too hot where you are). We also try to distract her when she’s in a scratching mood – by calling her over too us for pets and belly rubs - sometimes she listens, sometime she doesn't :)

Hope this helps.

Reggie’s mumma

[Squirt's Mom]

Hi and welcome to you and Henry,

In addition to the CC thread in Everything Else, one of our former members dealt with CC in her precious Pug, Tobey. Sadly Tobey is no long with us but her story stands as a testament in order to help others who come along behind her that are facing this same complication. Here is the link to her thread -

https://www.k9cushings.com/forum/showthread.php?5908-My-girl-pug-(confirmed-Cushings-amp-confirmed-calcinosis-cutis)-Tobey-has-passed

Hugs,
Leslie