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[tchapin50]

Hello Everyone! I am new to all this Cushings stuff. My dog, Jake, who is a Chiweenie at about 15 lbs, is 11 years old and he was just diagnosed with Cushings. He had the thirst, shaking, extra urinating, you know, all the classic symptoms. All of his counts were off the chart! I had been taking him to the vet because the vet found a mass on his liver/pancreas area and it was thought to be a tumor. Well, I started noticing little bumps and blood where he had been scratching all over his body. That is when we did the test for Cushings and it was positive. It was a relief and a fear, since it wasn't cancer, but it was indeed something. The vet shaved Jakes back and it looked like mold all over his back (so gross). So I got DMSO sauve to put on his bumps. Well, his bumps are breaking open and they are all bloody. Has anyone experienced this? That DMSO smells like garlic, it is so gross! Rubber gloves are hard to find these days!
The vet put him on Vetoryl 30 mgs. We just started it yesterday. I'm hoping for better numbers when we go back! Any advice I can have on his bloody spots on his back? Has anyone experienced this?

https://www.dropbox.com/s/u6s6p9d5n7pjj4p/Cushings%20jake.jpg?dl=0

[labblab]

Hello and welcome to you and Jake! We’re so glad you’ve found us, but surely sorry for the problems you’re having. From your description, I’m guessing that Jake may be suffering from a skin condition named Calcinosis Cutis. It is one of the most unfortunate side effects of Cushing’s due to the potential discomfort to the dog, and the patience it requires to treat it. The single most important issue is to significantly reduce the amount of circulating cortisol. Even once that’s achieved, it can still take time for the calcium deposits to work their way up through the skin. Secondary bacterial infections are common, so medicated shampoos and sprays are often recommended in addition to the DMSO. The only way to diagnose this condition for sure is through a skin biopsy. But if you Google it, you can find pictures that you can compare to Jake. Rather than writing more about CC here, I’ll go ahead and direct you to a specific thread that’s devoted to postings about it. Once you’ve looked it over, you can come back here and we can pick up any additional questions you may have.

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

Returning to the all-important issue of reducing the cortisol, Vetoryl is indeed an effective treatment and one that’s commonly used by our members here. However, I’m very concerned that your vet is starting Jake off with a dose of 30 mg. Given Jake’s weight, that is twice the dose that is currently recommended by researchers and specialists who commonly treat Cushing’s patients. When the medication was first introduced, higher doses were commonly prescribed. However, experience has shown that dogs typically suffer fewer side effects and less risk of overdose if the medication is introduced at a lower dose and then increased as needed, rather than vice versa. Current recommendations are to start at initial doses that do not exceed a formula of 1 mg. per pound. In the U.S., Vetoryl is sold capsule strengths of both 5 mg. and 10 mg. It would be much safer for Jake if he was started on a lower dose than the 30 mg.

Given Jake’s significant symptoms including his skin eruptions, your vet may be thinking that it’s better to be more aggressive in terms of dosing. But the manufacturer specifically advises that initial dosing decisions be based solely on weight — not on symptom severity. As I say, these dosing recommendations have evolved over time, and your vet may not be familiar with the changes. But here’s a post that you can print out to show him/her:

https://www.k9cushings.com/forum/showthread.php?185-Trilostane-Vetoryl-Information-and-Resources&p=1251#post1251

If Jake were my own dog, I’d ask my vet to start off first with either a 10 mg. capsule, or a combination of a 10 mg. and 5 mg. capsule. After subsequent monitoring blood testing is performed, the decision may indeed be made to increase the dose. But truly, it’s safer to start off lower to begin with.

OK, I’ll close for now. But once again, welcome to you and your little boy!
Marianne

[tchapin50]

Oh wow. I really appreciate your post. That was very informative. Yes, the vet did mention Calcinosis Cutis. I gave him a warm bath with oatmeal soap and he seemed to love it! I also put a bandage over the worst skin eruption so he wouldn't lick it and keep it moist. It looks to be working! He goes into the vet on the 27th for more blood work to see if his numbers are down. This sure is an expensive path we have had to take, but my boy is worth it! Thanks again for the welcome!

[Squirt's Mom]

Hi!

Welcome to you and Jake!

I cannot stress strongly enough how important the information Marianne gave you about the dosing is. This drug is VERY powerful and a dose that is too high can result in permanent adrenal gland damage, even death....and it can happen very quickly. If you have not stopped the 30mg you MUST do so today. Do not give Eli one more dose at 30mg, please, for his sake as well as yours. Call his vet and tell them to give you 10mg capsules and start him on that dose. Remember, they work for you not the other way around. ;) This drug has gone thru many changes since its release in the mid-2000's and sadly some vets are still referring to text books that have the old dosing guidelines, resulting in very sick dogs if they are lucky, in broken-hearted parents if they are not. Dechra, the manufacturer, says it is best to start as low as possible and gradually increase if needed based on signs and ACTHs. If this vet will not listen and do as Eli requires, find a new vet. Waiting a while to start treatment won't cause nearly as much harm as giving this drug at too high a dose, which 30 mg is.

You mention a tumor on the liver or pancreas? Am I understanding that right? If that is the case, then any positive results on any testing for Cushing's is highly suspect making it even more important that you stop giving the 30mg Vetoryl. My first cush pup tested positive on the LDDS, HDDS, ACTH, and UTK panel but when the ultrasound was done a tumor was found on her spleen. Once that tumor was removed her cortisol returned to normal. The tumor had caused the cortisol to rise in a natural response to the stress the tumor was causing. My second dog who tested positive had a host of other health issues. Her cortisol was so high it couldn't be measured. Her necropsy (animal autopsy) proved she never had Cushing's at all. Her cortisol was extremely elevated due to all the other things going on in her little body. Cortisol is a fight or flight hormone and will rise in response to any stressor, internal or external. So IF Eli does have a tumor then I am not at all convinced he actually has Cushing's. However if this is CC on his skin then I feel a little better about the diagnosis. CC is almost always caused by Cushing's, or steroid use, but can be caused by other things. A derm vet could make that determination if needed.

Your most important take-away from my post is to STOP the 30mg Vetoryl and get the 10mg from either this vet or a new vet plus get clarification on the tumor. Eli is counting on you since he can't speak for himself. ;)

I'm glad you found us and look forward to learning more as time passes about you as well as your sweet baby boy.
Hugs,
Leslie

[tchapin50]

Does anyone know what to do to combat the smell? I know it is mostly the DMSO suave that I put on him, smells like garlic, but the smell is overwelming. Any suggestions? Can they have a warm bath?

[labblab]

Welcome back to you and Jake! You’ll see that I deleted the new thread that you started since it is a duplicate of your question here ;-). We find that it works best to keep all the information and questions about a member consolidated on a single thread.

I’ve heard how nasty DMSO smells, although I’ve not had any personal experience with it. It also seems possible that Jake may have developed a secondary fungal or bacterial skin infection due to his open sores. I know that skin infections can also be smelly. However, if the smell is primarily “garlicky,” it’s probably mainly the DMSO.

Either way, it’s probably fine to bathe Jake. You can see how both he and his skin responds, and continue with baths if they make him more comfortable and seem to improve the skin situation. Many members battling CC have used medicated shampoo to treat possible infection. If you look back at the link I gave you earlier, you’ll find at least one suggestion in that regard. I’ve successfully used a specific antiseptic shampoo, myself, to treat my non-Cushing’s dog when she suffered from a persistent staph infection on her skin: Douxo Chlorhexidine shampoo. Having made these suggestions, though, you’d probably best check with your vet first before using a medicated shampoo (or before bathing Jake at all) in order to make sure that there isn’t any negative interaction with the DMSO. As I say, I’ve just not had any experience with that medication.

Overall, how is Jake doing these days? Are you seeing any improvement in his skin so far? How did his bloodwork turn out on the 27th, and what dose of Vetoryl is he on now?

Marianne

[tchapin50]

My dog has a TERRIBLE smell to him. Does anyone know how to get this smell to subside? Is it just how dogs with Cushings smell? Can you bathe them? Any advice would be helpful!

[labblab]

Hi again! You’ll see that I’ve combined your new question with your original thread about Jake. I’m not sure whether you saw my earlier reply to you, but I’m concerned that Jake may have a skin infection of some type. Skin infections can indeed be smelly. Does he still have sores on his skin? Are you still using the DMSO? Overall, how is he doing?

Cushing’s itself is not associated with bad smells, unless some type of secondary problem has developed such as a smelly skin infection. Yeast infections can especially have an odor. Have you talked with your vet about the problem? I would think that bathing should be fine. And as I wrote back in April, medicated shampoo can help with both fungal and bacterial skin infections.

Marianne

[tchapin50]

Hi again! You’ll see that I’ve combined your new question with your original thread about Jake. I’m not sure whether you saw my earlier reply to you, but I’m concerned that Jake may have a skin infection of some type. Skin infections can indeed be smelly. Does he still have sores on his skin? Are you still using the DMSO? Overall, how is he doing?

Cushing’s itself is not associated with bad smells, unless some type of secondary problem has developed such as a smelly skin infection. Yeast infections can especially have an odor. Have you talked with your vet about the problem? I would think that bathing should be fine. And as I wrote back in April, medicated shampoo can help with both fungal and bacterial skin infections.

Marianne

It just smells like the DMSO. Maybe it is soaked into his skin, but omg, the smell is so bad in the house. I have put up air fresheners lol. I love my boy, though, so I overlook it! I will try the bath this afternoon! Thanks!

[tchapin50]

Hi again! You’ll see that I’ve combined your new question with your original thread about Jake. I’m not sure whether you saw my earlier reply to you, but I’m concerned that Jake may have a skin infection of some type. Skin infections can indeed be smelly. Does he still have sores on his skin? Are you still using the DMSO? Overall, how is he doing?

Cushing’s itself is not associated with bad smells, unless some type of secondary problem has developed such as a smelly skin infection. Yeast infections can especially have an odor. Have you talked with your vet about the problem? I would think that bathing should be fine. And as I wrote back in April, medicated shampoo can help with both fungal and bacterial skin infections.

Marianne

Sorry, Marianne, I am new to forums and don't know how to post new subjects and such. His skin doesn't smell like infection, it is definatley the DMSO smell. I was afraid to bathe him because his fur still hasn't grown back and the skin is exposed. I'm afraid it will hurt him. Also, I applied to Brown Dog Foundation for help with my vet bill since his diagnosis was SOOOO expensive. I am into 600 bucks with the vet right now! Have you heard of them?

[labblab]

No need at all to apologize — I am not very techno-savvy, myself! But we just think it’s easier to follow what’s going on with each of our members if we keep all the posts related to any dog consolidated within one single thread. So no matter what your question is about Jake, you can just keep coming back to this thread and adding new replies here.

As far as the DMSO, I‘Ve never used it and I really don’t know any specifics about it. I assume that bathing is OK, but you’d best check with your vet to make sure. Also, hopefully there’ll be an endpoint in sight when you can stop using it altogether. If Jake’s skin is generally healing or healed, maybe you can discontinue it now since it’s so horribly smelly!

We surely do understand the burden of costs. I’m not familiar with the Brown Dog Foundation, but here are a few other resources that may be a help to you. The first is a general listing of financial aid groups. I apologize that I haven’t checked all the links lately — I do hope they still work.

https://www.k9cushings.com/forum/showthread.php?212-Financial-Resources-to-help-with-Vet-bills

At the top of that list, you’ll find an assistance fund that was started by two of our very own members:

http://www.tipper-squirtcushingfund.org

Also, here’s a thread that provides some cost-saving tips specifically for owners of Cushing’s dogs:

https://www.k9cushings.com/forum/showthread.php?9066-Cost-Savings-for-Owners-of-Cushingoid-Dogs

I hope that some of this info may help!
Marianne

[tchapin50]

He is on the same dosage. They didn't take more blood like I thought he said that he would. He is hanging in there!