Nallelyta5
06-28-2020, 10:28 PM
Hi, first of all I want to say thank you for this forum full of warmth and support. I'm so glad I found it! It has given me a lot of hope for my newly diagnosed Lucas and it has relieved some of my anxiety as well. However, he is presenting most, if not all, of the physiological symptoms and his labs don't look good either, so I'm worried I'm late with testing and treatment. I have read a few posts and feel ready to post myself, with all the information I have as well as some questions. I want to be very thorough so please prepare for some reading.
My sweet Lucas is a 9 year old Shih-tzu (weight: 16.6 lbs) who has been pretty healthy most of his life. With the exception of sensitive skin and surgery to remove a small benign tumor on his cheek/ear area he's never had major health issues and rarely ever gets an upset tummy or anything like that. My parents have his mom and I adopted him when he was about 4 yrs old. He wasn't completely potty trained, and couldn't roam around the house as freely as his mom without being constantly monitored. I was partially successful at improving his potty training but he still had accidents. He was also known for being a picky eater, and while he was at a healthy weight according to vets, I still struggled a little to make him eat. He is also very emotionally sensitive, gets easily stressed out and nervous, but is very compassionate and empathetic with human emotions as well. He's never had any formal training but I always say he is like a therapy dog, as he will make sure to cuddle with you and calm you down if you're sad or anxious. It was evident he was the most reserved, shy and dependent on human protection out of the pack (5 puppies) since he was little.
The first signs of Cushing’s started about 1.5 years ago. I had to ask my parents for help keeping him for a few months due to an increased amount of travel I had to do for work. During this time they switched his food to what his mom was eating out of convenience and the fact that he started eating her food (Hill's Science Diet for reference). Since I struggled with his appetite, and there was a noticeable improvement, we were happy and thought maybe he just prefers this type of food. He started gaining weight as well, but my family always thought he was too skinny (regardless of vets saying his weight was ok), so they celebrated this and even though I felt like something was not right I got carried away with the positive take on it. We also had a couple of discussions regarding his extreme thirst. He had always drank more water than we thought was normal, but because his labs kept coming up normal and his vet wasn't raising any concerns we also didn't think much of it. We did look into diabetes but again, his labs were normal.
Other signs of Cushing’s that we had ignored and increasingly got worse include the following:
- Hair loss (thought it was just age)
- Obsession with licking/sucking his tail, especially at night (vet said he was bored or coping with anxiety, recommended exercise and keeping busy/distracted)
- Increased pee accidents (thought it was due to failing at potty training him)
Some signs that I did find very strange, more unusual and recent but were ignored given he still seemed energetic, was eating "well", and overall happy:
- Asking to be taken out for peeing in the middle of the night
- Dry crusty nose
- Dry flaky skin (thought it was seasonal allergies since his skin is sensitive)
- A dark spot on his tail that looked like black heads
- Increase panting and needy for attention (I would try everything from giving him water, food, taking him out to potty, playing fetch as he loves his squeaky toys, all of this trying to identify the need)
- Begging for table food and scavenging around the kitchen and dining area for any dropped food.
I started looking into Cushing’s about 3 months ago, after he experienced diarrhea for two days. I took him to the vet, and it turned out to be a bacterial infection. However, the vet pointed out his hair thinning and that he was "borderline overweight". She told me I should consider hormone testing as it was possible this was a hypothyroid problem. After I left the vet, I focused on getting Lucas back to health from his infection and then started to do some research. I found hypothyroidism to be unlikely as he was exhibiting signs of hyperthyroidism as well (excessive water consumption) – I thought he can’t possibly have both, can’t he? So after doing more research and noticing other signs (pot belly, visible veins on his belly, thin skin, more black head looking dark spots, skin darkening, kicking in his sleep, fat pads around his neck and bony head), I came across Cushing’s and felt like all the signs/symptoms were spot on.
About 3-4 weeks ago, he had another episode of diarrhea and mostly vomiting. This time he was evidently in pain, and very lethargic. I freaked out thinking of the possibility the pain was caused by major damage to his organs due to untreated Cushing’s, so I took him to an emergency clinic. I told the doctor about my suspicion of Cushing’s but it turned out to be another infection. She did mention he had signs of it and we discussed testing. However, since I knew this condition involves long term care I wanted to find a clinic where I felt comfortable with pricing and reputation, as well as how open they are to holistic treatment. I had read that frequent infections are common in dogs with Cushing’s, so I tried to establish care as soon as possible, and he got his formal diagnosis last week.
I’m attaching here the testing he’s had. They did the Dexamethasone suppression test and while it confirmed Cushing’s, it was inconclusive for the pituitary dependent type, so he’s pending the ultrasound. His doctor understands the cost of it (~$400) and considered what I’ve already spent (over $600) and gave me options. She said in most cases it will be pituitary dependent and the tumors are typically benign. She explained that the most important thing is to control his cortisol levels as this is what is causing all the symptoms and having a negative effect on his health, so she said we could start treatment (recommending Trilostane) and see how he does and I could do the ultrasound later on if I wanted to.
I would really appreciate feedback on the following:
- Is Lucas doctor on the right track?
- Do the options she is giving me match those of the field experts?
- How important is the ultrasound?
- This is very hard to ask, but how late am I at treating Lucas? And based on Lucas’s progress of Cushing’s what is his prognosis? And if it’s a few more years, what will be his quality of life?
- How safe is Trilostane?
- Any Holistic alternatives?
- Is there any specific diet that mimics Cushing’s?
- Any diet that would help?
Any additional feedback is welcome!
Nallely & Lucas
https://www.k9cushings.com/forum/attachment.php?attachmentid=8624&d=1593391880
https://www.k9cushings.com/forum/attachment.php?attachmentid=8623&d=1593391880
https://www.k9cushings.com/forum/attachment.php?attachmentid=8622&d=1593391880
https://www.k9cushings.com/forum/attachment.php?attachmentid=8621&d=1593391880
My sweet Lucas is a 9 year old Shih-tzu (weight: 16.6 lbs) who has been pretty healthy most of his life. With the exception of sensitive skin and surgery to remove a small benign tumor on his cheek/ear area he's never had major health issues and rarely ever gets an upset tummy or anything like that. My parents have his mom and I adopted him when he was about 4 yrs old. He wasn't completely potty trained, and couldn't roam around the house as freely as his mom without being constantly monitored. I was partially successful at improving his potty training but he still had accidents. He was also known for being a picky eater, and while he was at a healthy weight according to vets, I still struggled a little to make him eat. He is also very emotionally sensitive, gets easily stressed out and nervous, but is very compassionate and empathetic with human emotions as well. He's never had any formal training but I always say he is like a therapy dog, as he will make sure to cuddle with you and calm you down if you're sad or anxious. It was evident he was the most reserved, shy and dependent on human protection out of the pack (5 puppies) since he was little.
The first signs of Cushing’s started about 1.5 years ago. I had to ask my parents for help keeping him for a few months due to an increased amount of travel I had to do for work. During this time they switched his food to what his mom was eating out of convenience and the fact that he started eating her food (Hill's Science Diet for reference). Since I struggled with his appetite, and there was a noticeable improvement, we were happy and thought maybe he just prefers this type of food. He started gaining weight as well, but my family always thought he was too skinny (regardless of vets saying his weight was ok), so they celebrated this and even though I felt like something was not right I got carried away with the positive take on it. We also had a couple of discussions regarding his extreme thirst. He had always drank more water than we thought was normal, but because his labs kept coming up normal and his vet wasn't raising any concerns we also didn't think much of it. We did look into diabetes but again, his labs were normal.
Other signs of Cushing’s that we had ignored and increasingly got worse include the following:
- Hair loss (thought it was just age)
- Obsession with licking/sucking his tail, especially at night (vet said he was bored or coping with anxiety, recommended exercise and keeping busy/distracted)
- Increased pee accidents (thought it was due to failing at potty training him)
Some signs that I did find very strange, more unusual and recent but were ignored given he still seemed energetic, was eating "well", and overall happy:
- Asking to be taken out for peeing in the middle of the night
- Dry crusty nose
- Dry flaky skin (thought it was seasonal allergies since his skin is sensitive)
- A dark spot on his tail that looked like black heads
- Increase panting and needy for attention (I would try everything from giving him water, food, taking him out to potty, playing fetch as he loves his squeaky toys, all of this trying to identify the need)
- Begging for table food and scavenging around the kitchen and dining area for any dropped food.
I started looking into Cushing’s about 3 months ago, after he experienced diarrhea for two days. I took him to the vet, and it turned out to be a bacterial infection. However, the vet pointed out his hair thinning and that he was "borderline overweight". She told me I should consider hormone testing as it was possible this was a hypothyroid problem. After I left the vet, I focused on getting Lucas back to health from his infection and then started to do some research. I found hypothyroidism to be unlikely as he was exhibiting signs of hyperthyroidism as well (excessive water consumption) – I thought he can’t possibly have both, can’t he? So after doing more research and noticing other signs (pot belly, visible veins on his belly, thin skin, more black head looking dark spots, skin darkening, kicking in his sleep, fat pads around his neck and bony head), I came across Cushing’s and felt like all the signs/symptoms were spot on.
About 3-4 weeks ago, he had another episode of diarrhea and mostly vomiting. This time he was evidently in pain, and very lethargic. I freaked out thinking of the possibility the pain was caused by major damage to his organs due to untreated Cushing’s, so I took him to an emergency clinic. I told the doctor about my suspicion of Cushing’s but it turned out to be another infection. She did mention he had signs of it and we discussed testing. However, since I knew this condition involves long term care I wanted to find a clinic where I felt comfortable with pricing and reputation, as well as how open they are to holistic treatment. I had read that frequent infections are common in dogs with Cushing’s, so I tried to establish care as soon as possible, and he got his formal diagnosis last week.
I’m attaching here the testing he’s had. They did the Dexamethasone suppression test and while it confirmed Cushing’s, it was inconclusive for the pituitary dependent type, so he’s pending the ultrasound. His doctor understands the cost of it (~$400) and considered what I’ve already spent (over $600) and gave me options. She said in most cases it will be pituitary dependent and the tumors are typically benign. She explained that the most important thing is to control his cortisol levels as this is what is causing all the symptoms and having a negative effect on his health, so she said we could start treatment (recommending Trilostane) and see how he does and I could do the ultrasound later on if I wanted to.
I would really appreciate feedback on the following:
- Is Lucas doctor on the right track?
- Do the options she is giving me match those of the field experts?
- How important is the ultrasound?
- This is very hard to ask, but how late am I at treating Lucas? And based on Lucas’s progress of Cushing’s what is his prognosis? And if it’s a few more years, what will be his quality of life?
- How safe is Trilostane?
- Any Holistic alternatives?
- Is there any specific diet that mimics Cushing’s?
- Any diet that would help?
Any additional feedback is welcome!
Nallely & Lucas
https://www.k9cushings.com/forum/attachment.php?attachmentid=8624&d=1593391880
https://www.k9cushings.com/forum/attachment.php?attachmentid=8623&d=1593391880
https://www.k9cushings.com/forum/attachment.php?attachmentid=8622&d=1593391880
https://www.k9cushings.com/forum/attachment.php?attachmentid=8621&d=1593391880