Advice please

[Hkeyse]

Hello,

My name is Hayley and my dog, Piper, was just diagnosed with hypothyroidism about 2 months ago and then with cushing's about a month ago. This last week, she had a hygroma on her elbow that ruptured and discovered it's down to her joint and the tendon is exposed. The vet did explain typically they would have to surgically repair it but did advise how difficult that area especially is to heal with all the movement it has. That, coupled with her two endocrine diseases, the vet explained it could be very hard on her to heal from the surgery and if it didn't take, they would have to amputate her leg. She is 10, and the vet did say he has noticed significant muscle loss since he last saw her about a month ago. I'm just looking for any advice at this point.

Thanks!

[labblab]

Hello, Hayley, and welcome yo you and Piper. Gosh, though, I’m so sorry for Piper’s problems right now. I don’t know very much at all about hygromas, but after quickly scanning a couple of articles, I understand why your vet has concerns about the path forward. Under the best conditions, it sounds like an elbow repair like this one carries a lot of question marks. And unfortunately, it’s true that the endocrinological issues can slow or complicate healing even more.

To help us with our suggestions to you, can you tell us more about Piper’s overall health history, and also the symptoms that led to the thyroid and Cushing’s diagnoses? Have you begun treatment yet for either of those conditions? Oh, what breed is Piper and how much does she weigh? One reason I’m asking is to maybe better gauge how she might do if an amputation were indeed necessary. Although, having asked that, I think that dogs, in general, have an easier time adjusting than humans.

Going back full circle, though, if you can tell us more about Piper’s past health/history and the status of any current treatment, that’ll help us all to move forward. And once again, welcome to you both although I’m surely sorry that this is such a worrying time for you.

Marianne

[Hkeyse]

Thank you Marianne! Piper is just a hound mix and weights about 60lbs. She has started Thyro-tabs when she was diagnosed and her levels have normalized. She has had a pot belly for awhile now and her breathing was labored recently so I took her in and the vet did a blood test and said her thyroid levels were low enough to be classified as hypothyroidism but not so low that he thought she's had it very long, maybe 6 months at the time. He also diagnosed her with a slight case of pneumonia and put her on antibiotics to clear it up.. After her thyroid levels normalized, her symptoms hadn't changed so he advised that usually once there is one endocrine disease, there's another and it was more than likely cushing's and advised to put her on cush-s drops but would take about 2 months to see a difference.

As far as her health history, this has been her only problem minus a stye on her eye a year ago that was removed. She does have all the signs of cushing's as far as thin, frail skin, significant hair loss, the pot belly, drinks a ton of water. My concern about amputation is her muscle loss thus far, if it would be too much for her. I am also selling my house in a month and will be staying with my mother for about 2-3 months until my house is finished, which is another factor for recovery.

[labblab]

Hello again, Hayley, and sorry for the delay in getting back to you. From what you’ve described, it’s indeed possible that Piper does suffer from Cushing’s, but it doesn’t appear as though your vet has proceeded yet with any actual diagnostic testing. So at this point, Cushing’s remains a big question mark. If Piper were truly to be diagnosed with the disease, there are currently only two researched prescription medications that are known to effectively lower cortisol levels. Cush-x drops are not one of those two. Anecdotally, over the years we’ve heard from some members that Cush-x is a nonprescription supplement that has helped to relieve symptoms for some dogs, for a period of time. But to try to learn more about it, we’ve contacted the manufacturer to inquire about any actual clinical studies that may have been conducted to back up their treatment claims. To date, we’re aware of none. So the point being that if you and your vet decide to seriously pursue a Cushing’s diagnosis, Piper would need to undergo additional testing. And if she does have Cushing’s, a prescription medication regimen would likely offer the best chance for genuine treatment success.

Right now, though, would likely not be the best time to actually test her. This is because the two diagnostic blood tests can both give “false positive” results in the face of other systemic illness or injury. So the pain and stress from the ruptured hygroma might falsely skew her results right now. Also, with the acute care that she’ll be needing if you do proceed with surgery, the time would not be good to be trying to launch into a new Cushing’s treatment regimen as well.

So for right now, I realize that the hygroma is your top priority. And what with my delay in replying to you once again, the surgery may already be all over with. I surely do understand why you’ve got a lot to consider right now in trying to make the best decision for Piper moving forward. I don’t know whether anything that I’ve written so far is at all helpful. But please do feel free to ask any additional questions, and to update us as to how Piper is doing.

Marianne