New member: SARDS and Cushing's

[TrishKS]

Hi, I'm Trish and I'd like to thank you for letting me join your amazing group.

We have a gorgeous 8 (nearly 9) year old westie called Bob. Apart from skin issues, he was a healthy, active dog but in January he became very lethargic. He stopped barking (very unlike him), didn't want to go for walks and stopped greeting us when we came home. He had always been an incredibly over zealous pooch and used to love to run around doing zoomies when he got excited. He still had a very good appetite though and there was nothing wrong with him in the toilet department either. Our vet at the time suggested a full panel of blood tests. The results were pretty inconclusive. His thyroid levels were a bit low and liver enzymes a bit high (they attributed the high liver enzymes to his apoquel medication) but not overly so and nothing significant to suggest what it could be. We were told to go back in three months. We were worried sick about him. He wasn't himself at all so we decided to get a second opinion about a month later from a different vet. Very similar blood test results again but they were concerned he may have hypothyroidism. After another round of blood tests a little while later they gave us Thyforon to try. It didn't really do much for him and it was decided we should wean him off them. In May Bob began to bump into things and trip up steps etc. The vet was concerned he may have a tumour. The Vet wanted Bob to have a thorough check over with an ultrasound, MRI and x-ray. Nothing was found. It was obvious Bob was having difficulty seeing. The vet checked his eyes but could find nothing wrong. He was then referred to a specialist vets which had an ophthalmology department. They suspected SARDS and diagnosed this on a follow up appointment.

Here we are 9 months after he became ill. He is completely blind but adapting well. However, he doesn't have much stamina when walking. At first we put this down to anxiety but this isn't the case. He's keen to go but he'll walk for around 15 minutes and then slows down and his tongue hangs out the side of his mouth. He pants a lot more than he used to, sometimes it wakes him up. He's back to barking at noises he sometimes hears and greeting us when we come home but he isn't there yet. He's been on liver supplements (which unfortunately started to upset his stomach) which have lowered his liver enzyme levels but his bile acid was high on this occasion. His thyroid levels are now within the normal range. The vet suspects Cushing's disease and says it often goes alongside SARDS. We are awaiting the blood test results which were carried out on Friday. Having read about Cushing's we're really scared and apprehensive for him and us (we don't want to lose him and read it can shorten their life). We've read some worrying comments about the medication and wonder what to do if he has it. The vet is also talking about doing another ultrasound. Will this show up anything new, considering he only had one in May? I feel as though we're on a road we can't get off and I don't really like where we're heading. We just want Bob back to feeling good again so he can enjoy life. There has been improvements and he's much better than he was back in January.

[labblab]

Hello Trish, and welcome to you and Bob — we’re really glad you’ve found us, too! I’m surely sorry about Bob’s problems this year, but glad to hear that he seems to be making adjustments to the blindness. Other owners of blind dogs have given us similar reports: the dogs themselves are often able to adapt to the vision loss much easier than their parents initially fear.

SARDS remains a very perplexing illness, but your vet is correct that it can occur alongside Cushing’s. There appears to be a hormonal component to both diseases, but the mechanism of any actual connection remains unknown. Many dogs with SARDS initially exhibit symptoms consistent with Cushing’s, but these symptoms sometimes drop out over time and Cushing’s is no longer suspected. That’s why it may be advisable to hold off on a Cushing’s diagnosis for a while after blindness first manifests. But if Bob’s symptoms are still present — and even worsening — after nine months, I understand why the vet is considering Cushing’s, as well. It may be that he wants the repeat ultrasound to get a better picture of both Bob’s liver and adrenal glands. The adrenal glands can be difficult to visualize well using standard ultrasound equipment. That’s why referrals are often made to specialty practices for this particular imaging. And if Bob’s liver is showing more abnormality, that could also be reason for a repeat view.

One question I have is whether Bob is exhibiting changes in his thirst, urination, appetite, and coat. Excessive thirst and urination, ravenous appetite, and hair loss are classic external Cushing’s symptoms. I don’t think you’ve made mention of them, so I’m wondering if they’re present for Bob. If so, that would add greater confidence in the diagnosis if Bob’s blood testing is also consistent with the disease.

Just to let you know, if Bob indeed has Cushing’s, existing medication can be very effective in reducing the symptoms and staving off longterm internal damage. We’ve witnessed many success stories here. Of course, there are many challenging ones, as well. But one key factor is a good partnership between the parents and the vet, and it sounds as though you already have a very good start there! So we’ll be looking forward to learning more about Bob’s situation and those test results. And then we’ll go from there.

Once again, welcome to you both!
Marianne

[TrishKS]

Thank you so much Marianne for your message.

I heard from our vet this evening. Bob's test results for Cushing's and liver function are normal. We are all perplexed but your comment earlier that symptoms cane abate over a period of time after the onset and blindness, has given me hope that this might be the case for Bob. We've ruled out all the obvious.

The vet has suggested more blood tests in 8 weeks or so if symptoms persist and a referral to a specialist vet. Hopefully, Bob will improve over time.

Thank you again for all your helpful advice.

[labblab]

You’re so very welcome! I’m really relieved to hear that Bob’s labwork has turned out normally, and I think your vet’s gameplan makes a lot of sense.

We’ll always be here if you need us again, but in the meantime, I’ll keep my fingers crossed that things just keep on getting better for Bob.

Best wishes to you both!
Marianne

[TrishKS]

Thank you so much Marianne. We were very relieved but also surprised as he has many of the symptoms. His skin has flared up, he pants a lot, he drinks more nowadays (although doesn't have accidents), he has a big appetite and is lethargic compared to how he used to be pre-January. We'll keep a close eye on him and hope for the best.

Please keep on with all your great work.
Very best wishes
Trish x