My 10yo boxer diagnosed in March - rapid weight loss, extremely picky eating

[Mae]

Hello all, first I would like to say how grateful I am to have found this community; I only wish I found it back in March when my girl Siouxsie (pronounced Suzie) was diagnosed with Cushing's. I will try to break down her story below as a timeline:


January 2021: Exhibited the classic symptoms like muscle loss, pot belly, extreme thirst, ravenous appetite--I knew something was wrong when she stole my breakfast off my plate and looked confused by what she was doing while she gobbled it up!
January 25th: First test administered; results pointed to Cushing's.
March 3rd: First ultrasound to confirm Cushing's (specialist appointments are extremely backed up).
March 15th: Started Vetoryl at 60mg once per day (82lbs) based on specialist's recommendation.
March 29th: Followup stim test; levels looked good. Siouxsie was no longer ravenous, but all the other symptoms persisted.
April-May: Siouxsie's health deteriorated and she dropped to 67lbs. Her appetite was gone, she was very weak, and still very thirsty and having accidents in the house.
June 21st: We did another stim test and the vet was alarmed by the results; sorry I don't know the levels, he just said they were not good and took her off Vetoryl immediately.
June-July: After getting off Vetoryl, she seemed to more "with it" for a couple days but was still picky with food. She was somewhat responsive to anything that wasn't kibble though.
August: Her weight dropped again to 61lbs, and she was barely eating anything now.
August 6th: Took her in for some more testing, which confirmed she was cushingoid again/still. We also got another ultrasound. There was nothing out of the ordinary like cancer or tumors found. I declined to do an MRI. *At this point we are being treated by another vet at the same hospital because that's all we could get-appointments are scarce these days.
August 11th: She was prescribed Entyce to see if that would help her eat, and it did help a little. She started to eat kibble with a little bit of freeze dried raw beef on top.
August 25th: We had several bad days over these two weeks; I found her lying in her own urine several times because she couldn't get up. Without many options left I discussed the possibility of euthanasia, and the vet said to try Vetoryl again at 30mg for 14 days. The problem is she won't eat. I asked for more Entyce, at which point my regular vet called me to discuss further. He says after hearing and reading all that's been going on, there may be something else going on with Siouxsie but at this point there may not even be a treatment available for whatever it is.

And so now we are here. Last week I had 99% convinced myself that letting her go was the right thing to do. But I woke up this morning and decided I couldn't do it yet. I already have the Entyce and the Vetoryl, so I'm going to see how it goes for the next couple of days. I then got her a nice t-bone steak and she gobbled it up. Maybe I am in denial, but I feel like if she could just eat regularly, she will do better.

Anyway, thanks for reading, and I appreciate any insight you may have. And if none, that is ok too, but maybe my timeline of events can help someone else.

[Jonathan]

March 15th: Started Vetoryl at 60mg once per day (82lbs) based on specialist's recommendation.

June 21st: We did another stim test and the vet was alarmed by the results; sorry I don't know the levels, he just said they were not good and took her off Vetoryl immediately.


Hi Mae. Not sure where to start, but I love that you did a timeline for your girls progress. (I did the same for mine)
Im no expert, and Im a few years removed from CushPup status, but Im certain other will come soon with better advice....

As of March 15 you were dosing 60 mg and were told June 21st to cut off vetoryl completely?
My experience was that Cushings was a "roller coaster" in levels, to the point where I still have leftover dosages, from when scrips changed... (hope that made sense)

[Jonathan]

As far as weight gain, I was pleasantly surprised with the notion of "hand feeding"...

Hard boiled eggs (I found myself sharing lol)was something I never thought of before I saw the weight loss of my little girl...

[labblab]

Hello Mae, and welcome to you and Siouxie! I’m really sorry, though, about the problems you’ve been having. I know you’ve come to us for our honest thoughts, so I’ll cut right to the chase here. Since you’ve not told us that her abdominal ultrasound showed any growths or tumors in her adrenal glands, I’m assuming that Siouxie has been diagnosed with Cushing’s arising from a pituitary tumor. If so, from what you’ve described, my prime worry is that her pituitary may be expanding and placing pressure on critical areas of her brain. You mention the suggestion of an MRI — was that to have been an MRI of her head? If so, I’d assume that the possibility of an enlarging “Macroadenoma” may be something your vet is considering, as well.

Unfortunately, boxers are among the breeds of dogs that can be at higher risk from the effects of enlarging pituitary tumors due to the flattened fronts of their skulls. I lost my own Cushpup to what we assume was one of these enlarging tumors. Loss of appetite and ability to drink are common symptoms of this condition, as are increasing lethargy and loss of coordination. My boy, too, started to lose control of his bladder and bowels although he had never soiled himself in the house previously. I know that head imaging is very expensive. We never had it done on our boy, either, partly due to the expense and also largely because we would not have chosen to put him through the prevailing treatment at the time which would have been multiple traditional radiation treatments of his head spread over a month, each one requiring general anesthesia. That remains the most common treatment for macrotumors I believe, although some specialty centers are offering more advanced “cyber” radiation that consists of only a few sessions.

In lieu of radiation intervention, we’ve seen prednisone offered as palliative care in order to temporarily relieve swelling and inflammation of the brain tissue. I know this seems counter-intuitive since it’s the direct opposite of the goal of *lowering* cortisol in Cushing’s dogs. In Siouxie’s case, I’m guessing you’ll find out pretty quickly whether the resumption of the Vetoryl makes her better or even worse. If it’s the latter, I think you’ll want to totally stop it once again.

There may be something entirely different going on with Siouxie. But the possibility of a macrotumor is the one possibility that occurs to me, as sad as it is. So I’d suggest you mention this to your vet to see what he/she thinks. No matter what, please do let us know how things develop for you girls. And please give Siouxie a big hug for me, too.

Marianne

[Kevin]

Haven't posted in awhile but feel like I should on this as its similar to what we are facing. Its difficult to discuss but I appreciate the kindness of this site and feel like I should contribute. You can see my earlier post to see Coopers background. Quick summary-- Boxer Pit mix. Diagnosed with Cush about 8 - 9 months ago. Limited success with Vetoryl, took awhile to get the dose right. Finally got his cortisol numbers correct with a low dose but clinical signs limited in improvement. Neurological signs worsened over time and eating became sporadic so we went ahead with an MRI 3 weeks ago. Note-- after alot of reading, anytime a Cush dog gets finicky with food, antennas should go up on the Pituitary tumor growing. Cush dogs should typically have ravenous appetites.

MRI showed a large Pituitary tumor/actually 2 of them. Michigan State and Purdue Vet schools consulted and lean towards malignant but could not know for certain without a biopsy which is nearly impossible with the Brain. Most Pituitary Cush tumors are benign but not all. Yea, tough times. They also believe Diabetes Insipidus is an issue which may explain why Vetoryl couldn't handle the clinical signs. Both Purdue and MSU indicate radiation could potentially help but can never make guarantees on radiation as they just don't know. Some dogs do very well, some don't improve much. And its very expensive.

I didn't mean to hijack your thread but its eerily similar and I feel like I should add my experience. As Marianne said Boxers/Pits seem to be more prone to the tumors growing and causing neuro impacts. I believe due to their short stubby skulls. I now know more than I wish I did about this god awful disease. Anger, sadness, you name it... I'm mad at the Veterinary world for not developing better protocols for this.

I guess 2 things to add--- Prednisone did help with his eating. It will not decrease tumor size but will lessen some of the swelling/inflammation going on. I've read about some alternating the Trilostane with Prednisone but our Doctors told us that was pointless, that they would just fight each other. Not saying they are 100% correct, but that is what we were told. You will really never know for sure until you go down the MRI / CT scan route. That would be the next step to determine where things stand. And its a difficult road but not impossible. If you thrive on hope and optimism -- some dogs do really well on radiation and some of the Cush signs will improve for a bit though many still have to take Trilostane longterm.

If you have a Cush dog and you see anything like the following-- Circling, "Knuckling"-- won't flip their paws over / drag their paws, shivering or tremors(there is a post on this I believe)... I would advise getting to a Neurologist asap. The sooner you can get there, the better any treatment will be should you go down that path.

Very sorry to hear you are going thru this.