Bonnie (8 yr old Amercan Eskimo) Cushings? SARDS? [Archive] - Canine Cushing's Information and Support Forums

craig

07-26-2009, 09:43 PM

We have two American Eskimos that are 8 years old. They are Bonnie and Clyde.Recently Bonnie has lost her spunk. She does not jump up on anything and is very lifeless . She drinks excessively and urinates alot more. Her appetite has increased dramatically. She even growled at Clyde over food. Before this ,she would generally never finish her food. She had two accidents on the rug last week.Her eyesight seems greatly diminished also. She actually bumped into objects yesterday. We took to the vet a couple of weeks ago thinking maybe diabetes,but the vet said she was negative. Bonnie had been limping so the vet said to keep her from going down stairs etc. We were going to take her to have her eyes checked when all these other syptoms seemed to appear at once. A friend said that maybe she has Cushing's . So we are taking her for tests tomorrow. Bonnie has to fast tonight and they will draw blood initially tomorrow then do the test. I will ask tomorrow if it is a low dose test. I have been reading everything i can about Cushings and the meds for it. Bonnie was the most spunky dog we have had and now she is so lethargic. We hope that we caught it in the early stages iuf it is iundeed Cushings. I know Lysodren is one med that has been used.Is the new med from the UK as effective.I know it does not destroy the Adrenals like Lysodren. It is an enzyme inhibitor. I hope to have the results to post tomorrow.It is very nice to have a great site where pet lovers can help others. I ;look forward to your help because Bonnie is such a sweet dog .Craig

gpgscott

07-26-2009, 09:50 PM

Hi Craig,

I moved your post to this area where most of the discussion of treament etc... goes on.

Welcome.

The symptoms you are describing do conform to a Cushing's diagnosis. It is important now you are entering the phase of diagnostics that you keep records of what tests and results.

Cushing's is very treatable, in particular when it is caught early.

So by now you have found the new thread (I saw you posting). Please let us know more.

Scott

Roxee's Dad

07-26-2009, 10:19 PM

Hi Craig,
I would also like to welcome you and Bonnie. Please do let us know what test are being performed and the results. Has Bonnie had a wellness panel performed (Blood test) lately? If yes, please do post the abnormal results including the reference ranges.

As has been said, we are here to help in anyway we can, experiences, advice, opinions and handholding. Feel free to ask any questions or just express your thoughts, sometimes it helps knowing there are others of us in the same situation and sharing the same feelings.

If Bonnie does prove positive for cushings, I would ask your vet about his or her experience with cushings. It is important to have a knowledgeable vet to work together as a team with you for a successful treatment. There are different meds, Trilostane, Lysodren, flax hulls and melatonin. Each can be successfull but it really depends on the type of cushings that is diagnosed as to which treatment may be recommended. Each are safe if used according to protocol and monitored accordingly. There are so many success stories here. So hang in there and let's get a proper diagnosis.

Give Bonnie and Clyde a belly rub from us.:)

StarDeb55

07-26-2009, 10:32 PM

I would like to welcome you & Bonnie, also! Craig, let me give a better explanation of how lysodren works. A lot of new members who are beginning the diagnostic phase, & are just learning about Cushing's have a big misconception about lysodren. The purpose of lysodren therapy is to necrose (destroy) enough of the adrenal cortex where all of the excess cortisol is being produced, to bring down the cortisol to a more healthy level. Normal cortisol for our cushpups is 1-5 ug/d. Lysodren does not destroy the whole adrenal gland. The only way that might happen is if the pup is give to much of drug to cause an overload situation. As long as your vet is using lysodren according to standard loading, dosing, monitoring protocols, there should be no problem. Vetoryl or trilostane is, also, a very powerful medication that may cause just a many serious problems as lyso can when used by a vet inexperienced in the proper protocols for the drug. I have now treated 2 pup with lysodren successfully, My 1st boy was treated for nearly 8 years, crossing the bridge at 15. Harley has been on lysodren for about 18 months & is doing well.

I must also warn you that there is one large drawback with Trilostane. There is a type of Cushing's called Atypical caused by an elevation in one or more of the intermediate sex hormones that the adrenals produce, with or without a concurrent elevation of cortisol. Trilostane is not an appropriate choice for an Atypical pup. If you are really interested in using Trilo, I would strongly suggest you have a full adrenal panel done at the Univ. of Tenn., Knoxville which will give the information about these intermediate hormones. UTK is the only lab that we know of in this country, if not the world, that is doing this testing.

Please get copies of all test results done on Bonnie & post them for us. This group is very big on numbers & results, so you can't ever give us too much information. The best thing you can do for Bonnie, now, is become a knowledgeable owner, as you are her only voice & advocate. Please take a look at the important information & resource section of the forum where you will find a huge number of links that will lead you to just about any information you will need to about Cushing's.

Please keep us posted as you proceed with Bonnie's diagnostics.

Debbie

lulusmom

07-26-2009, 10:39 PM

Hi Craig and welcome to you and Bonnie,

The symptoms you describe certainly fit with cushing's but the sudden loss of vision makes me think that Bonnie has SARDS (Sudden Acquired Retinal Degeneration Syndrome) or a similar condition called IMR (Immune Mediated Retinopathy). SARDS dogs lose their vision in a matter days to a week or two and often develop symptoms associated with cushing's before or after going blind. Nobody seems to know the cause nor if there is a true connection to cushing's as often times, the symptoms will actually resolve without treatment within four to six months. I would suggest that you get Bonnie in to see an opthamologist as soon as possible. I am providing a link to information on SARDS and IMR below. Please take the time to read through it.

http://k9cushings.com/forum/showthread.php?t=213&highlight=SARDS

Bonnie is a Spitz breed like my Pomeranian, Lulu. Spitz are part of the Nordic family of breeds and many of them are predisposed to hormonal imbalances. My Pomeranian has pituitary dependent cushing's with elevation of all adrenal steroids and intermediate/sex hormones. Bonnie has two predispositions to elevated intermediate/sex hormones; she is a Spitz and she may have SARDS. Dogs with SARDS, almost without exception, at some point will have elevated intermediate/sex hormones, in which case, Trilostane is not the treatment of choice because it always causes further increase in elevations with long term use. I know this to be true because Lulu treated with Trilostane for two years and I almost had a heart attack when I saw the results of her full adrenal panel. Every single intermediate was through the roof. So before you choose a treatment, it is very important that one of the diagnostic tests that your vet does is the full adrenal panel from the University of Tennessee Knoxville (UTK). This is the only facility in the world that runs these panels and most of us have a record on file there. A lot of gp vets are not familiar with this test so if that is the case with Bonnie's vet, I am providing a link to UTK which has all of the information s/he needs.

http://www.vet.utk.edu/diagnostic/endocrinology/index.php

I am also providing a link to a blind dog survey below and you will readily find that there are a lot of folks out there dealing with their pets sudden loss of vision. There is some great information there, including tips on how to help your pet adapt to being sightless. Be sure to take the survey as the more people that participate, the more meaningful the data.

http://blinddog.info/survey.shtml

You are not alone in this as we are all here to help in any way we can. I am sure that watching Bonnie struggle through this very difficult time is painful for you. Most of us have had the gut wrenches and some of us more than once. I have two cushdogs; however, both still have their vision. I am so sorry for the circumstances that brought you here but I'm very glad that you're here.

Glynda

P.S. I see that Debbie posted while I was rambling on so I apologize for any duplication.

Harley PoMMom

07-27-2009, 08:29 AM

Hi Craig,

Welcome to you and Bonnie from me too. I too am sorry for the circumstances that brought you here but I'm so grateful that you found this fourm with these very knowledgeable people. They have helped me with my cush-pup Harley tremendously.

My Harley had almost all the cushings symptoms: excessive peeing, drinking, ravenous appetite, weakness in his hind legs, a pot-belly appearance and accidents in the house. I took him to his former vet and he ran a LDDS test on Harley, which the vet said confirmed cushings, he wanted to treat Harley with Trilostane.

At the urging of the wonderful people of this forum I had the full adrenal panel done on Harley, this was done before starting the Trilostane, and the panel showed Harley's one hormone is very elevated, therefore Trilostane is NOT an option for him. Harley is known as having Atypical Cushings. His treatment consist of melatonin and flax hulls.

I've also had an ultrasound, endogenous test and many senior blood test done on Harley. It took me almost 3 months to get a proper diagnosis of which kind of cushings Harley has. So please take your time to get a proper diagnosis for Bonnie, the full adrenal panel I strongly advise. Because if you go for treatment first and then decide to do the panel, then you have to wait and do what's called a wash-out period so you get good readings. Your vet can do the draws of blood for the panel, then he sends them to the lab in Tenn. We have the links for you.

The best advice I can give you is to read, read, read all you can from the Resource Section, post questions...bc what you don't understand you can't learn from...and when the "other's" give you advice on something, as I seen they have, I would listen, bc there is a vast number of years of collective cushings experience under these people belts.

Hugs.
Lori

Squirt's Mom

07-27-2009, 12:55 PM

Hi Craig and welcome to you and Bonnie! :)

I just love the Bonnie and Clyde names! That is so cute! (Tho I kinda doubt "cute" is what you were after...:D )

When I read Bonnie's story my first thought was also SARDS and I am glad Glynda chimed in as she has done some research on the topic as you can tell from her reply. The main thing right now is to take it slow, know exactly what you are dealing with before starting treatment of any kind.

Lyso and Trilo are both very powerful drugs and are not to be used lightly or with little data to support a Cushing's diagnosis. Let me share a bit of my Squirt's story with you in the hopes you will see just how important testing is...Squirt was diagnosed in 3/08 as having PDH, the pituitary form of Cushing's. This diagnosis was based on the LDDS, the HDDS, and an ultrasound. Because of what I learned here, I wanted to eliminate all possibilities so I had the ACTH and UTK panel done (for Atypical); Squirt was diagnosed as also being Atypical and they recommended another U/S. The second U/S resulted in the removal of a splenic tumor. Since her surgery, her cortisol has returned to normal levels and her docs now say the original diagnosis of PDH is "highly questionable." So it is now 7/09, one year and 4 mos later, and she has still not had to start Lyso yet (Trilo is not an option since she is Atypical). So go slow, take the diagnostic phase seriously and be thorough, and don't let anyone talk you into starting treatment until there is no doubt it is needed.

I also want to address the misconception you, and many others, have about Trilo. It can and does "kill" the adrenals just like Lyso if not handled correctly according to protocol based on a definitive diagnosis. I felt the same way about Trilo when I first began this journey and was terrified of Lyso. My opinions have done a complete reversal as I have learned more. Even if Trilo were still an option for Squirt, I would not use it unless it was the only option. But that is just MHO. Many pups have done excellent on Trilo. I agree completely with Glynda and others about having the UTK panel if you are considering Trilo, tho.

The best thing you can do for Bonnie is to continue learning all you can about Cushing's, it's treatment options, and it's related conditions. You can find a lot of good info in the Resources section here:

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

I also have some other links that are easy to understand if you are interested. Read all you can including the threads of others here, ask lots of questions, and you will do just fine I'm sure. We are here to help you in any way we can, so please don't hesitate to ask.

I am so glad you found us and hope to learn more in the near future!
Keep your chin up!
Hugs,
Leslie and the girls

craig

07-27-2009, 03:23 PM

Hello and a big thanks to all those who have kindly responded. We had the vet vet do blood work on Bonnie two weeks ago because we thought she might have an undersecreting thyroid like Clyde has. Clyde is on soloxine and has been fine for two years. We initially thought since Bonnie was sluggish and gaining weight,that since they are littermates,they might have same condition. Her thyroid test was normal so we then ruled that out. I am asking the vet for a hard copy of those results so I can post them.I am picking up Bonnie today after her 8 hour test. Are there any specific questions I should ask the vet right away. It seems that the full adrenal test in Tenn is recommended.Should I also inquire about her alkaline phosphatase level. What numbers from this test and the low dose test today indicate cushing's? Since it was mentioned that maybe SARDS is a possibility,is there something specific I should ask the vet that she can look at?I will keep you posted on the results tonight. Thanks again .Craig and Bonnie

craig

07-27-2009, 03:38 PM

Hello again. I have a couple of other questions. Will vets automatically do an ultrasound or will they generally rely upon the low dose test for their opinion? Is there anything in the low dose test that can indicate SARDS instead of Cushing's? Craig

Squirt's Mom

07-27-2009, 04:09 PM

Hi Craig,

The LDDS will not give any indication of SARDS that I am aware of. Based on the results of this test, your vet may go on to the U/S or some vets prefer the HDDS to be included in the history so that will be done first. Not everyone has the HDDS done but my vet wanted it so we had it. Here is some info on the LDDS for you:

Low Dose Dexamethasone Test (LDDS)

The protocol utilized for this test is obtaining plasma samples
for cortisol before and 4 and 8 hours after I.V. administration
of 0.01 mg/kg dexamethasone. The 8-hour plasma cortisol
is used as a screening test for hyperadrenocorticism, with
concentrations >1.4 μg/dl being consistent with (not confirming) the diagnosis of Cushing's syndrome.

This test is relatively sensitive and specific, but not perfect. Approximately 90% of dogs with Cushing's syndrome have an 8 hour postdexamethasone plasma cortisol concentration >1.4 μg/dl
and another 6 to 8% have values of 0.9 - 1.3 μg/dl.

The results of a low dose test can also aid in discriminating PDH
from ACT, using three criteria:
1) an 8 hour plasma cortisol >1.4 μg/dl but <50% of the basal value;
2) a 4 hour plasma cortisol concentration <1.0 μg/dl; and
3) a 4 hour plasma cortisol concentration <50% of the basal value.

If a dog has Cushing's and it meets any of these three criteria, it most likely has PDH. Approximately 65% of dogs with naturally occurring PDH demonstrate suppression, as defined by these three criteria. A dog with Cushing's that fails to meet any of these three criteria could have either PDH or ACT. However, if it has two relatively equal sized adrenals on abdominal ultrasonography, it most likely has PDH.

IMHO, and based on Squirt's cush history, an abdominal ultrasound done with a high resolution machine and the UTK panel are the most crucial diagnostic and confirming tests available. You may need to get a referral to a specialist (IMS) for the U/S but your vet can help you out there. Here are some links about the UTK panel and Atyipcal:

http://www.vet.utk.edu/diagnostic/endocrinology/index.php
(The test you want is under the third heading, Adrenal Function, the seventh item down, Adrenal Panel (ACTH stim)-dog,cat-serum-adrenal function-$140.00. Your vet will tack on their charges for services as well as the shipping charges so the total cost to you will be more, usually in the $2-400 range..

Atypical Cushing’s:
(Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone – an elevation in one, all, or any combination of these hormones, without elevated cortisol; with or without presence of a tumor.)

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=485128&sk=&date=&pageID=1

http://www.vetcontact.com/en/art.php?a=132&t=

http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php

As for what to ask today, for copies of all her testing so far like any blood work-ups. That will show the ALT and ALKP as well as other levels that may be out of whack. You might want to ask what drug they usually prescribe, if they are familiar with Atypical, how many cush patients they have successfully treated, and just try to get a feel for whether or not they are going to work with you as a team. Teamwork between you and the docs is very important.

It sounds like your vet is doing a good job of ruling out other possibilities so that is a relief and a good sign. You have done a great job yourself, so keep up the good work!

Hope this helps,
Hugs,
Leslie and the girls

Harley PoMMom

07-27-2009, 05:17 PM

Hi Craig,

The only thing I'm going to add is, don't be too surprised if your vet doesn't know about Atypical Cushings or he/she has never heard of the full adrenal panel, like Leslie mentioned if your vet is willing to work with you, this is really important.

Harley's new vet never heard of Atypical Cushings or the full adrenal panel, but these wonderful people here posted the links for me so I could print them out and take them to Harley's vet. Harley's vet had no problems following the directions on what to do, I was charged $235.00 for the full panel and received the results in 2 weeks.

Best of luck to you and Bonnie...will be looking for your updates.
Lori

lulusmom

07-27-2009, 05:20 PM

Hi Craig,

Please see my comments in blue below to your questions.

I am picking up Bonnie today after her 8 hour test. Are there any specific questions I should ask the vet right away. Yes, please discuss SARDS with your vet and ask him/her for a referral to an opthamologist to confirm the cause of Bonnie's blindness. As I mentioned, if it is SARDS, your decision re treatment and choice of treatment should be guided accordingly. It seems that the full adrenal test in Tenn is recommended. Even if SARDS were to be ruled out, Bonnie is a breed with a predisposition to hormonal imbalances and if you are contemplating treating with Trilostane, the UTK adrenal panel is a must. Dr. Oliver at UTK is familiar with SARDS and it's relationship to adrenal steroids so if your vet is unfamiliar with the condition and/or has questions regarding intermediate/sex hormones, please have your vet call Dr. Oliver. He has always made himself available to answer questions and it is free of charge. Should I also inquire about her alkaline phosphatase level. Elevations in Alkaline Phosphatase (ALK), a liver enzyme, is just one of the usual abnormalities that is seen in a cushdog. ALT and GGT, cholesterol, triglycerides and a few others are also common. It is the ALK, however, that usually tips off a vet that cushing's may be involved. What numbers from this test and the low dose test today indicate cushing's? Leslie has already given you information as to how to interpret the LDDS but please post the results for us. Please keep in mind that if the results are consistent with cushing's, your vet should not confirm a diagnosis based solely on one diagnostic test. Please also keep in mind that false positive results are common in a dog with nonadrenal illness or very stressed out, which is all the more reason for further validating testing. If it were my dog, I would ask the vet to request the UTK panel as well as an abdominal ultrasound. Since it was mentioned that maybe SARDS is a possibility,is there something specific I should ask the vet that she can look at? If your vet has never heard of SARDS ask her to give Dr. Oliver a call or a specialist/opthamologist. There is a fair amount of info in the link I provide you previously that you can share with her. I will keep you posted on the results tonight. Thanks again .Craig and Bonnie

A lot of dogs diagnosed with SARDS do not have elevated cortisol which is common in typical cushing's. It is therefore possible that Bonnie's LDDS results may be normal. In these cases, it is usually one or more of the other adrenal hormones and steroids that are elevated, which by the way, can cause the same symptoms that you see in typical cushing's. Again, the UTK panel is the only facility to provide this information. I could go on and on but I have a feeling that you are on information overload and your brain is flashing, "tilt, tilt, tilt" so I'll stop torturing you now.

Glynda

P.S. Okay so I lied...I wasn't finished. Just wanted to add that we have had a number of members whose dogs were diagnosed with SARDS so we are familiar with the condition.

craig

07-27-2009, 07:14 PM

We have received our results from the low dose test and here they are;
8am blood test= 3.6
low dose dexamethadone .2cc
12 noon test= 1.0
4pm test= <0.5

The vet said test indicates no cushing's so our as one person suggested maybe it's SARDS ;We are scheduling an eye test in Charlotte,hopefully this week. They were closed when we got home.The vet said Bonnie's blood test results were all normal with the exception of the following; alkaline phosphatase( 346)normal is 10-150 ,AST(SGOT)( 65)normal is 5-55,CK(519) normal is 10-200,MCHC (36.1)normal is 32-36 T4was low(.8) where normal is .9-3.9 and her cholesterol was(340)normal is 112-326 .I have to look up what these numbers represent levels and see what that might indicate. Bonnie's vision seems to be worsening by the day which is scary.She can barely see if she can see at all.She is moving on sounds and instinct. I was given a link to SARDS so I am focusing on that but also keeping Cushing's open as well. The vet said Bonnie is overweight as well. She should lose c10 lbs.I think her thyroxine is low like Clyde's and maybe could use soloxine as well. The vet mentioned about a spray that the dog is given in their mouth to lose interest in food. I think I might just cut back on her food . I first have to focus on maybe the vision problem first because it seems to worsen daily. We are calling an opt. in Charlotte as soon as they open tomorrow. Any suggestions? Thanks again. Craig and bonnie

Harley mom (Lori) ;I noticed you are from York. My daughter just graduated from York college in 2007 with a degree in criminal justice and forensic chemistry.She was captain of the soccer team. She is working for NYPD crime lab. We loved York. Small world.

StarDeb55

07-27-2009, 08:11 PM

Craig, as several of us have pointed out, this could very well be Atypical Cushing's. In light of the normal LDDS, I strongly suggest you proceed with the full adrenal panel, especially in light of Atypical's conncection to SARDS.

Debbie

lulusmom

07-27-2009, 08:18 PM

Hi Craig,

I can't say that I'm surprised that the LDDS came back negative for cushing's and I think that it is Bonnie's other adrenal hormones that are causing the symptoms you are seeing as well as the labwork abnormalities you listed in your last post.

I am so happy to hear that you are moving quickly to get Bonnie in to an opthamologist. They have had some success with treatment of SARDS and IMR but it is imperative that a dog be diagnosed quickly.

Quote by Dr. Sinisa Grozdanic http://www.sciencedaily.com/releases/2007/05/070531094241.htm

"Once a dog gets SARDS, the retina degenerates quickly, so it's important the dog is treated with IVIg very soon after diagnosis," he said. "Usually dogs that have SARDS for longer than two months have severe retinal changes. The sooner it's treated, the better chance it will work."

I'll be looking forward to hearing about Bonnie's appointment with the opthomologist.

Glynda

Harley PoMMom

07-27-2009, 08:40 PM

Any suggestions? I beleive Glynda and Debbie got you covered there. :)

Thanks again. Craig and bonnie

Harley mom (Lori) ;I noticed you are from York. My daughter just graduated from York college in 2007 with a degree in criminal justice and forensic chemistry.She was captain of the soccer team. She is working for NYPD crime lab. We loved York. Small world.

OMGoodness, York is very happy and honored to have her, you must be very proud of your daughter, that is quite an accomplishment.

Hugs from your York, PA. friends.
Lori and Harley

gpgscott

07-27-2009, 09:42 PM

Hi Craig,

As has been pointed out LDDS is not conclusive as there are hormones other than cortisol which LDDS will not disclose.

Please proceed with all haste to the opto Dr. to try to arrest the vision loss.

And like the others, I think your next step at this point is the full adrenal panel from UTK.

Scott

craig

07-27-2009, 11:42 PM

craig

07-27-2009, 11:49 PM

Can anyone tell me what the AST numbers and the MCHC categories of the blood work represent? Are they the int. hormones from the adrenals? I read the report tonight but the vet was already closed. Thanks. Craig

AlisonandMia

07-27-2009, 11:56 PM

AST refers to a liver enzyme and MCHC stands for "mean corpuscular hemoglobin concentration" and is part of a standard full blood count. Both the AST and the MCHC would be part of the standard senior panel. Where the results on those ones out of normal range?

If you want to post the results of any blood tests there are people here who can help you with interpretation.

Meanwhile here's a link you might find helpful: http://www.k9cushings.com/forum/showthread.php?t=204

Alison

lulusmom

07-28-2009, 12:49 AM

Are these numbers consistent with atypical cushings? Iam not that familiar with indicators for A typ Cush. Does the vet take the blood sample and send it directly to UTK or do I have to arrange the transfer. I think that i read somewhere that the results can take two weeks.I will talk to the vet tomorrow and ask her about atypiucal cushing's. If she is not familiar with it,I will still take the blood sample while persuing the opthom. appt. Thanks. Craig and Bonnie

Hi Craig.

Your vet does the blood draws and can send it directly to UTK. Most vets send to a lab they contract with and the lab then sends to UTK. If you can get your vet to send directly to UTK, it will save you money. Your vet can call UTK and receive instructions on everything from how to do the blood draw and how to package and where and best day of the week to ship. The blood draw is done like a normal acth stimulation test and I am sure your vet knows how to do this. As I mentioned before, the University of Tennessee is the only facility that does the full adrenal panel so none of the blood tests that your vet has done will give you any information about the intermediate hormones.

Glynda

StarDeb55

07-28-2009, 07:38 AM

Craig, Glynda has pretty much got you covered about the UTK panel. The only thing I will add is that part G of the following link will give you specific information on how to submit sample to UTK.

The AST & alkaline phosphatase, along with cholesterol are all considered to be liver function tests. In fact, an elevated alk phos is usually what will clue a vet to possible Cushing's in our pups. The elevations in these 3 tests are quite common among cushpups due to the liver damage that is caused by the liver having to handle the overproduction of cortisol & other adrenal hormones. Assuming Bonnie has Atypical Cushing's, once she is being treated for that, these tests should improve.

http://www.vet.utk.edu/diagnostic/endocrinology/general.php

Debbie

craig

07-28-2009, 12:57 PM

We have an opth. appointment in Charlotte tomorrow morning. We had Bonnie's records faxed over already. Would the opth. be familiar with Cushing's/Atyp Cush and blood test results as a probable causes.I am hoping that he can connect the dots by using the test results. There seems to be a connection to all of this with Bonnie's immune syste m. In the past Bonnie had scabs on her nose that a vet said was an immune system problem.She gave Bonnie some type of gel for it and it cleared up. She developed this again recently.Maybe i should also ask about a supplement for her immune system and the proper dog food. In reading up on the internet,many suggest that commercial dry dog foods are possible sources for Bonnie's problems. We give our dogs Purina weight management dog food because Clyde was overweight and on soloxine.Is there any consensus on which foods are better? Hopefully we will know more to morrow.Thanks again.Craig and Bonnie

Harley PoMMom

07-28-2009, 01:23 PM

Hi Craig,

I never dealt with an opthamologist, but I would imagine that a really good one would be able to do the Cushings/Sards link, if I were you I would print out the links Glynda posted for you about the Atypical/Sards and IMR and show it to the opthamologist.

Most of us feed our cush dogs a better quality dog food...one not sold in a regular grocery store...some feed homecooked...some feed raw(Primal? spelling might be wrong), I do both cooked and regular high quality dog food. I believe it makes a difference, I'm not saying feeding grocery store dog food causes cushings, I'm saying it makes a difference in us humans..eating better foods... right...so why wouldn't it make a difference in our furry friends, that's my logic. :) I use Innova Senior Plus dry & canned. I think somewhere there is some links to websites for dogfoods so you compare them...have to see.

Hugs from your Yor, PA. friends.
Lori and Harley

Harley PoMMom

07-28-2009, 01:28 PM

Hi Craig,

Hope these help.

Hi Felice,

Here are a couple more links:

Research on dog foods
http://www.dogtorj.net/

Whole Dog Journal
http://www.geocities.com/rottndobie/wholedogjournal.html

Is it this one?? I've found it helpful.

http://www.dogfoodanalysis.com/dog_food_reviews/

Tammy

Lori

Squirt's Mom

07-28-2009, 04:55 PM

Hi Craig,

Glad to see you have an appt for Bonnie with the eye doc. That is an excellent, wise first move!

Here are a few more links on feed for you, plus some on a few good discussion groups:

Feed
BMD Health Library*
http://www.bestbeau.ca/bmd_health_links_4.htm
(scroll down for Dog Food Information)

Primal pet foods-raw available
http://www.primalpetfoods.com/

A link on food ratings:
http://www.petfoodratings.net/

Pet Nutrition Principles
http://www.thepetcenter.com/imtop/nbasics.html

Discussion groups for canine nutrition:

http://pets.groups.yahoo.com/group/ThePossibleCanine-Nutrition/

http://www.doggiedietician.com/aboutus/discussions.php

http://pets.groups.yahoo.com/group/K9Nutrition/

(If you would like the gory details of what you might find in many general commercial feeds, I have a couple of links on that as well.)

I home-cook for my cush pup most of the time, a menu design especially for her by a nutritionist. When I can't, she gets a high-quality canned feed. The others eat high-quality canned and dry feed - Innova, Evo, Eagle Pack, and California Natural. I have noticed that PetCo has picked up some better feeds lately but for the most part you will find these feeds in pet specialty stores...and hopefully not one that sells animals of any kind. ;) The store we use is called All About Pets but I don't know if they are a nat'l. chain or just a local one.

You are doing a good job with Bonnie. This can all be so overwhelming at first, especially if there is another condition to consider like SARDS. Just take your time, concentrate on her vision first, then start on the Cushing's if needed. As Glynda said, some pups with SARDS loose the cush signs after a bit and do not need treatment. Based on the LDDS results, I would have to say the pursuing that right now is secondary for sure. It indicates her adrenals are handling the cortisol as they should and they wouldn't if she had true Cushing's.

Once you have a plan in place with her eyesight, then look into having the UTK panel done if she is still showing signs and her chem work is still out of whack. If her signs disappear, then it is possible they were all attributable to the SARDS and no treatment will be needed.

Cushing's is a slow progressing condition and that includes the Atypical form as far as I know. So you have time to be sure of her vision plus learn a bit about Atypical before you have to take any action there. Just one step at a time, ok?

Keep up the good work!
Hugs,
Leslie and the girls

StarDeb55

07-28-2009, 06:09 PM

Craig, the best diet for a cushpup is one that is low fat as cushpups have a tendency to developing pancreatitis. I'm one of the members who feed Primal raw diet which meets the low fat requirement, along with the having no grain as my Lhasa is very allergic.

Concerning your comments about Bonnie's immune system, Cushing's is known to suppress the immune system, so it is very common for our babies to have repeated infections that can be difficult to control, especially with their skin/coat.

Debbie

ventilate

07-28-2009, 07:34 PM

Hi and welcome from me and mine;
I notice you said you have an appt in Charlotte. Where are you located at? I am in Asheville NC. My dog is a Giant Schnauzer who has had cushings diag for 3.5 years now. I agree with the others, if your dog has the symptoms and the Low dose was - atypical is a definate possiblilty.
good luck with the eye appt.
Sharon

craig

07-29-2009, 03:14 PM

We just returned from our visit with the OPT in Charlotte and he confirmed that Bonnie indeed has SARDS. He mentioned the 1% chance that a pituitary tumor could cause the problem and said that in that 1% prednisone can be taken over a period of time. If there was any vision corrected,it would be noticed in the next 4 days.He left that option up to us. He said that Cush symptoms generally abate in 4-6 weeks after SARDS occurs.Bonnie's retinas were very thin and the degeneration was severe.That was why he did not give much hope to the prednisone option;but he understood if we wanted to persue it. He reassured us that dogs deal with blindness much better than we do and he gave us literature to read about blind dogs. As for the atyp Cush, we still might go through with the tests anyway.We pray for Bonnie and maybe with a bit of (higher-up) help the pred might work for her.We will see. She is familiar with her surroundings and her brother (clyde) so at least she has comfort now. I will keep everyone posted on her and want to thank everyone who has weighed in on her behalf. Pets are like family;they are special.Thanks again. Craig and Bonnie

Harley PoMMom

07-29-2009, 08:22 PM

Hi Craig,

I am so sorry that Bonnie has SARDS, from what I've read the dogs do deal with the blindness amazingly, all their other senses heighten and as long as one doesn't rearrange the furniture the dog can find it's way around easily.

You and Bonnie are in my thoughts and prayers, please keep us posted on how you both are doing as you both are family now. :)

Hugs from your York, PA. friends.
Lori and Harley

frijole

07-29-2009, 10:31 PM

Hi Craig, I'm glad you posted an update. I just wanted to share that my cushings dog is 15 1/2 and was diagnosed 3 yrs ago. She is doing great but old age has caught up with her. She has very little hearing left and the cataracts that had been slowly growing have taken almost all her site.

I am amazed at how she gets along. The way she runs thru the house etc you would never know. I catch her running alongside her sister and so I am sure that Clyde will be a great help and companion to Bonnie.

I just wanted to share that my girl runs around all happy and is enjoying life despite a loss of senses and so what you are told is absolutely correct. I think its harder on us than them. Hang in there and keep us posted. Kim

craig

08-02-2009, 02:34 PM

Hello everone. I have been doing research on the SARDS for Bonnie and have come across many intersting sites. I have read articles from Caroline Levin,Dr, Plechnar,Dr. Groz and I am seeing a connection between SARDS and what is called adrenal exhaustion. i think it has syptoms similar to atypical cush. They mention that ACTH tries to stimulate cortisol but can cause an elevation in the estrogen produced.This in turn causes calcium to be aborbed by the nerves in the eye and leads to retinal degeneration. They say that with early teatment some of the nerves still unaffected can show electrical stimulation and maybe 20% can restore some vision. So I am trying to find out what I can give Bonnie to help lower the estrogen levels.Her initial cortisol before the low dose test was 3.4 which the vet said was normal. Is there any meds she can take. i would like to go natural to avoid any liver problems if possible. Are the flaxhulls of benefit, i also read that taurine is helpful. I did pick up some sea blend from the wholistic pet store that might help elevsate Bonnie's low T$ reading. She was .8 which is just below the low range. Vet thought that soloxine was not an option at this time.Any suggestions? Thanks again. Craig and Bonnie

Harley PoMMom

08-02-2009, 03:18 PM

Hi Craig,

Good for you for doing all the research on SARDS. As far as lowering the estrogen, I think.. estradiol is like estrogen in dogs, that is why we encourage the full adrenal panel from the UTK, it will be able to measure the estradiol level plus other hormones in Bonnie and see what they are. If her estradiol level is elevated, as my Harley is, then the usual treatment plan is lignans from flaxhulls, and melatonin. It really is best to get the panel done and get Dr Oliver's recommendation and let him know that Bonnie has SARDS and what other meds she is on. He is willingly to work with you and your vet, I've emailed him alot of times and gotten very quick responses from him. Harley's treatment plan (flaxhulls + melatonin) takes a long time to get that estadiol level to come down, so this is why you may want to have the panel done and converse with Dr. Oliver.

Love and hugs from your York, PA. friends.
Lori and Harley

craig

08-02-2009, 04:00 PM

Lori. Thanks for replying. I will call my vet Monday and talk with her.Do you know what Harley's estradiol number was and did harley also have elevated phosphatase? Where do you get your flaxhulls from and melatonin.I see melatonin in regular health food stores as well as flax powder. Is there a site for dodages as well? I try to read everything I can . I received a forward from a acupuncturist that gave me the name of a holistic animal hospital in Charlotte called Atrium Animal hospital which offers holistic and alternative treatments .Has there ever been anyone you know of that has used this type of treatment option? Thanks again. Craig and Bonnie

Harley PoMMom

08-02-2009, 05:41 PM

Harley had a full adrenal done in April 09, his estradiol level at post was 132.2, normal range for a Neutered male is (23.1-65.1), now he's been on his treatment of the hulls & melatonin since 5/16/09, had his estradiol level checked on 7/29/09, estradiol level was 116.4, so it did come down, but by very little.

Harley gets 1/2 teaspoon of the flaxhulls once a day and 3 mg of melatonin twice a day, per intructions on his treatment sheet from the UTK.

I really do advise getting the adrenal panel done or have your vet contact Dr. Oliver, I'm pretty sure it was Glynda that said that Dr. Oliver did research on SARDS and the intermediate hormones (estradiol, being one of them) involvements.

did harley also have elevated phosphatase? Are talking about the Alkaline Phosphatase? If yes, then Harley does have high ALP, when he was first dx'd w/cushings his ALP was 416 U/L, his recent ALP..1289.

Hope this helps.

Hugs to you and Bonnie.
Lori and Harley

StarDeb55

08-02-2009, 06:24 PM

Craig, I strongly encourage you to have the UTK panel done. You want to make double sure that Bonnie is dealing with an elevate estradiol before beginning any type of treatment, no matter what it is. The treatment of lignans + melatonins disrupts pathways in the adrenal glands where most of these hormones are made in very small amounts, so you don't want to start treating something until you are 100% sure that the specific hormone is elevated.

When it comes to the melatonin, You can buy it most anywhere, grocery store, drugstore, etc. You want to make absolutely sure that you don't get anything that says extended, timed, or, fast release.

If you are talking about the alkaline phosphatase, just about every single one of our cushpups has an elevated alk phos. This is the one abnormal test that usually tips a vet to take a look at Cushing's. The alk phos elevates because of the strain on the liver, since the liver has to process all of the excess steroid, & other hormone production coming from the adrenal glands.

Debbie

craig

08-06-2009, 04:00 PM

Hello. Bonnie is trying to cope with her blindness.She is doing better than I am at this time,but she is much more immobile.I know it's because she just can't see.I have noticed a decrease in her ability
to smell. I don't know if it is related to her SARDS. Since she is also hypothyroid,the vet is starting her on soloxine twice a day for 10 days then taking another blood test to reevaluate in 10 days. .I would like to do an adrenal ultrasound to check for tumors at that time.I have already changed her diet to a no wheat/corn based food from the pet store to help her allergies/immune system.So I am trying to what I can for her at this time.This is a great site to discuss cush. I went tro the SARDS site but they don't have the discussions like this site.Does anyone know of a SARDS dog that is also atyp.? I would like to know how they progressed with this and if there are SARD dogs with cush symptoms but not atyp cush at all.Thanks for your imput. Craig and Bonnie

Roxee's Dad

08-09-2009, 07:41 PM

Hi Craig,

Bonnie is trying to cope with her blindness.She is doing better than I am at this time,but she is much more immobile.I know it's because she just can't see.

I work with a number of blind dogs and they learn to get around quite well. In fact, I had just learned that a dog I have been grooming with and playing with at the rescue for some months was blind. I was shocked as she always knew when I would arrive and just bug me until I picked her up. Some time ago, another member posted about a safety vest for blind dogs, you may want to check it out just in case your afraid Bonnie might run into something and hurt herself. I thought it was a great idea.
http://angelvest.homestead.com/

lulusmom

08-09-2009, 08:02 PM

I'm glad that John posted to you as I didn't see your last question regarding whether we are aware of any SARDS dogs that also have atypical cushing's. The answer is yes and unfortunately, we lost the threads of many of these dogs when our predecessor forum was taken off line by the owner for reasons unknown. I do recall that we had a disproportionate number of Brittany Spaniels that were diagnosed with SARD's. Some were also diagnosed with typical or atypical cushing's before going blind and some after going blind.

If a SARDs dog is showing symptoms that are associated with cushing's then the chances are that one or more of the adrenal steroids/hormones are elevated. Keep in mind that not all vets opt to treat elevated adrenal hormones in a SARD's dog as it is known that adrenal imbalances correct themselves in time in a good many of these dogs. Is Bonnie showing symptoms of cushing's now?

Glynda

craig

08-10-2009, 01:28 AM

Bonnie has been a bit better lately. She does not drink as much.and during the day she has gone 4 hours without having to urinate. At night,she has lasted 8 hours without an accident. So in that respect,that symptom has abated a bit. She is still very hungry and always wants to eat. She will bark if her brother barks and she waits by the door when someone is returning. We get her to go out and she will follow the bell sound on Clyde.She knows the inside of the house well and will only occasionally bump into things. She likes to lay where it is cool,but she always did that.She still gets excited about chewing her bone;especially if I put a bit of cheese in the end of it. She sheds,but that seems normal compared to past years. She does not have any spots where hair is gone.The lack of smellingbothers me a bit,which makes me think there could be something with the pituitary.
I can get her to go out whenever I want. She even jumped up on small sofa on the porch then stretches her front legs down to touch the ground getting down. I notice a bit more drool from her and we noticed a red dot in her right eye.She does not blink her eye when something moves in front of it,but will close them when sleeping and for natural
processes. I assume if her blindness is pituitary based,there is nothing to do about that tumor. Hopefully it won't grow and cause other problems like seizures.If it is an adrenal tumor,does that tumor need to be treated or can the dog still function with the tumor and just be medicated?Are there other symptoms of cush or atyp that i can look for/ thanks. Craig and Bonnie

Roxee's Dad

08-18-2009, 03:00 PM

Hi Craig,
I was just wondering how Bonnie is doing and what course of action you decided to take for Bonnie.

If it is an adrenal tumor,does that tumor need to be treated or can the dog still function with the tumor and just be medicated?Are there other symptoms of cush or atyp that i can look for/ thanks. Craig and Bonnie

Has or is an ultrasound planned to determine that there is an adrenal tumor?

craig

08-20-2009, 03:35 PM

Hello. We had Bonnie's low thyroid rechecked again and she needs soloxine like her littermate,Clyde. She is on .4 twice a day. She discussed the atyp with our vet and she seems to think that the symptoms will abate in a couple of months.I mentioned that an adrenal ultrasound would determine it right away. She is sending our file to the vet who does the ultrasound to get his reaction and a price for it. i tried calling the vet for a price,but they would not give me any price until our vet faxed over Bonnie's file. Does anyone know approx. the cost of the ultrasound? Bonniw still has a big appetite and still urinates more frequently.She likes her walks,but seems arthritic at times;especially at night. She is very hesitant at night,which makes me think that she can see a little dark vs. light .But it could be just the night sounds that scare her because she knows she can't protect herself.Maybe it's just instinct.She loves to chew on her bully stick. it is her one pleasure that she has continued with.I am hoping she is adjusting to her blindness as well. Thanks again. Craig and Bonnie

Harley PoMMom

08-20-2009, 05:17 PM

Craig,

Altho an u/s in a very good test to have done, I don't believe that will tell you if Bonnie's Atypical or not. For that you will need to do a full adrenal panel done at the University of Tennessee. Below is the post from Leslie where the info. for the adrenal panel is located.

Harley's u/s was $400.00 at the Univ. on Penn.

Love and hugs.
Lori

Hi Craig,

IMHO, and based on Squirt's cush history, an abdominal ultrasound done with a high resolution machine and the UTK panel are the most crucial diagnostic and confirming tests available. You may need to get a referral to a specialist (IMS) for the U/S but your vet can help you out there. Here are some links about the UTK panel and Atyipcal:

http://www.vet.utk.edu/diagnostic/endocrinology/index.php
(The test you want is under the third heading, Adrenal Function, the seventh item down, Adrenal Panel (ACTH stim)-dog,cat-serum-adrenal function-$140.00. Your vet will tack on their charges for services as well as the shipping charges so the total cost to you will be more, usually in the $2-400 range..

Atypical Cushing’s:
(Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone – an elevation in one, all, or any combination of these hormones, without elevated cortisol; with or without presence of a tumor.)

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=485128&sk=&date=&pageID=1

http://www.vetcontact.com/en/art.php?a=132&t=

http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php

As for what to ask today, for copies of all her testing so far like any blood work-ups. That will show the ALT and ALKP as well as other levels that may be out of whack. You might want to ask what drug they usually prescribe, if they are familiar with Atypical, how many cush patients they have successfully treated, and just try to get a feel for whether or not they are going to work with you as a team. Teamwork between you and the docs is very important.

It sounds like your vet is doing a good job of ruling out other possibilities so that is a relief and a good sign. You have done a great job yourself, so keep up the good work!

Hope this helps,
Hugs,
Leslie and the girls

Nathalie

08-20-2009, 07:22 PM

We had Bonnie's low thyroid rechecked again and she needs soloxine like her littermate,Clyde. She is on .4 twice a day.

Hi Craig,

Just a word of caution - I quickly scanned through your thread to find Bonnie’s weight, perhaps I missed it.
Unless Bonnie weighs 60 lbs or more (if she does – just disregard my post) 0.4 mg of Soloxine twice daily it might be too much for her weight/age. The suggested dose is 0.1mg per 15 lbs twice daily to start and then test in 4-6 weeks, 4-6h post pill.
My Phillip weighs 63 lbs and is getting 0.4 mg BID which puts him just a tad below Geriatric Optimal Levels last T4 test.
At 0.6 BID he went HYPERthyroid – almost twice as high as he should be. He became restless, fearful, decrease in appetite, heavy panting ….

Nathalie

craig

08-23-2009, 03:19 AM

Natalie. Bonnie weighs 45.7 lbs. She has gained about 7 lbs since all this started. My vet said that since bonnie was retested on .4 twice a day,her thyroid numbers were now good. i have noticed that she is panting more than before.I remember Clyde panted heavily when he was taking .6 soloxine. He weighs about 60 lbs. He is now on .4 twice a day. We wondered why our vet thought that when Bonnie was .8 that she didn't need soloxine and now she puts her on .4 twice a day. We decided today,after watching Bonnie that we are going to ask the vet if reducing the dosage is recommended. I know vets get a little testy when you question them on their opinion but Bonnie seems to pant more.I also had two holistics vets contact me and they suggested giving Bonnie homeopathic remedies like Supraglan or cushex as alternatives to Bonnies excessive urinating,drinking.and panting symptoms.. Has anyone tried these alternatives over lysodren or other meds? My opto was convinced that since Bonnie has SARDS that her cush symptoms would abate over time. He said that he has seen it many times. Even our vet said that with Bonnie's lab results,all her results were good and not out of whack. She said that she was fairly certain that there was no pit. tumor based on lab results and that the treatment ,if it was ,would be too difficult. She also thought that even if there was an adrenal tumor, surgery or even the lysodren could be more stressful and complications would be worse than what Bonnie is dealing with right now based on her present condition. We did call the one vet hospital and got a price of $230 for an abdominal ultrasound.They said that we had to leave Bonnie there for the day.We are calling the other hosp Monday to get another price and to see if Bonnie has to be left there all day as well. We thought that maybe we could be present when they do the ultrasound so Bonnie would relax and not have to be put under.Lots of questions still but trying to resolve them.We want to do what is best for bonnie. Thanks again. Craig and Bonnie

StarDeb55

08-23-2009, 07:45 AM

Craig, Cushex & Supraglan are rip-offs. They do not work. If there were any so-called natural remedies for Cushing's, all of our pups would be taking them in a heartbeat. The people who make these products are simply out to line their pockets with your money, so please do not be taken in by them.

When it comes to the ultrasound, you need to make sure that it is done on a high resolution machine so that the adrenals are readily visualized.

Debbie

Roxee's Dad

08-23-2009, 10:24 AM

Hi Craig,

Once again I have to quote Glynda, she has really done her homework and we have and do benifit from it. I am sure if there was a proven natural treatment, we would all prefer to use it. There have been members that have chosen to use alternative treatments but no one has come back with proven test results.

I am the member that wrote to PetAlive, as well as other companies claiming to have natural remedies that are effective in treating cushing's. None of these companies have done any testing to prove their claims. PetAlive ignored my very direct question about testing and provided a list of wonderful things their natural remedy would do for my dogs. They also mentioned that it is safe to use with conventional treatment. Well duh, the point of my email to them was to ask them to provide supporting documentation that their product's efficacy would allow a pet owner to avoid conventional treatment. It is pretty disturbing that these people get away with such blatant fraudulent advertising.

Pet owners with cushdogs, especially those new to the disease, are overwhelmed and very vulnerable which makes them huge targets for these unscrupulous companies. I would suggest that any member that is contemplating treating with anything other than conventional treatment, to do their own research and ask questions of any company that claims to have an effective treatment for cushing's. It is only effective if clinical trials have been done to prove its efficacy by way of acth stimulation tests, low dose dexamethasone suppression test, urine cortisol:creatinine ratio, etc.

Glynda

lulusmom

08-23-2009, 11:47 AM

Hi Craig,

Can you please post the results of the tests that your vet did to diagnose Bonnie with Hypothyroidism? I am always suspicious when Hypothyroidism is diagnosed in a dog that is having other underlying problems. Here is a quote that explains things a lot better than I can.

Some Cushing's dogs may also be affected with Hypothyroidism so testing for hypothyroidism is often part of the diagnostic process we go through with our Cushing's dogs. A full thyroid panel can be run from a single blood sample. Two of the tests that are usually included in a thyroid panel to check thyroid function are Canine TSH and Free T4 by equilibrium dialysis

Here is an excellent website about Canine Hypothyroidism which may affect our pets:

http://www.lbah.com/canine/hypot4.htm

Sometimes a Cushing's dog may be truly hypothyroid and need to be taking medication for that condition along with the Cushing's medication they are prescribed. But there is also a form of hypothyroidism called "Sick Euthyroid Syndrome" or "non-thyroidal illness" which may actually only be secondary to (caused by) another condition such as Cushings, and this type of hypothyroid condition will often resolve without need for medication once the excessively high cortisol production caused by the Cushing's is lowered and brought under good control. (Note that sex steroid/hormone elevations can cause low thyroid and I suspect that Bonnie has elevations in one or several of her sex hormones) from the above website:

A knowledgeable Vet should know how to tell the difference between true Hypothyroid condition that requires medication and a case where the dog only has a "Sick Euthyroid" or "non-thyroidal illness" which does not require medication.

Here is another good website about thyroid function:

http://www.newmanveterinary.com/ThyroidBasics.html

and here's a link to another page on that website about Hypothyroidism which has some really good photos (if you put your mouse arrow over any of the photos and hold the mouse arrow there the picture will stop moving and stay still to give a better view)

http://www.newmanveterinary.com/Hypothyroid.html

Some of the symptoms of Hypothyroidism are very similar to some of the symptoms of Cushing's, so it can get confusing ...

A knowledgeable Vet should be able to figure out if the dog has Cushing's and is also truly Hypothyroid (and therefore needs medications to treat both conditions) or if the pet has Cushing's and "Sick Euthyroid Syndrome" (which would resolve once the cortisol levels are well controlled and without needing specific thyroid meds), or if the pet has only Cushing's or only a True Hypothyroid Condition, each of which would have a separate treatment protocol.

Craig, see my comments/questions in blue below:

Natalie. Bonnie weighs 45.7 lbs. She has gained about 7 lbs since all this started. My vet said that since bonnie was retested on .4 twice a day,her thyroid numbers were now good. How long after you started the .40 twice daily did your vet recheck thyroid values? i have noticed that she is panting more than before. I remember Clyde panted heavily when he was taking .6 soloxine. He weighs about 60 lbs. He is now on .4 twice a day. We wondered why our vet thought that when Bonnie was .8 that she didn't need soloxine and now she puts her on .4 twice a day. We decided today,after watching Bonnie that we are going to ask the vet if reducing the dosage is recommended. When you talk to your vet, mention that Bonnie could very well have sick euthyroid syndrome as a result of adrenal hormone elevations in which case, medication isn't normally recommended as the condtion is transient and will correct itself once the underlying condition is controlled or resolved. As with many dogs with SARDS, adrenal hormones can be elevated but resolve over the course of weeks or months. I know vets get a little testy when you question them on their opinion but Bonnie seems to pant more. I've had at least two gp vets that would get indignant when I asked questions of them in an effort to understand how they came up with their diagnosis and why they chose the drug they chose. We are our dog's only voice and if a vet gets testy with us for trying to take a proactive position in our dog's treatment, then we need to rethink if this is a vet that we want treating our dogs. The two vets I mentioned never saw my dog(s) again after they copped the "how dare you question anything I do because I'm the the all mighty and knowing medical professional" attitude. I also had two holistics vets contact me and they suggested giving Bonnie homeopathic remedies like Supraglan or cushex as alternatives to Bonnies excessive urinating,drinking.and panting symptoms.. Has anyone tried these alternatives over lysodren or other meds? These so called holistic vets are full of horse pucky. I personally contacted both manufacturers of Supraglan and Cushex Drops and determined that neither company has done clinical trials/testing on their respective snake oils to prove their efficacy in treating either typical or atypical cushing's. They could not offer one shred of evidence that their products have any impact whatsoever on the adrenal steroids. Shame on these companies and shame on the holistic vets that suggest you waste your money on these products. My opto was convinced that since Bonnie has SARDS that her cush symptoms would abate over time. He said that he has seen it many times. I think your Opto has the best understanding of Bonnie's condition. Even our vet said that with Bonnie's lab results,all her results were good and not out of whack. She said that she was fairly certain that there was no pit. tumor based on lab results and that the treatment ,if it was ,would be too difficult. If the LDDS test was the only diagnostic test your vet did, then I am not sure how she could make this determination. :confused: She also thought that even if there was an adrenal tumor, surgery or even the lysodren could be more stressful and complications would be worse than what Bonnie is dealing with right now based on her present condition. Aside from the few symptoms that remain and her blindness, is Bonnie dealing with anything else? If a dog is otherwise healthy, surgery for an adrenal tumor is the first choice of treatment but Lysodren is a also an option and is certainly preferrrable to letting a dog go with uncontrolled cushing's. If it were to be determined that Bonnie had an adrenal tumor, your gp vet would not be qualified to determine what would be in Bonnie's best interest. I realize this is all hypothetical at this point but I want you to understand that an internal medicince specialist and a board certified surgeon would probably not agree with what your vet is telling you. We did call the one vet hospital and got a price of $230 for an abdominal ultrasound. They said that we had to leave Bonnie there for the day.We are calling the other hosp Monday to get another price and to see if Bonnie has to be left there all day as well. We thought that maybe we could be present when they do the ultrasound so Bonnie would relax and not have to be put under.Lots of questions still but trying to resolve them.We want to do what is best for bonnie. Craig, if I were in your position, I would listen to the Opto and give it some time before incurring the expense of further testing. Both typical and atypical cushing's is a graded process so there is plenty of time to do whatever testing is necessary. If after a few months Bonnie is still symptomatic or symptoms worsen, I'd probably start with the UTK adrenal panel and then an abdominal ultrasound. Thanks again. Craig and Bonnie

Squirt's Mom

08-23-2009, 12:54 PM

Hi Craig,

Glynda has covered your questions and comments with her usual insight and understanding of this condition and its accompanying issues. And I agree with what she has said....most important of that was the advise to let Bonnie adjust and see if the signs will disappear in time, as is common with SARDS pups.

While I am one who believes that things other than drugs can help, products like Cushex and Supraglan just ain't the way to go, IMHO. Both contain ingredient that can make the signs of Cushing's worse, like dandelion or licorice. Cushex has an arsenic derivative! Supraglan is scary to me because as the name implies it contains glandulars from deceased animals. These products are not regulated so there is no control over what is included in them, nor any semblance of a guarantee that the glands used in Supraglan came from healthy animals and not diseased ones. I am a bit surprised that a holistic vet would suggest these. A good holistic vet, IMHO, would be unlikely use premixed, untested products for their patients. To me, this is just lazy...and dangerous.

If you are wanting to control her signs for a while, then look into Anipryl. But I think your best course of action is to take no action for now. Patience sucks, huh? :p

Hang in there!
Hugs,
Leslie and the girls

Roxee's Dad

08-23-2009, 02:30 PM

Hi Craig,

We did call the one vet hospital and got a price of $230 for an abdominal ultrasound.They said that we had to leave Bonnie there for the day.We are calling the other hosp Monday to get another price and to see if Bonnie has to be left there all day as well. We thought that maybe we could be present when they do the ultrasound so Bonnie would relax and not have to be put under

When our Roxee had her US, the vet receptionist ask us to bring her in at 8 am and pick her up between 4 and 5 pm. When I asked why, she stated that they didn't know exactly when the mobile U.S. truck would arrive. (I guess they are like the cable guy) I asked if they could at least verify if morning or afternoon? They did. I asked if I could bring Roxee to the office and hang out with her until the truck came and they agreed. One of the concerns they had was that we would feed Roxee before the U.S. I promised I wouldn't. So I hung out with Roxee until I saw the truck arrive. They took her, shaved her belly and performed the U.S. without any anesthesia. I would also never leave Roxee for an ACTH stim. I would bring her in for the first draw and injection then hang out at the local park, then bring her back in exactly 2 hours for the 2nd draw.

Maybe your vet would be okay with this. They just want to make sure your pup is available when the U.S. truck arrives and you don't feed before the U.S. (if there is any food or gas in the intestines, it would really screw up the visibility of the U.S. and would be a waste of money)

We have an old saying "If you don't ask, you don't get"

BTW - We paid 325.00 USD for Roxee's High Res. U.S. here in middle TN.

bgdavis

08-24-2009, 09:58 AM

Craig,
I just had to post this. It may be here on the board someplace, but there is some hope.

Press Release: Iowa State University
Released: Wed 30-May-2007, 15:40 ET
Available for logged-in reporters only

Blind Dogs Can See After New Treatment for Sudden Onset Blinding Disease

Iowa State University veterinary researchers may have found a cure for a previously incurable disease that causes dogs to go blind suddenly. They have successfully treated two dogs for sudden acquired retinal degeneration syndrome (SARDS). The dogs were treated with intravenous immunoglobulin
(IVIg).

If two dogs are any indication, Iowa State University veterinary researchers may have found a cure for a previously incurable disease that causes dogs to go blind suddenly.

In the past six weeks, two dogs have been successfully treated for sudden acquired retinal degeneration syndrome (SARDS) by a research team led by ISU veterinary ophthalmologist Dr. Sinisa Grozdanic in the College of Veterinary Medicine.

The experimental treatment is the first to reverse blindness and restore sight to dogs diagnosed with SARDS. The treatment restored sight to the two dogs that were treated on April 12 and April 27.

"This is the first small sign of hope that actually something can be done," Grozdanic said.

The dogs were treated with intravenous immunoglobulin (IVIg), a human blood product that contains antibodies from the plasma of thousands of blood donors. It is used to treat immune deficiencies, inflammatory diseases and autoimmune diseases.

"Although the dogs won't be catching any Frisbees, they can navigate and not bump into objects," Grozdanic said.

SARDS was first identified in the 1980s and blinds as many as 4,000 dogs each year in North America, he said. The dogs have a sudden loss of vision despite no structural changes to the eyes or damage to the retinas in the early stages of the disease. Their eyes appear completely normal, but their retinas show no electrical activity.

Grozdanic and his colleagues wanted a better understanding of the molecular mechanisms that cause SARDS. They worked with the University of Iowa's Department of Ophthalmology and Vision Sciences to conduct genetic testing of SARDS tissue, cross referencing the results with the U of I's datebase of genetic information from different human ocular diseases.

"We saw that the molecular profile of SARDS eyes is very similar to immune mediated retinopathy in humans, which is usually antibody induced. That was the key factor," Grozdanic said.

Immune-mediated retinopathy in humans was not treatable until about 10 years ago when IVIg was found to show results in some patients.

Although the treatment has worked in two SARDS dogs, not every dog is a good candidate, Grozdanic cautions. Dogs with severe cardiac or kidney disease cannot tolerate IVIg. And it won't work in a dog whose retina degeneration is advanced.

"Once a dog gets SARDS, the retina degenerates quickly, so it's important the dog is treated with IVIg very soon after diagnosis," he said. "Usually dogs that have SARDS for longer than two months have severe retinal changes. The sooner it's treated, the better chance it will work."

An optical coherence tomography scan is needed to confirm the condition of a dog's retina. Iowa State University's Veterinary Medicine Hospital is the only veterinary institution using this advanced diagnostic technology, which is more commonly found in large ophthalmology centers for humans.

Diagnostic tests cost about $700. If the dog is a good candidate for
treatment, hospitalization and intensive care fees will be about $1,200. The IVIg cost will be between $35-40 per pound of the dog's body weight.

"At this point, the biggest unknown is how long the treatment will last. It could be anywhere from a few weeks to a few years," Grozdanic said.

Grozdanic recommends owners visit the nearest veterinary ophthalmologist as soon as a dog exhibits any loss in vision.

Bonnie and Angel Criss

-------------------------------------
* Admin note: The article posted above is indeed in our Resources Forum (currently on page 1 there). Here is a direct link:

Information About SARDS (Sudden Acquired Retinal Degeneration Syndrome)
http://www.k9cushings.com/forum/showthread.php?t=213

craig

08-25-2009, 06:04 PM

Hello. I have Bonnie's thyroid lab results.On 7/7/09 Bonnie had all of her blood work done. Her FREE T4-ed (ng/dl) was .8 and the reference range was (.7-3.7) Her (pmol/L was 10.3 and the reference range was (9.0-47.4).Bonnie was put on .4 soloxine on 8/05/09 twice a day then blood work was done on 8/17/09. Her T4 results came back at 2.9ug/dl and the reference range was .9-3.9 ug/dl.The note at the bottom read. "Dogs with no clinical signs of hypothyroidism and results within the normal range are likely euthyroid." Now i have to research euthyroid to see what that involves. I actually split Bonnie's soloxine pill in half and I give her each half twice daily instead of two .4 pills. She has stopped panting at night. I checked her brother's lab results also. He has been on soloxine for over a year. He weighs 60 lbs and also takes .4 twice a day. His T4 results were 1.9 ug/dl. Thanks for your help. Craig,Bonnie and Clyde

Nathalie

08-26-2009, 02:55 PM

Hi Craig,

Hello. I have Bonnie's thyroid lab results.On 7/7/09 Bonnie had all of her blood work done. Her FREE T4-ed (ng/dl) was .8 and the reference range was (.7-3.7) Her (pmol/L was 10.3 and the reference range was (9.0-47.4).Bonnie was put on .4 soloxine on 8/05/09 twice a day then blood work was done on 8/17/09. Her T4 results came back at 2.9ug/dl and the reference range was .9-3.9 ug/dl.The note at the bottom read.

Usually you would want to wait 4-6 weeks after starting thyroid replacement before testing. Test should be done 4-6 h after morning dose of Soloxine to be sure that her levels are in the upper third to 25% above the lab's references ranges at that peak response time. In Bonnie’s case only 12 day’s have passed so - just something to keep in mind. You also mentioned in one of your previous posts that you giving ‘sea blend’ – I am assuming it has kelp and seaweed - many commercial dog foods also include kelp or seaweed as well as treats. Too much iodine can cause induced hyperthyroidism and hypothyroidism.
Personally, I would not supplement with Kelp or something similar at this point but rather retest T4 and Free T4 in 4 weeks.
How many hours post pilling was Bonnie’s last thyroid test done?

"Dogs with no clinical signs of hypothyroidism and results within the normal range are likely euthyroid." Now i have to research euthyroid to see what that involves.

Craig – check page 5 of your thread – Glynda has posted info/ links.

I actually split Bonnie's soloxine pill in half and I give her each half twice daily instead of two .4 pills. She has stopped panting at night.
I am confused .... Are you saying that you have 0.8 mg pills and you split one in half and give one every 12h (1h before or 3h after feeding)?

Nathalie