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Cushing's disease - my daschund...

Started 1334657859.957 in Pet Lovers | Last reply 1334778295.29 by pepes mom

We've been carefully watching Pandy, my 11 year old daschund. A few months ago she needed work on her teeth and routine blood work came out with high liver enzymes - I forget the darn initials. The repeat test last night showed she has continued elevated enzymes and they suspect Cushings. I have noticed she is drinking a TON of water (she's 12 pounds) and can't wait to pee outside so I have pads everywhere. She is peeing copious amounts. No hair loss or other symptoms, tho her cognitive functioning seems off...

Does anyone have first hand knowledge of this illness with dogs? I forget about this Pet Lovers Column, so this is a rare appearance here for me, but I don't know who else to ask. Internet surfing is freaking me out - I need someone to tell me what to expect and what meds to use and avoid. My wonderful vet (same one for over 20 years with my doggies) is searching around pharmacies in the area for selegiline as that (she claims) is the first step along with milk thistle, which we are already giving her. I'll be speaking with her later today.

Any suggestions? The only thing we're bothered by of course is the peeing in the house - even the pads are messy and stinky, and of course I have to work. We're keeping her in one room with a baby gate but the other dog (border collie) will have the run of the house still so not sure how this will work.

Help! I'm beside myself, but I'm willing to try anything. Sorry this is so long, I am just so upset and have no one to talk to about this right now.....

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beastielove1334664858.4478961 PostsRegistered 8/11/2008Another galaxy, far, far away

erbist...

As I have always had kitties (currently am mommy to four that I rescued), I have had no experience with this terribel disease.

I know that there are many wonderful ladies who also post on this board who have dogs, so hopefully a few of them will have the information that you are seeking.

I just wanted to send you and your beloved Pandy lots of very special prayers and lots of very special hugs.

((((((((((ERBIST & HER BELOVED PANDY)))))))))

-----------------------------------------

All of my children have paws{#emotions_dlg.wub}

Rachelle1334669110.471285 PostsRegistered 9/30/2007

Yes, unfortunately I lost my precious Sammy to this terrible disease, years back. He started to only drink water and as you said, tons of it. He would go out to pee and then stay under my bed till it was time for more. He started to lose his hair and sore spots began to take over. I brought him for several tests and the results came back, Cushing's. I had switched vets many months earlier because no matter what I brought Sammy in for, his then vet always gave him cortisone injections as the cure-all.. Well this new vet told me too much cortisone was the culprit in his Cushing's Disease..The term he used was self-induced Cushing's.. My heart broke that day,,,he wanted to start him on chemo and as much as I loved that little guy there is no way I would ever subject him to that... We put Sammy down as we knew life under my bed was no way fro him to continue.... I vowed if I ever got another dog/or cat, I would never allow cortisone to be given.. I never got another pet, I didn't want to ever go through that heartbreak again.. I held Sammy while they administered the fatal shot that day, brought him home and buried him under the small tree out back, the very tree he always went to pee on...... FYI.. One of the Kennedy's died from Cushing's......

I wish you well with your little one....

free-spirit1334684605.082080 PostsRegistered 11/4/2007New Jersey

Have you been feeding any treats from China??? Especially any type of jerky???

Cushings is the symptoms that dogs are developing.

If the bags say Made in the USA it does not mean the ingredients did not come from China.

CamilleP1334685080.43342 PostsRegistered 8/1/2007Oregon

Erblst, please, I implore you, read my entire post, esp. regarding selegeline.

Okay, #1 is DO NOT PANIC!!! Number two is don't believe everything you read on the Internet about Cushing's, *especially* if the writer is pushing some "natural/organic/totally safe" snake oil for sale! Cushing's Disease is a very manageable condition these days, and dogs can live for years and years with it, BUT it takes education of the owner and a vet who is up to date on modern therapy. First, a "primer":

Cushing's Disease is an over-production of cortisol by the adrenal glands which is caused by two different processes, and must be treated differently. The most common form of Cushing's Disease is pituitary-dependent, meaning that the pituitary gland is telling the adrenal glands to produce too much cortisol. The main reason the pituitary does this is that there is a very tiny tumor inside the gland, releasing excess stimulating hormone. This pituitary micro-tumor is most commonly benign, meaning that it will not continue to grow or invade other organs, but it's action is most certainly NOT benign, because the excess cortisol, over time, is a killer. The other, less common cause of Cushing's Disease is adrenal-dependent, in which a tumor on one of the adrenal glands themselves is causing that gland to over-produce cortisol, indepently of the pituitary signals. About half the time, those adrenal tumors are malignant, meaning they will continue to grow and invade other organs. Surgery is an option in the case of adrenal-dependent Cushing's, but it's extensive, dangerous, and many vets lack the expertise to attempt it. However, if a non-malignant adrenal tumor can be removed, that surgery is curative. Pituitary-dependent Cushing's must be managed with medicine, not surgery, due to the physical location of the pituitary gland in the dog. Determining whether a dog is PD or AD can be done via blood tests and confirmed with ultrasound examination of the abdomen, where a PD dog will usually be found to have bilaterally enlarged adrenal glands, and an AD dog will usually be found to have one very enlarged adrenal gland and the other gland very shrunken or nearly gone.

There are other forms of Cushing's that are less common, one form is referred to as Atypical Cushing's, and is caused by an over-production of non-steroid hormones. Diagnosis and treatment of this is more difficult in that few labs test for the related hormones, but it can be done, and treatment returns the dog to a more normal life. Another type of Cushing's is Iatrogenic Cushing's. This disease is due entirely and totally to human failure. Vets who give steroid shots or prescribe prednisone in massive doses, and the owners who allow vets to do so are the cause of this disease. The "cure" is simple, the artificial steroids must be withdrawn, VERY slowly and carefully, so that the patient does not suffer an Addison's-like crash. Thankfully, Iatrogenic Cushing's is less common than it used to be, as vets realize that steroids are truly dangerous if misused and owners become more pro-active in the care of their pets.

Treating PD Cushing's is the most common thing owners have to learn to manage. The goal is to reduce the amount of cortisol circulating in the dog's bloodstream. This used to be done with a drug called Lysodren, which worked by actually physically eroding the adrenal glands themselves, reducing their capacity to produce cortisol, no matter what the micro-tumor in the pituitary gland was telling them to do. The danger of Lysodren was that a dog's response was quite variable, some dogs needed much larger doses than others, and some dogs responded so well and quickly that they were actually overdosed, destroying the adrenal glands entirely and causing the opposite disorder, Iatrogenic Addison's Disease. That's what happened to my own dog, almost five years ago now. Very fortunately, a newer, safer drug is now the standard treatment for Cushing's, it's trade-named Vetoryl, the drug name itself is trilostane. It works not by destroying the adrenal glands but by interrupting the synthesis pathway of the cortisol inside the glands. It must be given once a day, and some dogs need it twice a day to control symptoms, but it is VERY safe, and VERY effective, and the lifespan prognosis for a dog treated properly with trilostane is now quite normal.

There USED to be another drug used in the treatment of Cushing's that has been proven to be USELESS, it is NOT effective, and should not be used! That is the drug used for Canine Cognitive Dysfunction (doggie Alzheimer's) called Anipryl. I believe that is the trade name, and the drug name is selegeline. All Anipryl does is mask the symptoms of Cushing's, it does NOT reduce circulating cortisol and it does NOT prevent the organ damage caused by that cortisol. I repeat, Anipryl should not be used in the treatment of Cushing's Disease.

There are many "experts" hawking their potions on the internet that all claim to cure Cushing's, these products may be anything from useless to downright toxic. Their claims are not backed up by actual clinical proof that circulating cortisol is being reduced by their products, and I don't care how many testimonials they post from "satisfied clients", until something is proven safe and effective in clinical trials, it's not going into my dogs' mouths, other owners must make their own decisions and live with the consequences.

There are many resources on the internet that can help an owner learn more about Cushing's and manage their pet's disorder in such a way that the dog is returned to full health and normal lifespan. One thing I found very helpful was joining a "yahoo" group called "Canine Cushing's and Auto-Immune Disease" (CCAD), the other owners of Cushing's dogs can really be of support and information as you learn to manage Pandy's Cushing's. Most importantly, DO NOT GIVE UP HOPE!!! My Peggy Sue was only 7.5 when diagnosed with PD Cushing's, was treated with Lysodren (trilostane was not legal in the US back then), developed iatrogenic Addison's Disease, was treated for that, and is ALIVE and doing pretty well today, going on 12 and a half years old! She's slowing down, her heart is showing some aging signs, and she's not as speedy as she used to be, but woe betide any squirrel she sees, she's still going to go after it, guns a'blazin! She keeps her three daughters in line and fraps and plays around the house and yard, and still nearly takes my fingers off when offered bites of pizza, so overall, she's doing just fine! Pandy CAN do better than that, trilostane is safer, and she can return to her normal self in a very short period of time, just don't give up on her!

erblst1334694975.8072531 PostsRegistered 5/19/2008Central NH

Camille - what is the source of your info regarding Anaypril? and the trilostane? I should have mentioned that I know about Cushings, just not in dogs/animals.

Is this your own experience, or is it cited somewhere I can see it? I know you mean well, and I sure do appreciate this.

I am a bit upset by some of your comments, tho - I'm a HS health teacher,after attending nursing school then becoming a teacher. Also, I attended herbal school and courses for 6 years (hence my nickname, erblst) and not ALL people that 'hawk' their potions are jerks. I know I'm not! I agree (as does my vet) that there is a happy medium between herbal/traditional medicines. I respect your views, please, respect mine? I'm not going to be doing anything that would hurt any of my pets' health!

Again, thanks for the info, all of you. Please, continue to post anything as I'm more confused than ever and I need to start making some decisions on what to do.

PS - how does one find 'groups'??

Last edited on 4/17/2012

Last edited on 4/17/2012

CamilleP1334701640.523342 PostsRegistered 8/1/2007Oregon
On 4/17/2012 erblst said:

Camille - what is the source of your info regarding Anaypril? and the trilostane? I should have mentioned that I know about Cushings, just not in dogs/animals.

Is this your own experience, or is it cited somewhere I can see it?

PS - how does one find 'groups'??

Last edited on 4/17/2012

The source on Anapril is that my own dog died of liver failure in 2000 after her Cushing's was unsuccessfully treated with Anapril. She was my first Cushing's dog. The information on Trilostane is fully reviewed and published and it is an FDA-approved treatment for Cushing's in dogs. It has been in use in Europe for many more years than here in the US. Currently, two of Peggy Sue's siblings are being treated for Cushing's with Trilostane, and are doing very well, their liver enzymes are now in the high normal range. The researcher who first tested and promoted Anapril for the treatment of Cushing's has actually since withdrawn his recommendation, but I don't know where that was published, it's been several years since I read it. I believe he's a professor at one of the vet schools in California?

To find the CCAD group, go to the main Yahoo website, and look at their menu, they have hundreds and hundreds of special interest Yahoo Groups listed. You can probably search the Groups listing for Cushing's and find them. You do have to be a Yahoo member to join a group and read their files, but with complicated vet-med issues it's worth it. Their files are worth their cyber-weight in gold. (there is no charge to get a Yahoo account)

In conjuction with milk thistle for liver support, check out the use of s-adenosyl methionine, sold as SAM-e, it is also very beneficial as a conjunctive therapy. However, supporting the liver with such meds won't save the dog, it's like giving transfusions when a patient is spurting arterial blood. Once the cortisol levels normalize, then milk thistle and SAM-e can actually act to speed healing of steroid hepatopathy.

I'm sorry if I came off curt and dismissive, I'm at work and rushed for time but still wanted to give you the quickest info I could, because I hate to hear of someone with a newly diagnosed Cushing's dog get bad info that could cost the dog it's life when there is such a good, safe drug out there that could save it.

PpprMintPa­tty1334705723.6318627 PostsRegistered 8/7/2007Outside our Nation's Capitol

Don't have time to read all the threads, will come back later.

Our little Zoe girl has Cushing's. They did a specific test which showed she has a tumor on her pituitary gland.

She is on Trilostane every day. They monitor her blood to make sure she's not getting too much.

She had a rough patch a month or so ago but pulled through and is doing very well right now.

Her symptoms were drinking excessive amounts of water, wanting to eat ALL the time, gaining weight, and UTI's.

I must warn you, we've spent quite a bit of money on all of this but for us, she is worth it...we are willing and able to do this for her. But it isn't cheap.

~Formerly known as Danny~

pepes mom1334712313.5575192 PostsRegistered 7/21/2005SW PA

Our Buster had Cushings. Testing found that it was the pituitary dependant type. I was not going to put him on Lysodren, as he was 12 or 13 when diagnosed. We opted to use Anipryl and he did amazingly well with it. His water intake and subsequent needing to go out decreased. Unfortunately, he developed diabetes when he was 16, and we eventually needed to put him to sleep. But, I do not regret the decision to use Anipryl. As far as I'm concerned, it gave us 3 or 4 good years with Buster.

I wish you and your dog the best.

~ Pepe's Mom ~

I'm cool toned. Yellow foundations make me look jaundiced. That is NOT the look I am going for.

erblst1334745651.5872531 PostsRegistered 5/19/2008Central NH

Your wonderful answers have me asking more questions- PmPatty -- what kind of doggie was Zoe? Our vet has already told us this is not a 'cheap' diagnosis but we feel she is worth it, if she is free from pain. BTW - not to be dumb, but how do you know if a female dog has a UTI??

Pepe's Mom - why did you decide not to use Lysodren? I'm staying away from the internet still and depending on word of mouth for now (Pandy is suspected but not diagnosed yet, will be discussing details later in the week about more testing - once diagnosed I'll surf the net for more info - I'm too scared to now). Also, what kind of dog was Buster?

It's true what we say about animal owners - you are ALL so kind to answer this post. I know it's not easy when your information is not the best to share, but I so appreciate it. I am feeling better emotionally today and am willing to ride this out - Pandy is my shadow and the best dog I've ever had, and believe me, I've had dozens.

You folks are great. Please tell me your stories - they help me.

Should I get a second opinion? I've had the same 2 vet (clinic type set-up) for over 18 years and know both the vets well, but this is serious enough -- my only issue is I'm in the NH and we just plain don't have many vets....

PpprMintPa­tty1334777122.4618627 PostsRegistered 8/7/2007Outside our Nation's Capitol

erblst...Zoe is a 12-yr old Westie-Poo. It can affect their joints also so she is on Rimadyl right now but we are going to stop it for a while and see how she does...that can be hard on their livers.

She had blood in her urine. We were on vacation and came back to the hotel room to change to attend my son's wedding reception and there was blood and pee-pee all over the place. She NEVER goes potty in the house...eVer. She looked so ashamed, it still breaks my heart to think about it.

She had been tinkling more frequently and seemed a little out of sorts, but we assumed it was because of the traveling. It was hot so we weren't too alarmed that she was drinking more and going potty more.

Needless to say, I freaked out when I walked into that room and saw the blood. My husband had to take her by taxi to the ER vet and missed almost the entire reception! She had a couple more after that, then we had a big move from FL to VA and she got another one in the hotel up here.

I had researched online and was wondering about Cushing's.

This new vet agreed it was time to test her for it and sure enough, she had it.

She has had 3 doctors up here and they all agree Trilostane is the way to go now if they'll tolerate it. They all said it is the safest one available at this time.

We take her to a large hospital where many people travel from out of state to come. Have heard wonderful things so feel comfortable with them at this point.

Last edited on 4/18/2012

Last edited on 4/18/2012

~Formerly known as Danny~

pepes mom1334778295.295192 PostsRegistered 7/21/2005SW PA

erblst: when the labs came back indicating Cushings, the vet gave us information/options about the disease. 3 of the vet techs said that if Buster was their dog, there would be no way in Hades that they would use that drug on him. All indicated that Lysodren was a rough drug, in that you had to be extremely vigilant about watching for side effects.

I am a nurse who no longer practices, due to having horrible back injuries. Even though I am home all day, every day, and I have a wealth of medical knowledge, I was extremely bothered by this medication. I didn't have the heart to put Buster through it. My husband and I made the decision to try the Anipryl and see where that went. Buster's labs did not change, but he was symptomatically improved, and appeared much more comfortable. We purchased our Anipryl from Entirelypets dot com

Don't quite know how to answer your question of what kind of dog Buster was. He looked to be a mix of doxie, corgi, sheltie and golden. One time when the pizza man delivered our dinner, he squatted down next to Buster and asked why we, his parents, didn't purchase the rest of his legs. Buster had a normal sized body on tiny little doxie/corgi legs. He was a very unique dog.

I will say, with hindsight being 20/20, I wouldn't change a thing about our choice in treating Buster with Anipryl. We made the best choice for our dog.

~ Pepe's Mom ~

I'm cool toned. Yellow foundations make me look jaundiced. That is NOT the look I am going for.

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