Sabre 10 year old Hungarian Vizsla Lysodren

[Sabre's Mum]

Hi everyone

I have just typed an essay, minimised to screen to type in results and poooof the magician made it disappear!!!!! So I am now typing this is Word first!!!
Sabre went for an ACTH on Thursday and we are now restarting Lysodren after a 4 ˝ month Lysodren Holiday! We are restarting on 41.6 mg/kg – 1000mg split into four doses.

ACTH results were
Pre 2.35
Post 3.73

Sabre has had a roller coaster ride on Lysodren and we are hoping that this dose is going to be OK. I have a gut feeling that it may be slightly high but Sabre has a “body” of his own and time will only tell. Since we have no archive this has been his results in the past –

7 April 2008 Pre 1.27 Post 1.41 after loading at 50mg/kg

Changed dose to 25mg/kg
9 May 2008 Pre 1.56 Post 3.22

Dose the same but changed to 30mg/kg (due to weight loss)
26 May 2008 Pre 2.14 Post 4.57

Dose changed to 50mg/kg
26 June Pre 2.97 Post 4.35

Remained on 50mg/kg
17 Sept Pre 0.72 Post 0.8

Took one week off Lysodren and commenced at 40mg/kg
3 Nov Pre 0.6 Post 0.8

Reduced the dose to 35mg/kg (dosing every second day ˝ tab)
2 Dec Pre 0.47 Post 0.43

LYSODREN HOLIDAY
10 Dec Pre 0.47 Post 0.65
29 Jan Pre 1.34 Post 1.48
16 Apr Pre 2.35 Post 3.73

We also had CBC and Thyroid done and the liver values were absolutely fantastic . I didn’t write one value down ... with working the night shift I was SOOOO incredibly tired and I haven’t had a chance to get into the vet to get a copy of the results.

ALT - all I can remember is that she said normal
ALT 179
ALP 297

This compares with the last results on 2 December of
AST 248
ALT 699
ALP 406
WOW!

The thyroid (T4) wasn’t so great – it came back 5 and I recall the vet saying 25 was normal. So the next step is TSH (I think she said it was this one) but the lab on does this every fortnight so we have to wait 1-2 weeks for results.

Sabre has also had a developing lump just below the elbow of his front leg which has now grown to a size that the vet and we believe needs to be removed but she wants to get the thyroid results back before we proceed. Thank goodness I have a job for the kiwifruit season!!! It happened by chance ... I won a ski season pass in a raffle on a site that you watch ads and accumulate what was called “mint” dollars which could be redeem for products. There was no way that we could all afford to go skiing so the kiwifruit season had just started and I thought ... blow it ... why not just do the season - I applied for a job and started the next night! It’s about 10 weeks and I work 60 hours a week on night shift.

Enough about me!!! It is so fantastic that Natalie has found space for us.

So ... thyroid tests back, surgery then retest ACTH in a months time.

Angela and Sabre

[Harley PoMMom]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Angela and Sabre,
Although I can't offer you any advice for your dog, I might be able to help with when you type in, before you sign in, check the "remember me" check box, that way when you write essay's (like me too), the program doesn't forget you. Hope this helps!
Harley and Lori

[gpgscott]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Angela, I am just seeing this, very glad you found the k9 site.

The fact that Sabre's cortisol numbers are so sensitive to Lysodren make me think that he may have other hormones out of range.

I think if this was my dog I would ask the Dr. about washing out and then trying a maint only dose of Lysodren. You might also consider the Atypical treatment of melatonin and lignans.

Glad you are here, the cortisol numbers are way too low in my judgment.

I love kiwi!

Scott

And sorry, since we have no history, I do remember that this treatment was not undertaken lightly but for the time being I cannot refer back.

[Sabre's Mum]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Scott

Thanks for persevering with my very long post.

So... am I getting you right? You believe that the numbers are still too low even with a post of 3.73? Sabre was diagnosed with cushings with an ACTH post of 39.39 – with major clinical signs – major calcinosis cutis (which to this day is still on the skin – just under a furry of hair), major hair loss, pu/pd, lethargy, rear leg weakness ..... Due to his major clinical signs we did not differentiate between PDH and ADH due to financial constraints at the time and also due to the fact that if he did have ADH we would still be treating with Lysodren.

Two months ago I started including in Sabre's diet ground flaxseed and have been giving him 1 tsp per day. I had been doing further research on the BARF diet and saw that it was actually recommended to be included in the diet. I remember reading somewhere recently ( I really must form a system of my research .. not just recollection which may or may not be factual) that if there are hair loss issues it is most likely that there other hormones out of range. At the time of initial diagnosis Sabre lost LOTS of hair along with the major calcinosis cutis. Two months ago the vet shaved a small portion for the ACTH around in neck ... it still hasn’t grown back! So if my recollection is correct ...it is likely there are other hormones elevated.

I have put him back on Lysodren with some hesitancy with his changing sensitivity but will be watching him VERY carefully, as I always do. We are off to surgery tomorrow to remove the lump. On a positive note the TSH came back normal!

I have just under four weeks of Lysodren supply left so it was my intention to get him tested at this stage ... or sooner if needed.

Angela and Sabre

[AlisonandMia]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Angela,

Re the coat issue - not regrowing after shaving - what is Sabre's post-Cushing's coat like? Is it normal sparse, smooth Vizsla coat or is a bit more shag-pile?

Mia's "normal" coat was of the smooth, sparse sort (like a smooth-hair Doxy or a Beagle) but after shedding all her old "sick" hair (and skin) her new coat was thick and fuzzy and coarse and the color was different too. She never shed that coat - she just added to it, it seemed and she needed shaving each of the two succeeding summers.

Previous to this she, typical of dogs with that sort of fine, sparse coat, shed slightly almost all the time without ever obviously blowing her coat like our Cattle Dog does. Once she had that post-Cushing's coat she never left hairs on you when you picked her up - she seemed to want to hold onto each and everyone of them forever!

Mia was treated with Lysodren - so all hormones (with the possible exception of estradiol had it been elevated) would have been controlled as a "side effect" of controlling the cortisol. Apart from the coat weirdness, there was never any evidence either clinically or on her blood tests to suggest she had any steroid hormones of any kind elevated once her Cushing's was successfully treated.

What I don't know is whether her ongoing "crappy coat" was caused by the big physiological upheaval of developing Cushing's and then having it treated or if it was somehow caused by the pituitary tumor. I gather it is believed that shaggy coat that horses with Cushing's get is as a result of pituitary dysfunction affecting the annual cycle of hormones regulating coat shedding in relation to the change of season rather than the cortisol elevation itself. I don't know if that (with horses) is a proven fact or just someone's supposition or what though - I will look into it. This is me thinking out loud here: When an animal has an ACTH-secreting pit tumor they do lose the normal 24 hour cycle of cortisol production so maybe this can interfere with their bodies capacity to measure day-night length and thus to regulate coat shedding???

I guess what I'm saying is that long-term coat "strangeness" in a treated Cushing's dog (particularly a Lysodren dog) may not necessarily be a result of steroid-hormone excess - although of course it could be too as estradiol can be produced elsewhere in the body apart from the adrenals.

Alison

[Sabre's Mum]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Alison

I do miss your wisdom on the cushings site and it is WONDERFUL to hear from you again. You have such amazing knowledge!

Sabre was once the beautiful short haired Vizsla, then became the hairless Vizsla. After Lysodren treatment ... his hair grew back just like Mia's .... a rather fluffy, fuzzy coat. He has not shed it and I would have to confer that he indeed is just adding to the furriness. In fact the other day someone asked my husband ... what else has he got in him ... I can see the Vizsla but what is he crossed with! On his underside between his rear legs he is the hairiest beast I have ever seen. This just used to be bare skin!

Thanks for the info.

Angela and Sabre

[ventilate]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Angela
I would also be cautious with giving lysodren before your dog goes for surgery. It can be stressful and the dog may use up the reserved cortisol pretty quickly so it is possible that your dog may need pred or another steroid to be sure the level does not get to low with all the stress. I know when Nike s levels were within normal cushings dog range my IMS still had me give her pred even when she went to get her hair cut or any time I felt she may be stressed.
You may want to talk to your vet/surgeon about it, would hate to see Sabre going to low because of the stress.
Good luck with the surg and the resuming lysodren. I am getting Nike tested again in a month to see where she is as well.
Sharon

[AlisonandMia]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

That sounds just like Mia's hair-growth pattern - right down to the hair between the back legs - is Sabre's hair "down there" rather long, wiry and coarse?

Every time Mia was shaved for a stim test or because I got her shaved for comfort every shaved area stayed visible for the rest of her life although some more fur would grow through it. It looked like the original hair (which had been shaved) had not been shed but rather it had all just been added too.

I think it is possible that she may have shed and renewed some of her fur down on her lower legs but I was never sure - it was just a feeling as the fur there seemed to look "newer" than the nasty old shag-pile fright-wig that covered the rest of her.

I had people ask what sort of dog she was too. (At least they didn't ask what sort of animal she was!) I always said that she'd Cushing's and explained it as simply as I could and said that her weird coat was something like the strange hair people who've lost their hair to chemo can get when it regrows. That seemed to satisfy people. Isn't it a great thing that self-image ain't an issue with dogs? - that is as long as they smell right, of course! She looked very smart just after she'd been clipped and was a lot more comfortable for it too although I left her "long" for the winter.

The acid test as to whether this is related to the pituitary function or just the biochemical upheaval would be dogs with iatrogenic and/or adrenal Cushing's. Do they go on having long-term abnormal coat issues, I wonder?

Alison

[Sabre's Mum]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Thanks Sharon for posting.

My husband and I even discussed the whole issue of low cortisol levels vs a "normal" dog and the fact we should have just got the lump cut off months ago when Sabre was off Lysodren and it wasn't so big. Sabre's vet didn't want to have to do surgery at all as she was hoping that it would just stabilise and stop growing at a comfortable size for him.

I had a discussion with the Practice Manager at the vet this morning as to the best plan of approach ... more for timing of dropping him off and picking him up. He has always been a "barker" at the vet when awaiting any surgical procedure so I have arranged to drop him off just before his surgery and to pick him up when he is ready to come home. ie. not when the usual dog comes home but when sabre is OK and starting to bark! He has never liked being placed in the cages at the vets!

The pred sounds a great idea and I will definitely discuss this with the vet. I will also discuss the next day of dosing with Lysodren as he has had Sat, Mon so far and was due for Wed, Fri, Sun.

Thanks for your advice
Angela

[Sabre's Mum]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Alison

I do believe that Sabre will have long term coat issues. Any new hair that is growing back is definitely of the fluffy variety. Yes, his hair "down there" is coarse and wiry. We have a laugh about it all the time as Vizslas do not have any visible hair "down there" (well very fine and barely there). We just call him the hairest Vizsla in the world.

On the matter of self-image issues ... I would have to disagree with you there. I believe Vizslas are VERY vain. Sabre was NEVER happy when he had no hair on him as he picked up on all the vibes from people staring at him. Hence we made the decision to make sure that he wore a coat out in public!

Angela and Sabre

[Squirt's Mom]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

This is an interesting topic ya'll got going here. How about this to factor in:

Squirt is not on anything but melatonin and purified lignans for Cushing's treatment, and I have noticed that the hair on her belly is much longer, there is more of it, and it is softer than her usual coat which is more like a Cairn's. It extends down the inside of her back legs on the thigh area, too. I could always seen her belly skin quite easily before, now I almost have to part the hair to see it. She has been losing the Cairn long hairs, but I believe that is expected at her age (11), but no other shedding or hair loss. The other two coats, show no changes other than softer, shinier since her new diet, then there is the belly hair which is different from the other three.

Is this the melatonin at work? That has been my thought on it.

Hugs,
Leslie and the girls

[Sabre's Mum]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Leslie

Yes I suppose in Squirt's case it probably is the melatonin or lignans. Sabre is not atypical and I haven't done any research on the effects of the treatment and the "hair" issue. Nor, for that matter have I looked into it for Sabre's case. But, yes it is interesting.

Angela and Sabre

[Sabre's Mum]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

I have just picked up Sabre from surgery. It is a little uncomfortable for him so for his sake I hope the pain killers stay around in his system for a little while. We are going to keep him off Lysodren for the week and he is taking pred for the next few days along with Clavulox. Let's hope another lump doesn't reappear!!!!

Angela and Sabre

[Squirt's Mom]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Hi Angela,

Glad Sabre is back home with you and that he has no problems in recovery.

Hugs,
Leslie and the girls

[ventilate]

Re: Sabre 10 year old Hungarian Vizsla Lysodren

Glad to hear Sabre is in his own home and that the vet is holding the lysodren and is giving some pred, sounds like a great plan to me, especially with the Sabres levels getting low before and taking so long to come back up.
Hugs to you and yours from me and mine
S,N and K ( AKA DS)