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  • Midge - Cushings + other problems - help please

    Hi all

    I was a member of the Canine Cushings forum before it crashed out. Not my fault it did so ... honest! Apologies in advance for the length of this post ...

    In a nutshell, I have Midge, a 9.5 year old male cross West Highland White/Jack Russell (as far as we know ... he's from a shelter). He's had the chop (already done when we got him at 9 months). He has always been a sedate little dog, quite happy just to potter about, odd mad dashes around, but never one for manic running around etc like most dogs do. He's always had a very good appetite and likes his water, his shape was once described by a French vet as 'rotund'! This could be, however, because he was a little over-weight at the time as he'd pulled his leg so couldn't do much exercise. He is a barrel shaped dog with spindly legs - but he's always been like this so it could just be his cross breeding as Westies are more 'barrel shaped' and Jack Russells tend to have thin legs.

    Anyway, in September 2008 he developed a sore patch on the front of one of his legs which wouldn't heal, it was lumpy and he used to nibble it - he's always been a nibbler too! Unfortunately it wouldn't clear up and eventually it spread to his feet, all 4 of them, which were sore and swollen, so walking was extremely uncomfortable for him. After many types of antibiotics, eventually the vet suggested we test for Cushings, which we did and she diagnosed him as being a Cushings dog (don't ask me for the actual tests/results, I don't have them, might be able to get them if really needed but a bit reluctant to bother the vet at the moment as you will realise as you keep reading).

    Since then he's been on Vetoryl 30mg daily but whilst his Cushings appears to be under control (excellent levels apparently) the problem with the feet hasn't gone away although they are nothing like as swollen/sore as they were and he can walk fairly well on softish ground, but they are now covered in a few layers of a type of scale - the vet says this is caused by a yeast/bacterial infection - something to do with us all having a certain amount of yeast and bacteria on us normally which our immune system keeps in check but as Midge's body isn't functioning correctly it's not doing so. The 'infection' is patchin all over his body - around his eyes in particular, in his ears, round his bottom, nearly covering all of his feet up to his 'knees' and patches on his tummy and on both sides, with a few other smaller patches on his neck etc. They come out as crusty scaley patches and then eventually the skin turns black, due to, I assume, the bacteria being trapped in the moist yeasty stuff.

    We have to try to bath him every day (Maleseb or another anti-bacterial shampoo), not always possible, to wash all the horrible yeasty stuff off, especially on his tummy which gets very hot and sweaty and this makes the yeasty stuff come back with a vengence - within 12 hours of washing him it can be nearly as bad again.

    The vet also thinks he's got serious liver problems as his enzyme (?) levels are high - he's just had another blood test and his levels were way high again and to add insult to injury he's anaemic as well.

    He's getting more picky about food, sometimes doesn't want to eat at all which is quite upsetting - he was on a fairly strict chicken/fish, rice/potato diet to try to help the liver but he's now won't eat rice at all, he's also not as interested in things as he was so we've had to resort to feeding him just about anything we can get down him so as well as the fish and potato which he will eat most of the time, we're having to supplement this with Frolic and Bakers complete dog food plus a couple of tinned hot dogs to get his tablets down him in a morning (ie to hide them in). I assume he's less interested generally partly down to his now being anaemic and feeling crappy but we're also worried that it could be the Vetoryl as well as this is contra-indicated for dogs with liver problems but there's not a lot else we can do for his Cushings. The side effect of Vetoryl include lethargy, loss of appetite and diarrhoea - he's not quite got this last one but his stools are not really solid, sometimes it's the consistency of toothpaste (sorry if that is not a nice image!).

    The reason why I'm reluctant to contact the vet again at the moment is that both when I saw her on Thursday for the blood test to be done, and when my husband spoke to her on Friday morning, she suggested that Midge is suffering and things we should look at his quality of life - she's said this a few times over the past few months but to be honest she doesn't see him at home, on a 'good' day, he's not in pain or discomfort, will have a little potter, eat and drink normally and is more alert - of course when you take a dog to the vets they are anything but normal and she does acknowledge that dogs generally are at their worse in the surgery. He has got more of the yeasty patches on him since she last saw him a couple of months ago but they don't seem to be bothering him - he just looks manky. He does get quite hot, but he's always been a hot dog, which unfortunately adds to the yeasty problem as he sweats more and this encourages the yeasty stuff to come back.

    We're trying to do the 'right thing' whatever that is for Midge. We don't want him to suffer but we also want to give him as much of a chance as we can. Whilst we were on holiday just over a week ago (in our motorhome) we took Midge with us and made a point of taking him out (in his buggy) and he was quite perky and interested in what was going on - he had a few gentle walks on the beaches we visited ... although he was turning into a homing pigeon by trying to go back to the motorhome some of the time.

    Rightly or wrongly, we've stopped his Vetoryl at the moment - he didn't have a tablet yesterday morning, nor today, as we want to see if he 'perks' up off them to see if they are making him feel lethargic etc. As a result, we think, yesterday lunchtime and evening he ate loads of potato, fish and chicken, and again today he's done the same so he's certainly got a much better appetite since stopping the tablets - before that it was really a chore to get anything down him that was 'good' for him. We're closely watching him for any signs of anything untoward, or out of the ordinary, as we don't want him to have problems with being off the tablets. I know it's only been since yesterday, but he sees to be more relaxed without the tablets in his system.

    The questions is what do we do now! Do we keep him off the Vetoryl and try to boast him by getting him to eat better and therefore hopefully improve the anaemia? Or should we put him back on it and see if he again has the same problems? Should we give him a tablet every other day and see if that is a good compromise? Should we be doing something to try to help the liver problem? Or is there something else we should be considering?

    Any suggestions/help will be greatly appreciated.

    Thanks in advance.

    Mel B & Midge the Squidge

  • #2
    Re: Midge - Cushings + other problems - help please

    Hi Mel,
    Welcome back to our temporary home thanks to Natalie and K9diabetes.

    I think you did the right thing by stopping the Trilo. It has always been said that we don't give these meds to a sick pup. The symptoms you describe, It seems to me that your Midge is a little low on the cortisol. Excellent levels really don't mean anything, in this game you / we have to work with numbers followed by treatment followed by numbers and it goes on until we find the right combination. Some pups do better on the higher end of normal and some do better on the lower end, but you'll never know unless you have the results in numbers.

    I think everyone would agree that we would like to see the acth stim test result/s or the last few results. It would help alot. I'm sure your vet or assitant would be glad to make copies for you.

    By liver problems, what do you mean? Was there an ultrasound done? or was it dx'd by bloodtest results only. Most cush pups have high liver enzemes.

    Also wondering if his thyroid was checked, often times a thyroid problem will lead to skin and hair problems.

    Was diabetes ruled out?

    Yeast and bacteria problems...can be caused by many things. I would feed her some plain yogurt, possibly all the antibiotics have killed the good bacteria and yogurt is a probiotic and should help replace the good bacteria.

    I'm happy you found us again and I am sure the others with much more experience than I will help you sort thru this.

    John (Roxee's Dad)

    Comment


    • #3
      Re: Midge - Cushings + other problems - help please

      Hi Mel,

      I am so happy to see that you found us. I do remember your first post and the site may have gone down before you had an opportunity to answer some questions that some of us had for you. I had a copy of my post to you which contained a other posts as well. I've copied below in order to bring everyone current. Please read through and make sure you answer as many questions as possible. The more information we have, the better able we can provide you with more meaningful feedback.

      Glynda

      Hi all - New to the forum - be gentle with me!

      I'm hoping you can help me as I am at my wits end ....

      I have a dog, Midge, he's a cross West Highland White/Jack Russell, approx 9.5 years old. He started to have problems with a leg infection in September 2008 that wouldn't clear up, he then got like a yeast type infection which spread to all 4 feet (sticky creamy stuff), then he also got black crud on the feed which covered his pads. After blood tests and the cortisol level tests he was diagnosed with Cushings and has been on Vetoryl ever since. In the vets words the medication has "excellent control" of his Cushings which is good. Looking at the signs of the disease, and thinking back to how he's always been (we got him at 9 months old from a rescue centre) I think he's always had it but has always coped so we never really knew there was anything wrong.

      Although the Cushings is under control, the problem we have is the other bits - the yeasty stuff and the black stuff, both on his feet and body. His eyes, nose and ears are affected too and he's had several ear infections. He now has lesions on his body, similar to the yeast type stuff which mats his hair together and they then turn the skin a bit black - possibly caused because of the moisture held in by the matted fur - keeping the fur clipped short helps a bit but we can't stop it totally.

      We've had all sorts of antibiotics, creams etc, Maliseb shampoo with a nightly cleaning routine of bathing and then putting on the creams etc as appropriate. His feet 'yeast and black crud' problem improved a lot with the use of a human atheletes foot powder but we just can't shift the remaining black crud no matter what we do/use - it eventually covers his pads and it has to been picked/peeled off. Nothing seems to be helping much though with the lesions no matter what we do. One of the creams we were using I discovered was contra-indicated for dogs with Cushings so we had to stop that, but I wasn't convinced it was really helping either.

      To add insult to injury he's also got a problem with his liver - his enzime levels were in orbit and although they did start to come down since December they shot up again, higher than ever, just over a month ago. Unfortunately the treatment for this is steroids and that is the exact opposite of what we should give him for his Cushings so we can't do so. Instead, since then, he's been on a strict diet of rice/potato, chicken/fish and vegetables for his dinner, plus hyperallergenic dry complete dog food for lunch - the only 'junk' food he's allowed is some sausage in a morning to get him to take his tablets - he's gotta have something nice to hide them in otherwise he spits them out like missiles!

      He's very strong and eating well, much better than he was a couple of months ago, which is great, but as you can appreciate he is totally fed up and often has tantrums and duffs up his bean-bag with frustration!

      We're at a loss what to do next really, we can continue with his daily bathing, picking etc but it can't be nice for him to have these lesions all over his body and the yeast/black around his eyes and nose really drive him nuts at times. He's so strong though that were not really considering having him put down, he's not bad enough for that and whilst he's willing to be strong and keep going so will we.

      We're considering asking the vet about stopping his Cushings meds so that we can try to treat the liver problem ... it's not certain whether it's the Cushings or the liver that's causing his lesions etc problems but as it's got worse again, at the same time that the liver has, we're thinking it's more to do with that - but we don't know if that's going to make things worse!

      Does anyone have any experience of Cushings and liver problems and what did you try ... did it work?

      Or does anyone have anything to suggest that might help overall?

      Thanks in advance for reading this ... I'll keep my fingers cross for a 'glimmer' of hope...

      Mel B
      --------------------------------------------------------------------------------

      Hello and welcome. You will get lots of answers from here. I can tell you that liver and cushings can go hand and hand. Miko gets Milk Thistle for the liver and you can also try SAM-e. Midge is adorable. Christine

      Miko's Mom
      --------------------------------------------------------------------------------

      Hi and welcome to our site,

      I am so sorry to read about the skin problems your pup is having - poor little guy. Thank you for posting these photos as it gives a look at his condition.

      Yep, Christine is right we will ask for more information.

      Let us know the exact numbers from the ACTH stim tests performed to let us see the what the cortisol levels are. Also, ask your vet to give the exact numbers of the blood tests performed recently to see the elevations. The liver, yes is one of the organs that is affected by Cushings, but since treatment has begun I am wondering like you why the liver values are still very high.

      It may not be the case with your pup - but I just wanted to add a note on Vetoryl as seen in the brochure - is that dogs with liver disease really should not be taking Trilostane.

      How much Vetoryl are you giving?

      In addition has your vet looked in the possibility of thyroid problems - please take a moment to read through this link - http://www.lbah.com/canine/hypot4.htm - some interesting reading.

      Are you seeing a dermatologist on these skin and infection issues?

      I know others will chime in shortly,
      Terry
      --------------------------------------------------------------------------------

      Welcome from me, as well!

      I just want to "second" what Terry has said about concern regarding using trilostane with a dog who has liver disease or damage from other causes. Here is a quote from the U.K. product insert for Vetoryl:


      Quote:
      Special warnings: As the majority of cases of hyperadrenocorticism are diagnosed in dogs between the ages of 10-15 years, other pathological processes are frequently present. It is particularly important to screen cases for primary hepatic disease and renal insufficiency as the product is contra-indicated in these cases.

      Here is the source for this quote: http://www.dechra-uk.com/downloadfil...tDataSheet.pdf.

      I encourage you to discuss this warning with your vet, to make sure that the Vetoryl is not causing additional harm. In the meantime, I am so glad that you have found us here, and I look forward to finding out more about your sweet Midge.

      Marianne
      --------------------------------------------------------------------------------

      Hi and welcome to the forum.

      I think Westies are one of the cutest darned dogs in the whole world and at one time I was thinking about sharing my life with one. I did quite a bit of research on them and decided against it as the breed has some serious health concerns. Westies are at the very top of the list for dogs with severe allergies and autoimmune disease. The latter seriously compromises the immune sytem and a dog is unable to fight off the smallest of infection. Copper toxicosis and portostymic shunts are also on the list of health concerns. The last three conditions can seriously impact the liver and symptoms can develop at any age so I am wondering if your vet has done any liver function tests or suggested a liver biopsy? An ultrasound is usually done but a biopsy is really necessary to diagnose the problem, including determining if the damage to the liver is steroid induced.

      Skin issues developing before a dog is one year old would not be considered a symptom associated with Cushing's. Aside from the skin and liver issues, does Midge have any other symptoms such as excessive drinking and urination, voracious appetite, panting, pot bellied appearance, hindquarter weakness?

      It would help us a lot if you could please post the results of all tests done by your vet to diagnose Midge. Did he tell you if she had pituitary dependent cushing's or an adrenal tumor? If you don't know the answer to that, we may be able to determine that by the test results you post. If an abdominal ultrasound was done, please post the findings here too. How long has Midge been on Vetoryl? How much does she weigh and what is her current dose?

      Sorry for so many questions but the more information you can give us, the better able we can provide meaningful feedback. I am sure you will be hearing from others and we'll all be waiting to hear more about your precious girl.

      Glynda (LulusMom)
      --------------------------------------------------------------------------------

      Midge is real cute; never saw a westie/jack cross before!
      As others have mentioned, milk thistle & Sam-e are two good supplements to try. You can buy at Walgreens or go with a veterinary version of same (Denosyl, Marin or Denamarin, which is a combo of the first 2).

      I can't comment on the trilo, but others have said it is not a good mix when the pup has liver problems.

      My Aussie is on several supplements plus generic Anipryl. We are due for blood work soon and I'm hoping her liver values are down....hers were sky high several months back (2000 range). But she seems to have responded well to her meds since then and many symptoms have subsided/moderated. I have heard that Anipryl may actually lower liver values...we shall see.

      Good luck

      jrepac
      --------------------------------------------------------------------------------

      Hi Mel,

      Welcome to you and Midge!

      The other have given you some good info as usual so I don't really have much to add other than some links on Cushing's which will be at the end of this post.

      When I read about the skin and feet problems my first thoughts were zinc issues and allergic skin diseases. I would strongly recommend that Midge be seen by a dermatologist. They have more training and experience with this sort of thing than a GP vet will.

      I would also follow Glynda's suggestions about the liver. Liver diseases can cause the same signs as Cushing's and the stress can cause false positives on the tests. An ultrasound and liver specific tests, including a biopsy, would be tops on my list.

      I am glad you found us and hope to learn more in the near future.

      Hugs,
      Leslie and the girls

      the links

      Kate Connick*
      http://www.kateconnick.com/library/cushingsdisease.html

      Long Beach Animal Hospital*
      http://www.lbah.com/canine/cushings.htm

      Drs. Foster and Smith*
      http://www.peteducation.com/article....2+2097&aid=416

      Newman Veterinary*
      http://www.newmanveterinary.com/CushingDiag.html

      Cushing’s signs and pics*
      http://www.newmanveterinary.com/CushSignFrame.html

      BMD Health Library*
      http://www.bestbeau.ca/bmd_health_links_4.htm
      (scroll down to see Endocrine Diseases)

      Mar Vista Animal Medical Center*
      http://www.marvistavet.com/html/cushing_s_disease.html

      Vetstream*
      http://www.vetstreamcanis.com/ACI/Fe...ctSheet052.asp

      "Find a Specialist near you"
      http://www.acvim.org/Specialist/Search.aspx

      Leslie-n-Squirt

      Hi and welcome from me as well,

      I agree with the others and that a lot isn't clear. For one thing, high liver enzymes in itself, isn't considered a liverdisease. It's symptomatic of other processes going on in the body. So depending on how high they are, your vet should start testing (if he already hasn't done it) for any kind of liverdisease or any other condition that can cause high liverenzymes.

      I'm a bit confused since you say: "his enzime levels were in orbit and although they did start to come down since December they shot up again, higher than ever, just over a month ago. Unfortunately the treatment for this is steroids". The treatment for high liver enzymes, is finding the cause of the elevation. So, if your vet told you that the treatment "for this" is steroids, I wonder if the vet already has some diagnoses of the cause of the elevation of the liverenzyms?

      Also, all the creams, antibiotics, shampoos and powders you use for the skincondition...are they prescribed by the vet? (over the counter creams, ointments and stuff, aren't as safe/innocent as people sometimes think and might contain for example steroids you don't even recognize...and also everything you put on the skin will be absorped by the skin and enters the dogs system.) And what is the vet saying about the skincondition? According to the diet, it sounds like the vet thinks its an (food) allergy issue? I just have to say, that in case of a true food allergy issue, giving even a small piece of sausage once a day, may be quite enough to keep the allergic issues going.

      Another thing I noticed, is that you stated that the one thing that really seemed to help, was the athlete's foot powder. Athlete's foot is caused by a fungus...was your dog ever checked for a fungus infection?

      I think it would be wise to step by step start diagnosing what is going on exactly with his liver and skin. Randomly trying things like stopping the Cush meds is not such a good idea. It's best to look at all issues that are going on and diagnose them...maybe with the help of an internal medicine specialist (liver) or/and a allergyspecialst (skin)

      Best of luck,

      Saskia and Yunah,
      The Netherlands.

      Comment


      • #4
        Re: Midge - Cushings + other problems - help please

        Hi Mel,

        I have only a moment to welcome you back and to post. But something that you mentioned caught my eye -- you've said that Midge is anaemic. Here is a specific warning contained in the U.K. Data Sheet published by the manufacturers of Vetoryl:

        The product should be used with extreme caution
        in dogs with pre-existing anaemia as further reductions
        in packed-cell volume and haemoglobin may
        occur. Regular monitoring should be undertaken.
        The quote comes from here: http://www.dechra-eu.com/downloadfil...tDataSheet.pdf

        I just checked, and I don't see the same warning included in the most recent U.S. Data Sheet for Vetoryl. But I would feel concerned enough about this issue to have my vet check with Dechra before reinstituting Vetoryl treatment if that is the route you decide to go. Hopefully, I can stop by with some more thoughts a bit later on.

        Marianne

        Comment


        • #5
          Re: Midge - Cushings + other problems - help please

          Hi Mel,

          I, too, am glad you found us and wanted to add my "welcome back" to you and Midge. As Glynda has said, the more information you can provide from the questions that were previously asked the more it will enable us to give you feedback.

          Sounds like you are feeling a tad unfortable about asking your vet for copies of Midge's labs and test results. I can certainly understand that feeling. In the past, asking for copies of tests was nothing that ever even crossed my mind. However, I soon learned the importance of having copies of all the testing on hand and have been keeping a file ever since for all of my animals (and myself too!) I urge you to ask your vet to provide you with copies of Midge's test results. As John (Roxee's Dad) said:
          Your vet or assitant would be glad to make copies for you.
          Will be watching for your next post and update. Give Midge some extra pettin' from me!!

          Louise
          Munchie, 11 yr. old Mini-Schnauzer, 23.2 lbs., diabetes 10/24/12. 8 units Novolin N 2xdaily.

          Comment


          • #6
            Re: Midge - Cushings + other problems - help please

            Hi,

            I probably missed you at the other board but am so glad to see your post here. The scales, the infections, it all reminds me so much of what my Scooter had. Same thing...the yeast, then it would ooze and scale over and get infected. The only thing that helped him with that would be a weekly bath with a colloidal oatmeal rinse. I would trim the fur back the best I could without hurting him to allow the oatmeal rinse to get as close to the skin as possible. You don't rinse that off....leave it on. Aveeno sells it in packets and I would just pour and pour it over him for at least 15 minutes at a time. Then, the rest of the week, I would take a mild shampoo, usually oatmeal and put a little on washcloth and pat it on and gently wash the infected areas only. And then rinse it off using the same technique. My fear was by giving an actual bath daily it made him worse...his skin got very dry and even more likely to get infected. I used the antimicrobial shampoos and for whatever reason I swore they made things worse....again almost too drying.

            The other thing we added was a strong broad spectrum antibiotic. It took about a week but I did see some improvement.

            As for the liver enzymes, I see you have been given great advice already. Scooter's enzymes were in perfect control so we felt it was more an allergen. I see you are feeding fish and potatoes which is excellent. I am wondering if you aren't dealing with allergies and the chicken and rice could be lending to the problem? A strict hypoallergenic diet may help things out too. Nothing but the fish and potatoes for a few weeks at least until you can see if it helps.

            I know someone, I think Leslie (Squirt's Mom) told me that her vet mentioned that sometimes an older dog's immune system just can't handle things any longer....I am not quite sure what exactly she said now (sorry Leslie) as it was shortly after I lost Scooter. But, I do know she reassured me that I did everything I could and sometimes there just isn't anything else you can do.

            But I do think these other things are worth trying out. I hope this helps some bc my heart truly goes out to you and Midge! I feel your pain and am so very sorry!!!!

            Sending my very best healing wishes!!! Beth, Bailey and always Scooter

            Comment


            • #7
              Re: Midge - Cushings + other problems - help please

              Has a culture been done on his skin? Also it is extremely important that you have a vet that is knowledgeable on Cushings. I would see an Internal Medicine Specialist as they have more expertise
              Marianne and canines: Jasmine( diabetic since 4/10) Puma,Harley,Sebastian,Sophie and cats: Yoda,Sabrina and Cleo. Also Baby Boy (my cockatiel) & Angel Pebbles

              Comment


              • #8
                Re: Midge - Cushings + other problems - help please

                Hi all

                Update on Midge. He's still off the Vetoryl. The good news is that he's now eating properly again and generally appears to be much happier. He's more alert and when we went away for a couple of days he had a little potter on the beach and 'sniffed' the rocks etc, same when he had a little potter on the field - he hasn't really done this for ages! Today he actually got out of his bed to come over to us to say hello without us even asking him and we actually got licks!!! I feel like my little 'boy' is coming back again ... yes I know I shouldn't get too excited by all this, we don't know how long he will go on for but we feel it is better for him to have a quality to his life rather than be fed up and like a zombie.

                Tonight he's eaten his hot dogs for breakfast with his vitamin tablets, plus some complete food biscuits (Bakers Complete), at lunch time he had more of the Bakers, and at tea-time he had an egg, 4oz of white fish, a little drop of very thin gravy and some potato, and he's just had a small jacket potato!

                He's had his nightly bath and whilst my hubby was getting it ready, Midge went and laid in his favourite spot in there ... something he hasn't done for months.

                I can't be sure but I think his skin is a little better, very difficult to say for sure as its only been a few days, but I don't think it's quite as 'angry' looking, possibly because the Vetoryl isn't supressing his immune system? he has't had a skin culture done but it's pretty certain it's his own system that's causing the problem ... the yeasty type stuff that's on his tummy every day is yucky and when we clean it off there's nothing else there, but it just comes back again. He's having some pro-biotic yoghurt daily to try to boost his 'good bacteria' and immune system.

                The vet is aware of what we are doing and doesn't have a problem with it, we just have to watch out to see if he develops any liver problems due to the excess cortisol in his system again. He's putting some of the weight back on that he gradually lost and once we feel he's back to a better 'size' and hopefully his anaemia is not so bad, we'll look to getting him on a better diet again so that his liver isn't so stressed.

                Tests - we've asked the vet for the results and she's going to get them together for us so we should have them in a day or 2 and I'll then post them on here for you to see.

                Thanks for all your suggestions/help so far, much appreciated.

                Comment


                • #9
                  Re: Midge - Cushings + other problems - help please

                  Hi all (licks from Midge)

                  Midge is definitely feeling better, he's actually getting up from his bed more and more now and is happily standing to eat his food, he's drinking but now at least he stops himself when he's had enough, rather than us having to stop him, which is a good sign I think. His lesions are definitely not as crusty and the yeasty stuff on his tummy isn't coming back anything like as fast or as much as it was and he's gone 'flaky' ... in the sense that the crusty stuff on his body etc is coming away much more easily now. We've had a few goes at his feet and whereas normally he would be sore, its actually not really bothering him now.

                  I've now got the test results from the vets, not sure exactly what you need to see but here goes, I've just included the bits which are either high or low to save space (omitting other items given on the test result sheets which were normal):

                  19 Nov 08:
                  ALKP - 1168 U/L (high)
                  ALT - 507 U/L (high)

                  UREA - 4.3 mmol/L (normal)
                  CREA - 39 umol/L (low)

                  5 Dec 08:
                  ALKP - 1100 U/L (high)
                  ALT - 355 U/L (high)

                  UREA - 18.9 mmol/L (high)
                  CREA - 75 umol/L (normal)

                  7 Jan 09:
                  ALKP - 860 U/L (high)
                  ALT - 292 U/L (high)

                  UREA - 13.1 mmol/L (high)

                  23 Feb 09:
                  ALKP - 1629 U/L (high)
                  ALT - 253 U/L (high)


                  30 Mar 09:
                  ALKP - 1503 U/L (high)
                  ALT - 141 U/L (high)


                  30 April 09:
                  ALKP - 1569 U/L (high)
                  ALT - 159 U/L (high)

                  HCT - 17.6% (low)
                  HGB - 5.9 g/dL (low) (I assume this shows he's anaemic? )
                  GRANS 13.8 x109/L (high)
                  %GRANS - 88%
                  NEUT 13.3 x109/L (high)
                  EOS - 0.5 x109/L (Low/normal borderline)

                  All comments/views gratefully received!

                  Comment


                  • #10
                    Re: Midge - Cushings + other problems - help please

                    Hi,

                    I'm not up to date on your story. Could you fill me in a little bit.

                    Why is your dog "off" vetoryl.

                    How long and why??

                    I'm so glad so so glad he's feeling better

                    Thanks, Patti and Jesse

                    Comment


                    • #11
                      Re: Midge - Cushings + other problems - help please

                      Hi Mel,

                      Thanks for the kisses, Midge!

                      I'm no good at reading lab results like these but others like Glynda and Debbie are and I am sure they will be along to give their input.

                      In looking at the results, tho, did something happen between the Jan and Feb tests? The ALKP numbers were going down until the Feb reading then nearly doubled. Was Midge sick at that time, or was he under some sort of extra stress then? New med? That seems to be a big jump to me, but as I said I'm no pro at this at all, so it could just be my funny mind doing it's funny stuff.

                      7 Jan 09:
                      ALKP - 860 U/L (high)
                      ALT - 292 U/L (high)
                      UREA - 13.1 mmol/L (high)

                      23 Feb 09:
                      ALKP - 1629 U/L (high)
                      ALT - 253 U/L (high)

                      Well now, I was a lot of help, huh?

                      I am really glad to hear that Midge is doing better and better as the days pass. Sounds like stopping the Trilo was the right move for now. His skin sounds like it is improving as well and I'm sure that makes all of you more comfortable. I hope he continues to improve all around!

                      Hugs,
                      Leslie and the girls
                      "May you know that absence is full of tender presence
                      and that nothing is ever lost or forgotten." Anne, a Corgi mom

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                      • #12
                        Re: Midge - Cushings + other problems - help please

                        Hi Patti

                        In a nut-shell: Midge was not well on Vetoryl, he was getting weaker and weaker and not eating properly, in fact it was getting harder to get him to eat much at all. When he had his last lot of tests done on 30 April, we found that the levels were raised again and that he was anaemic too. After weighing up the way he was and the problem with trying to sort out the anaemia in a dog that doesn't really want to eat, we decided to stop the Vetoryl, which can apparently cause lethargy, anorexia etc to see if we could sort out the anaemia and then decide where we went from there once (hopefully) he was stronger again. After all, if we couldn't sort that out then he was just going to continue to get weaker and eventually he definitely wouldn't have the reserves to fight the illness and would probably have faded away. We weren't prepared to let that happen. He's been off Vetoryl for a week now (last 30mg dose was on 1 May 2009).

                        Hi Leslie:

                        Midge kept getting ear/eye infections around January a time and was not a happy lad at all. He was also very picky about his food and getting him to eat was more and more difficult, we had been trying to give him a better diet but when he wouldn't eat it was to some extent a case of just getting food down him. He had been on Vetoryl continually since November 2008. When we got the 'bad' results we then tried to change his diet to a purely chicken/fish, potato/white rice one, with just odd bits of other food (such as hot-dogs to get his tablets down him). He was also on antibiotics to try to see if they helped with his skin infection so these may have added to the levels, I'm not sure but since he's been off the antibiotics his levels have reduced - may just be coincidence?

                        Midge was on Antirobe from 29 Dec to early January but after the course had finished he went back on his original ones (can't remember the name) as the Antirobe didn't appear to be having having any effect. Later in January he got much more of the yeast/infection back on his feet, more than ever before so he was put back on the Antirobe for a second time to see if that helped this time. He was also extremely fed up at the time - having really good 'whinging' sessions and beating seven bells out of his beanbag, he also kept waking in the night having whinging sessions too and getting himself into a right old tiz.

                        In early Feb we had to do a lot more 'washing/bathing' of his feet, Midge didn't like but we didn't know what else to do. I suspect this increase in 'care' (he didn't do baths at the best of times!) and the ever spreading 'gunk' didn't help. The Antirobe finished around this time and he then stayed off it, it didn't have any effect at all, in fact I suspect it made things worse by killing off the good bacteria in his tummy and making him feel even more grotty.

                        By 22 Feb the infection on his feet had remained pretty static but the yeasty stuff had started to spread more to his legs etc and he'd started to develop more of the 'lesions', up till then he'd only had a few patches but then they were spreading like mad. I assume the horrible progression of the disease is what was 'reflected' in the Feb test with the raised levels? He was extremely fed up during this time and getting himself into a right stew too which won't have helped either.

                        Back to now - he's much more content and calmer, which is why I assume his results have improved a little since February.

                        (I've tried to get the 'dates' etc right - fortunately I was putting postings on my Motorhome forum's 'chatterbox' section so can at least refer to that for some of the info as my memory is totally addled!)

                        Mel

                        Comment


                        • #13
                          Re: Midge - Cushings + other problems - help please

                          Thought you all might like to see a photo of Midge so I've put him 'smiling' as my avatar, and a full photo of him in my profile.

                          Comment


                          • #14
                            Re: Midge - Cushings + other problems - help please

                            OOOHHHH Mel,
                            Midge has an absolute BEAUTIFUL smile that goes with that absolute BEAUTIFUL face.

                            Harley and Lori

                            Comment


                            • #15
                              Re: Midge - Cushings + other problems - help please

                              Hi Mel,

                              I just took a quick look at your posts to refamiliarize myself with Midge's history and realized that you never answered some of our questions. The more information we have, the better able we can provide you with meaningful feedback. Sooo, let's backtrack a bit. I see that you have posted the blood chem results but is it possible for your to post the results of the diagnostic tests that your vet did to confirm a cushing's diagnosis. Those would be acth stimulation tests prior to treatment, low dose dex suppression test (LDDS) and abdominal ultrasound findings.

                              Aside from Midge's skin and coat issues, did he have any other symptoms associated with cushing's such as excessive drinking and urination, voracious appetite, panting, pot bellied appearance? Can you also give us the history of treatment. For instance, can you list the date you started treatment and the mg dosage and the dates of amount of any adjustment to the dosage. Please include the dates and results of the acth stim tests that were done after starting treatment and let us know if those tests were done within 3 to 6 hours after dosing? I realize that your memory may be a bit sketchy but your vet should be able to give you copies of all testing which has the dates and results.

                              Does your vet have any idea what is causing the anemia. If not, will s/he be doing additional testing to make this determination? I think Midge has a lot going on that is more urgent than cushing's at the moment so I agree that you made a wise decision to discontinue the Vetoryl. Actually, Vetoryl should never be given to a sick dog and when it comes to cushing's, any dog that is not eating is to be considered a sick dog.

                              Here is a link to info on anemia in dogs that might help you understand how it is diagnosed. It also touches on the bloodwork results. Debbie (Stardeb) is a long time lab technician and I am sure that she'll be by to give you her educated opinion on Midge's bloodwork.

                              http://www.sniksnak.com/doghealth/anemia.html

                              We'll all look forward to receiving more of Midge's history.

                              Glynda

                              P.S. Midge is adorable...his smile is contagious for sure.
                              Last edited by Lulusmom; 05-08-2009, 02:08 PM.

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