Cushing's disease in old dog...getting desparate...

[chicknmania]

The nurse is in today and she said he wrote in the chart "may want to start Veterole" in September of last year.
probably he told me we may want to start it, but lets see how she does, or words to that effect.
The nurse was not familiar with any of the meds you suggested and said they don't carry them.
Vet will be in later today but of course it's his first day back so she said he will try to call me today if possible,
but may be tomorrow.

 

[SunnySkies]

Trilostane is the generic name of Vetoryl, which may be what the assistant was talking about.

Hope you get some answers.

 

[chicknmania]

Good, I hope so. He didn't call today, but it was his first day back and I was in a seminar all day, which he knew.
I hope to talk to him tomorrow.

 

[chicknmania]

he agreed with you the Veteryl would be the best, and it might do a lot for her, but he thought she would still need to be on Proin, and that's an issue with her. Also, he said that if she is that weak in the hindquarters, it might not be worth it. He won't do anything without seeing her again and doing some bloodwork, to rule out other possible things that she might be developing. So she has a tentative appointment for tomorrow morning. He said that he doesn't feel that the Veteryl, if we had started it last year, would have extended her life this year to a much better point than what it is now.
He does know the dog, and has known her her whole life, or most of it, so for that reason I guess we will go with whatever he recommends tomorrow.

 

[chicknmania]

So this is just flipping maddening. We went in, he does bloodwork, and NOW he says that her blood count is almost perfect, except that she is a little anemic. He attributes that to fleas, we have had a bad flea season this year..everyone has. But she has hypersensitive skin even when she doesn't have fleas. He says he diagnosed her as "cushinoid" before, because of her high liver counts..but that is gone. Dioesnt knowWHY she had high liver counts for so long, that it could have been some kind of poison, or bad food. Something in her blood work, indicated to him that her kidneys are not functioning efficiently. (no kidding). Her heart and lungs are excellent. Atrophy and weakness in her rear quarters he attributes partly to her breeding (German Shepherd) and age. He thinks that we should switch her to Science Diet, one of their Senior dog formulas, and he gave her a steroid injection to deal with the skin sensitivity. After a week he wants us to start her up on Proin again, just one a day. He says he thinks it is worth it for us to continue with her, because her overall health is not bad. He says he thinks the food will make a big difference. I'm not so sure. Just can't figure out why she would have classic Cushing's symptoms for so long, and now she doesn't have it? wth???I mean I know part of it is he is trying to keep our costs down, but still, he's just treating her symptoms, and we still ended up with a big vet bill, just for today.

If she does not improve by the time winter sets in, we're going to be back to square one.

He also said absolutely no protein..no cheese, peanut butter, or meat...even as a treat to give her meds in.

 

[SunnySkies]

That would be highly unusually for liver values to drop to normal after having been high. If he never did an ACTH stim, an LDDS test or sent you for an ultrasound, he might be correct. It could have been a fluke or related to something else.

But now, if her kidney values are elevated, she could have what is called chronic renal failure. And yes, little to no protein is one thing that we offer to try to help support what little kidney is left (by the CRF is diagnosed, much of the kidney is nonfunctional). Anemia could be secondary to CRF having been longstanding as well...not just fleas..especially if an enzyme called amylase is also elevated. There are some other supports that can be done for CRF as well.

CRF can cause muscle wasting, excessive urination, vomiting, panting, and a whole host of other symptoms. It would certainly complicate matters if she has Cushing's as well.

It might be beneficial to find a second opinion. I am sorry you are dealing with all of this.

 

[chicknmania]

In doing research I read that cortisol levels can fluctuate a lot in Cushing's, making it hard to diagnose. She is not any better. Vomiting water. Gee, no wonder.
Her hypersensitivity in her skin is gone, probably thanks to the cortisone injection, but since we see no evidence of fleas, I'm assuming the hypersensitivity
will return as a result of the underlying problem

 

[SunnySkies]

They do,but the increased liver values are always there after a dog becomes Cushingoid, because of the increased level overall of circulating steroid hormones.

Vomiting water is no bueno. Call your vet.

 

[chicknmania]

Ok.

thanks.

 

[chicknmania]

WEll, she actually is feeling much better....much as I hate to admit it. She's still very shaky on her old legs but she's been playing in the mornings, trying to get the cats and chickens to play with her. We have had her on the Hill's Science Diet Active Senior food which is what he told us to keep her on exclusively, and I reluctantly started her on Proin again, just one per day, like he told us, in a Greenie pill pocket. I started her on that two days ago. And last night she had a dry bed all night and today she's been able to stay inside a lot and didn't leak pee at all...She's still got a bit of skin issue, but not bad, so far....