# Max's Test Results



## Kayos and Havoc (Oct 17, 2002)

Well, we know for sure that he has Cushing's Disease. His Cortisol is eleveted.









His Thyroid was a little low but his TSH was normal so the endocrinologists really feels the thyroid is being affected by the Cortisol level. 

The endocrinologist's recommendation to my vet was to have an internal med vet look at the results as well. I guess a lot of Cushings is caused by pituitary problems and not by tumors on the adrenal glands. So he wants to have another specialist see the results and if they are positve it is pituitary we will start medication. If they are not sure we will have an ultraosund done on his abdomen to see his adrenal glands. The US will be done by a specialist in Tulsa. Depending on that will determine course of treatment.

My vet has a US machine but it is not as sophisticated. He did a quick one on Max 2 weeks ago but did not see anything on his. machine 

At least we have a partial answer but hope to have more info tomorrow. 

You know I had Max's thyroid tested a year or so ago because his coat was rough and he kept getting constipated adnnthen had diarrhea and it was a tick low then so we put him on medication that did nothing for him. So we stopped it. I would imagine he has had the Cushing's for a while now and that has been causing his little problems off and on.


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## rover51 (Apr 21, 2009)

What is Cushing's? Is that treatable?


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## Kayos and Havoc (Oct 17, 2002)

Cushing's is a disease of the adrenal glands which sit on top of the kidney. Yes it is treatable but the medications are not cheap and frequent monitoring is required. 

I need to go back and re-read myself.


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## rover51 (Apr 21, 2009)

Well good luck to you and Max. At least it's not the C word, huh?


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## 3K9Mom (Jun 12, 2006)

Kate Connick has one of the best webpages for Cushings:

http://www.kateconnick.com/library/cushingsdisease.html

The links at the bottom are useful too. 

Cushings IS manageable. The good news is that the drugs they have now are better than those they had even 10 years ago. I would def want a board certified radiologist to do the ultrasound and an internist to do the testing and treatment. 

Are they talking about doing actual testing on Max besides just the ultrasound?? 

Zamboni has a mass on her adrenal gland (well, either that or the lobe is enlarged. Darn ultrasound, it's hard to tell). I opted to not do the ACTH stim test. I had a dog that was suspected of being Cushings, but we couldn't ever tell conclusively, so I refused to treat her because back then because the drugs were so harsh. My internist suggested we do the Low Dose Dexamethasone Suppression Test for Boni, but frankly, we have so much else going on, that I haven't made it a big priority. 

But for Max, this could explain quite a bit.









Kathy please us know.


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## GSD07 (Feb 23, 2007)

Kathy, I'm sorry to hear the bad news but the good news is that now you know what it is and know what to do to help Max!


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## JenM66 (Jul 28, 2005)

My friends 15 (?) year old lab has been living with Cushings for a few years now. I'll find out what med they give her - at home - and just go for blood level monitoring. I"m sorry it's not great news but at least now you have answers. Are the puppy pills still working?!!!!


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## JenM66 (Jul 28, 2005)

My friend's dog is on Trilostane.

http://www.wedgewoodpharmacy.com/monographs/trilostane.asp

http://www.drugs.com/cons/trilostane.html


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## Kayos and Havoc (Oct 17, 2002)

Yes that is what the vet mentioned. I am going back outside to work in the garden, it cooled off a bit here today. I will do some reading tonight. Thanks for all the links and info.


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## Kayos and Havoc (Oct 17, 2002)

Those articles were excellent and Max has almost everyone of those symptoms listed.

Sadly, a year ago I had him to the vet we were using in Kennewick, WA. Oksana knows this vet practice. I was concerned that Max might have Cushings or some form of Lupus because of his skin and other issues. The vet thought it was more likely hypothyroidism and tested him for this. Lo and behold the test showed borderline low thyroid. Se we treated that with no result at all. So we stopped that and Max continued on and did okay for several more months until we moved here. 

Given that cortisol is a hormone directly related to stress I imagine that the stress of moving sent him into an acute problem. The incontinence in the house is what sent me back to look again. 

What is funny is that the Cortisol being high actually helps his Spondylosis which is why I was able to greatly reduce his Rimadyl and even stop it for periods of time without him being crippled. 

What a paradox. It is tough getting old. 

Now on to the next step pituitary or adrenal?


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## JenM66 (Jul 28, 2005)

> Originally Posted By: KathyWIt is tough getting old.


Canine and human



































I really don't know what to tell you. My friend's lab has been on that drug 2+ years now. Like I said she's 15 or so and still getting around, slowly but does it. They have done NO other treatment except that drug. They are in the middle of a nasty divorce and the dogs are getting lost in the shuffle







but last time I saw her her coat was nice and she was very happy.


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## Kayos and Havoc (Oct 17, 2002)

*Re: Max's Test Results - latest news!*

Vet called a bit ago. The Internal medicine vet called back after reviewing his results. All 3 vets concur that they are 99% certain this is pituitary based due to the low thyroid. So vet is ordering the meds to start next week. 

He did say we could do an US of his abdomen to be certain but they all felt certain it probably was not needed. SO we are going to treat it as pituitary and if there is no improvement will do further testing. 

Max has diarrhea again and I have NO idea why.
















He is also pretty out of it today.


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## WiscTiger (Sep 25, 2002)

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Kathy could the fluctuations of the Cortisol have an effect on his digestive system, ie diarrhea? I don't have time to go back and read all the Cushings info, but I was just wondering. 

Val


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## JenM66 (Jul 28, 2005)

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That or is he sensing your stress? It is really hot / humid with lots of thunderstorms? Regardless, sounds like a great plan!!!!! And keep on givin' those puppy pills


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## BowWowMeow (May 7, 2007)

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Chama had diarrhea today too. Must be a bad digestive day for seniors.









Hope the medication helps Max!


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## Kayos and Havoc (Oct 17, 2002)

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I have to go back and read again too Val. Max had every symptom except 2 on the list! we had no rain for weeks just a lot of heat and he has been inside except to potty and we sit out after it cools a bit in the evening and play fetch in the morning before work.

I am heading out to track Kayos and Havoc - it is cool this morning! When I come back I need to do some more reading.


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## LisaT (Feb 7, 2005)

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Glad you found some answers -- I know how tough the unknown is!!

If you are giving any supplements, you might want to google the name of the ingredient(s) and cortisol, just to see if there are any interactions. For example, some herbs will directly influence cortisol levels:

http://ezinearticles.com/?Herbs-To-Take-To-Lower-Cortisol&id=758595

My dogs seem to tend towards the Addison side, low levels of cortisol -- licorice works wonders for Indy. I know I've taken Holy Basil and felt great on it.


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## DancingCavy (Feb 19, 2001)

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Poor Max. At least you have some answers though. I hope he's feeling better soon.


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## Kayos and Havoc (Oct 17, 2002)

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Thanks for the link Lisa! You are a wealth of knowledge.

Max still persists with gloppy pooy for no reason I can fathom. If anyone would get the trots from something it would be Havoc and he is fine. So it is not something in food. He is back on abx for a few days to see if it helps. I think I may just switch food and see what happens. 

Thank goodness for the dog run and cooler nights right now. I just spent an hour hosing it out. I feel bad leaving him out at night away from the family but he won't tell us he has to go.


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## LisaT (Feb 7, 2005)

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That has to be tough with all that diarrhea. What abx are you using? 

Did the diarrhea all start after a food change? I can't remember.


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## BowWowMeow (May 7, 2007)

*Re: Max's Test Results - latest news!*

Poor Max.







Chama has to sleep downstairs now by herself and doesn't like that either. Some nights I sleep down there with her but I guess you don't want to sleep out in the kennel.









A couple things for the diarrhea:

Digestive Upsets by Homeopet (this gets diarrhea under control FAST). Only used for acute situations. http://www.homeopet.com/

Slippery Elm

For digestive help (add to food): 


Perfect Form by Honest Kitchen http://www.thehonestkitchen.com/products/perfect_form.shtml
Digestion Blend by Berte's Naturals http://www.b-naturals.com/digestion-blend-16-oz-p-101
Only Natural Pet GI Support http://www.onlynaturalpet.com/products/Only-Natural-Pet-GI-Support/999044.aspx


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## Kayos and Havoc (Oct 17, 2002)

*Re: Max's Test Results - latest news!*

Lisa, he has not had any food change. Ruth thanks for the links, I started pumpin last night. It is not really diarrhea, just gloppy poo. He is eating well but not having a good few days. I hope as soon as we start treatment he will perk up. The side effects from the Cushing's meds sound wonderful too.


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## Barb E (Jun 6, 2004)

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x 1,000,000,000.50


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## LisaT (Feb 7, 2005)

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Hope he gets some relief soon.


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## mjbgsd (Jun 29, 2004)

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I too hope he gets relief.


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## WiscTiger (Sep 25, 2002)

*Re: Max's Test Results - latest news!*

Kathy just checking on you and Max today. Thinking about you guys.

Val


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## Kayos and Havoc (Oct 17, 2002)

*Re: Max's Test Results - latest news!*

He is not doing badly today. His meds should be here tomorrow for us to start. His poops are still gloppy but at least he knows when he has to go so we can let him out.

Tonight I screwed up and left a door ajar from the house to the garage and the garage door was up. I was getting ready to load Havoc for obedience practice. Well Max pushed the door open and was gone. He has been getting lost and confused and he did not know where he was and panicked. He finally recognized my car and came to it. He was okay just afraid. 

Stupid of me.


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## LisaT (Feb 7, 2005)

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Sure glad that ended well. My heart skipped a beat before I read how it ended!!


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## WiscTiger (Sep 25, 2002)

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Checking in on Max again. 

Sorry to read that he wandered off, but so happy that you found him. Kathy, don't beat yourself up about forgetting the door, it happens.

Val


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## middleofnowhere (Dec 20, 2000)

*Re: Max's Test Results - latest news!*

Glad that ended well. I'd guess that although Max may be getting forgetful, he probably won't wonder out that door again!


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## Kayos and Havoc (Oct 17, 2002)

*Re: Max's Test Results - latest news!*

Well, Max started his Cushings meds on Thursday morning. From reading up on this I am not so sure the cure is any better than the disease! The side effects if Lysroden are terrifying.

We are working through the induction phase and will go back in for more monitoring probably late next week. Hopefully we can start a maintenance dose then. The medication is a chemotherapy drug and is very expensive. The last 2 weeks have cost us almost $1000. Money may become an issue if we cannot get him under control.









Today he must have had another puppy pill as he was really having a good day.







I hope as we get him under control that he will have a lot of good days for another year at least. The pooping when the mood hits seems to be abating a little. He also seems clearer in his head, thank goodness.


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## BowWowMeow (May 7, 2007)

*Re: Max's Test Results - latest news!*

This is great news Kathy! So glad to hear that Max is doing better. That is shockingly expensive for meds! Max is very lucky he has such caring (and financially stable!) parents!


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## Kayos and Havoc (Oct 17, 2002)

*Re: Max's Test Results - latest news!*

Ruth I took out pet insurance for Havoc and Kayos. Max was too old but knowing that I have that for the others, I can dip a little deeper for Max without being afraid of dipping too deep and not having enough for the younger 2 in an emergency. 

If the outlay decreases over time with the maintenance dose it will be easier for us to manage it, but we are not bottomless and we also have 4 cats. The oldest cat is 10 and still very healthy but she is approaching senior years too. So if the induction phase takes longer than normal or he has a relapse or the med just does not work we are going to have to decide with Max -- how much can we do? 

I hope we don't have to go there. 

He is still pretty bright eyed today.

The vet did tell us as the Cushings disease can hide other issues due to the high cortisol levels, we may see stuff we did not know he had pr did not show up on tests. I know his cataracts got "better" with the cortisol high, so did his Spondylosis. He still has those conditions plus some bone spurs on his hips that are not really bothering him due to the cortisol. I would imagine that as we get the Cushings under control we will have to add Adequan for the other stuff. I won't give him NSAID's anymore. 

I do have him on Glucosamine and Omega 3's. 

So paws crossed that we see an end to induction in the next few days so we can do the also very expensive ACTH stimulation test to check his progress. Then he goes on maintenance for a month and we check the ACTH again and then if all is well it is done every 6 months.


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## Woodreb (Oct 27, 2008)

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I hope Max continues to show improvement.


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## GSD07 (Feb 23, 2007)

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I'm so glad to hear that Max is doing better!!!


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## LisaT (Feb 7, 2005)

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> Originally Posted By: KathyW Money may become an issue if we cannot get him under control.


I know that this is a very real concern, having two expensive issue dogs. I sure hope that things settle. I don't know if a compounding pharmacy would have the meds any cheaper. You could always give them a call and see if they can help. This is the one that I get my Max's meds from:
http://yellowpages.heraldextra.com/meds+for+vets.9.17217951p.home.html


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