[zowiandnikasmom]

hello, i'm sorry to hear that you're having so many problems with reese. this is going to be long but i hope it really helps. what you're describing really does sound so familiar.... my almost 11 year old yorkie zowi has cushing's. she was diagnosed in june of 2011 but she starting getting a huge belly, incredible appetite, and panting in june 2010. she also started have the age spots pop up all over her. my vet called them lipomas and also said they should not be removed. hundreds of dollars later, everything looked fine... complete senior workup including bloodwork, urinalysis, ekg for her heart, xrays to rule out tumors and stones, etc. etc. our regular seen vet (of 12 years) had moved back to the sister hospital we originally found her at but it's an hour away so we continued to use the same hospital closer to home we were going to and saw a different dr.... january 2011 came around and still same problems, but wanted to have a dental on her if we could as i noticed a loose tooth in front. we took her back to our trusted vet of 12 years an hour away for this. all pre op testing once again came back perfect and her dental went very welll thankfully but she did have to have the one loose tooth pulled.

fast forward to spring of 2011... zowi would run up to me and get my attention and pee right in front of me inside. we are talking about a completely housebroke dog so i took her in the next day. she was found to have a uti, which is also another clue of cushing's. her water intake increased dramatically, peeing constantly. that's when cushing's was 1st mentioned based on her appearance with a large abdomin and her symptoms. an ultrasound was then performed to rule out tumors or stones anywhere. zowi's liver was extremely enlarged (but not diseased), another clue of cushing's. nothing else of concern was observed on ultrasound. the best test to do first is a urine creatine ratio test. it is inexpensive and can rule cushing's out, but it cannot confirm a diagnosis. zowi's dr explained that we needed to have an "endocrine panel to tennessee" to see if zowi had typical or atypical cushing's. typical cushing's can be diagnosed by an acth stimulation test or low dose dex test (ldds) but if zowi was atypical (elevated intermediate steroids rather than elevated cortisol) the test would come back normal but she could still have cushing's. all of my girl's testing looked normal too, but indeed she did have cushing's. university of tennessee is the only place in the country that can test for atypicals. if reese was my dog, i would request this test to u of tenn be done immediately as the results from tenn take up to 2 weeks to receive. the plus of this is it evaluates 5 different hormones and the experts will give their recommendation on treatment. they are fantastic working with your vet and for no additional charge. your vet would be consulting with THE EXPERTS on this disease by communicating with u of tenn over the phone. the vet would draw a baseline blood sample, then inject a cortisone, then wait 2 hours and draw another blood sample. both samples are evaluated by the experts in tennessee and a diagnosis is made. the ldds test is good also as it can determine if the cushing's is adrenal or pituitary dependant but this test takes 8 hours and 3 or 4 blood draws. my girl was diagnosed as pituitary dependant via ultrasound of her adrenal glands, which were both clearly visualized and enlarged. most small dogs with cushing's 85% of the time have the pituitary kind, 15% have adrenal tumors. the adrenal tumor type sometimes does have the option of surgery but it is very high risk and in the range of $5,000-8,000 in my area (near chicago) if surgery isn't an option, it can be managed medically also. pituitary type can only be treated medically.

initially, my girl was treated with melatonin and hmr lignans for about 4 months. she got a skin infection during that time on her head, another uti, constantly panting, constantly drinking, constant licking the air, the floors and everything she could get her tongue on. she was also hospitalized with pancreatitis in september 2011 which can be caused by uncontrolled cushing's. her cholesterol and triglycerides were through the roof. she changed her to a very low fat high quality protein diet. we did another endocrine panel to tenn and decided to move on to the next treatment as this plan did not seem to help and some things were getting worse. at this time she was also diagnosed with hypothyroidism via a full thyroid panel i believe was sent to university of michigan. so my girl truly has both conditions. she takes l-thyroxine every 12 hours for her thyroid and gets it rechecked every 6 months.

at this point it was october 2011... results came in from tennessee and we decided to keep her on melatonin and hmr lignans but also to start her on trilostane. this is the newer medication that robintz was referring to. lysodren is still a better option for atypicals and is more predictable as it has been used for 30 years or so. trilostane was just approved in the usa for use in 2009 but has been used in the uk much longer and is not as predictable as lysodren but many vets believe it is "safer" than lysodren. but both meds have their pros and cons and are considered quite toxic. that being said it is extremely important that you have a vet who really knows about these meds or you will definitely need an internal medicine specialist to get the proper dosage without adverse side effects of overdosage. i was scared to death starting my girl on trilostane, but now i'm so glad i did.

we've had a rollercoaster of adjusting zowi's dosage and for now, we beleive that we are at the correct maintenance. my girl has her energy back and is NOT PANTING, appetite is better, thirst is less, she is once again feeling great! her belly has gone down and she is so much more comfortable and happy. i can tell you it has been no picnic getting to where we are today and the expense can really be great but totally worth everything to have my girl back to herself. this required a lot of at home monitoring and a fantastic vet! at my vet the endocrine panel to tennessee was $185 the first time we had it done (june 2010), and has gone up to $255 the last time we had it done (december 2011). once maintenance is acheived, testing can be reduced to 2 times a year.

the hardest thing is not knowing what is wrong but knowing something is. i had to go through that for a year before i got the answer and it was so hard!!! zowi's dad thought i was crazy too, but did agree with the panting not being right. we had just lost our other yorkie at only 6 years old and he thought i was being overprotective or had lost my mind from the loss, being so worried about zowi. but i'm sure you know reese better than he and are correct about something being wrong here. i was right too!!!

please keep us updated and if you have any specific ?'s feel free to pm me. i'm glad that wylie's mom has responded, as she was there for me when my girl was diagnosed and helped me find a wealth of info. patti and lillymae and others also helped by sharing their experiences. i will refer you to the yahoo group canine cushing's autoimmune care also as the info there is great and so many helpful experienced people will respond to your ?'s.

wishing you the best of luck with reese! i really hope she can feel better asap! ~ carrie