Wylie has Hypothyroid, Pyoderma, and maybe Cushing's Disease
 

I'll try not to make this too long...but let it be a real lesson if any vet keeps telling you that your dog's skin issues are *nothing*. I've taken Wylie to the vet about 4 times in the last 3-4 months bc something did not seem right. The issues were mainly skin, fur, and more recently - a huge increase in his water-drinking and peeing frequency. EVERY time, my vet said "all normal" and I left feeling like a crazy person.

In the meantime, the same vet told me that Marcel could absolutely *not* be given Atopica for his seasonal allergies. Here is a pause for you to imagine my blood boiling out my ears at that statement _________. That was the last straw - and I made an appt. with a Vet Dermatologist for Marcel bc I knew what my vet said was wrong. ON A WHIM, I decided to make an appt. that day w/ the Derm for Wylie as well -- just to see what she had to say about Wylie's skin/fur/drinking/peeing. [before I move on -- yes, Marcel *can* have Atopica and he's doing well on it, day 2].

So, she looks at Wylie and immediately diagnoses Pyoderma (secondary to disease state), which he basically has all over his skin (I KNEW it was not just "dry, seasonal skin" :(!). When I tell her about the thirst, peeing etc. - she says we need to check for diabetes, thyroid, and do a screening test (not diagnostic) for Cushing's.

Well, he is not diabetic - but he has hypothyroid and I'm bringing him to an Internist Tuesday morning to explore the Cushing's bc his urine had high cortisol (urine I collected at home, when he was not stressed, btw). The hypothyroid could be secondary to the Cushing's (if he has Cushing's) bc excess cortisol suppresses TSH.

Cushing's would mean either a pituitary tumor or adrenal gland tumor - and it is a tough disease. I sooooo hope he doesn't have it and that somehow the hypothyroid is all that this is, but I just don't know. If they do the test tomorrow (which takes 8 hours) - I don't know when I'll have results, if it's right away or takes a few days. Does anyone know?

Anyway, please keep Wylie in your thoughts.

And please...if you ever have an undiagnosed skin issue - push push PUSH - until you truly have a diagnosis of 1) confirmed allergies - or 2) secondary to disease - because it IS either/or. The skin is such a vital organ...and it can tell us so clearly that something is very wrong...and if your own vet won't listen, find one that will.

I am so sorry about Wylie. He will be in my thoughts and prayers.

I very much can relate to pushing your vet or moving on to a Vet Dermatologist, when questions go unanswered about our furbabies' skin. Glad you finally have answers.

I think the 8 hour test you speak of might be the "Low dose Dexamethasone Test". A baseline blood sample is drawn in the morning, an injection of Dexamethasone is given, and then follow-up blood tests are taken at 4 and 8 hours later.
In a healthy dog the Dexamethasone should suppress the cortisol in the blood stream. In Cushings, this does not occur.
If your vet has a lab on facility for bloodwork, he might be able to give you an answer right there. But if it has to be sent out, it might take a few days.
I am really sorry to hear that you are going through this with your little one. My thoughts and prayers are with you all.

Ann, Im so sorry to hear about Wylie, Prayers headin your way. So he is going to be tested for Cushings? Is a Hypothyroid like an overactive thyroid. Has he been gaining or loosing weight or is it his skin issues only. Let us know.....Bless you and Mr Wylie.....Lissette

I'm so glad you could find some answers, what's the reason he said, Marcel could not be given Atopica? Poor Wylie, I hope it is just hypothyroidism, it's an easy thing to treat, but if left untreated can cause a host of problems. I sure hope it isn't Cushing's, but it sounds like that's what you may be facing. Good for you Ann, for pushing and finding some answers, my thoughts and prayers are with you; you sound really frustrated.

So sorry to hear this about Wylie. Will keep him in our thoughts and prayers!

Thank you for getting the word out. Wylie will be in my thoughts.

O Ann, I am So so So sorry, I know how worried you much be. I will keep you and Wylie both in my thoughts in prayers. You have always been here for me when I need someone to talk to so just know that I am here for you.

Oh Ann, i'm so sorry to hear about Wylie. I hope he just has hypothyroidism and not cushings.

How does his abdomen look and feel? is it bigger or harder?
Is he going to have an ultrasound done so they can measure his adrenal glands? i'm not sure if anything will show in a dog that is just being diagnosed or if it takes a while for a noticeable difference in size.

I think the vet is going to be doing an ACTH Stim blood test. It can be used to diagnose and to monitor cushings that is being delt with by medicating (and addisons which is the opposite of cushings). Its kinda like a bile acid test. Blood is taken as a "resting" sample, then a dose of ACTH is given according to the dogs weight. Two hours after the ACTH is given another blood sample is taken. This is sent out to the lab. I do not remember how long it takes for it to process, i'm sorry.

There is also a Low Dose Dexamethasone Suppression test they may possibly do. Since you mentioned he has to stay 8 hours i think this is what they may be doing. A pre test blood sample is taken. Then a dose of Dexamethasone is given. 4 and 8 hours later, more blood samples are taken. These are all sent to the lab and again, i'm sorry i do not remember how long these tests take to get back.

Oh Ann. I am just heartbroken for you- what an awful day. On one had it is great to finally have answers, but on the other hand- what a horrible thing to have to deal with. Good for you for pushing for what you knew was right. Please keep us posted- I will be thinking of Wylie.

That's exactly the test I believe they'll run tomorrow. I so hope they have a lab on site so I can know asap. Thanks so much.

Yep, he'll hopefully be tested tomorrow for Cushing's. Hypothyroid is underactive. Oddly, he has not gain/lost weight -- but I've noticed a "redistribution" of wt. - meaning he has felt more "boney" in the last few months -- which makes me think Cushings even though he doesn't have the pot-belly. I think bc I don't free-feed, the weight issue may be less obvious in him.

His old vet said "there is nothing we can give a 3lb dog for allergies - and absolutely not Atopica bc he is 3 lbs" -- which is just crap! I know you can compound almost anything or chop a med or whatever. And sure enough, the Derm. said there were like 3 different ways to give Marcel Atopica and that it was a great med for him to try! Can you believe that? :mad:

Thanks for the positive words -- I really am so glad I listened to my gut and made that appt. for Wy - imagine if I hadn't made it! :(

Well, I hope you tell your "old" vet that. Maybe he would be receptive to learning something?

I'm glad you saw this, Kellie :).

Oddly, he doesn't have "pot belly" - but I have thought for months that he feels more boney and has lost muscle mass -- but his weight is pretty much the same. So, it "feels" like a redistribution of muscle mass - which would make one think more cushingoid. He has terrible polydipsia and polyuria, which worries me more about Cushing's. He does have an increased appetite - but since I feed 2x day - he can't really overeat. He has so many signs of Cushing's...

...but then again, I have to say that he has ALL of his usual tons-of-energy, is not lethargic at all (although his duration of fetching is a bit shorter - he tires a little quicker and I have noticed this). He definitely has the skin and fur issues that come w/ Cushings...although these could also be just from hypothryoid.

I'm not totally sure which test they'll do, but I'm kind of assuming after reading my eyes out that they'll do that 8hr test (and the Derm also mentioned that test) -- and then if they do feel it's Adrenal (please no...), then I'm guessing they'd want to do an US to see if it's operable...and we'd also have to figure out if it's benign or malignant.

Even though adrenal is somewhat worse in terms of prognosis, at least it may be operable. But the operation is said to be "extremely complicated" -- so that's scary.

This might be just hypothyroid though....my hubby keeps telling me to focus on it being only that...but you know how worried you get and you think the worst...:confused:

Sorry to hear about Wylie's dx but so glad you followed your instinct and pushed to get answers for both of your babies. I think a good vet will listen to an owner's concerns. No one knows them like we do! I keep thinking if I had been more forceful when I first voiced my concerns to the vet about Sadie's post partum time she might still be with me today. You are passing along such good advice -- if you think there is an issue -- push for a diagnosis!

I actually called the old vet this morning and I told the receptionist to please tell Dr. Patti and ADD to Wylie's chart that he has hypothyroid, pyoderma, and could very likely have Cushing's. I said "I know Dr. Patti thought all of this was nothing, but it's not the case - so I'd like this added to his chart" -- AS IF I'll ever go back there...but I wanted to get the message across nonetheless. :mad:

Oh Ann.......I am sorry to hear about this ordeal! I am so glad that you took that leap of faith and went to another vet.....Good for you!

Please keep us all posted.....and give that baby a big hug from all of us here! :hug:

i am SO Sorry your going through this.. my prayers are with you...

Ann - I am so sorry to hear this. Good for you for being Wylie's advocate and listening to your instincts. Remember that Susan Davis may have some recommendaitons for Wylie as well. Sending our thoughts and prayers along.

:thumbup::thumbup: good call Jodie- never thougth of Susan- definitly worth a call!

Oh Ann,

I'm sooooooo very very sorry about little Wylie. I will keep the little guy in my prayers. Please keep us updated on how your little baby is doing... :)

How old is Wylie now? he's only a few years old right?

unfortunately with his symptoms is does sounds like cushings... :( but there is a possibility its not.

If it is cushings and its determined that he has an adrenal mass they will probably monitor it for the first few months. U/S will be needed to check the growth every few months. if its rapidly growing, i think they'll want to take it out since Wylie is young and otherwise healthy. I don't know if they do biopsies first under ansesthesia with a U/S needle guided aspiration. I don't know a lot about this as i was on the surgery end of the disease and not the internal medicine end.

I had assisted in a few adrenalectomies before and it is quite complicated. Not to get graphic but when the dog is on the operating table on his back all the other organs are basically on top of the adrenal glads. With a smaller dog it might be easier since they are not as deep. As you known and i'm sure you'd do, i recommend a board certified surgeon to do this surgery. Are you going to an Internist at a referral center? If so they probably have a surgeon there that would do the surgery. These dogs need to be highly monitored during and post surgery. Many test need to be run prior, during, and post to make sure the patient is doing ok. After all is said and done, many dogs do great afterwards. I'm not sure if they need to be on meds for life after surgery.

Wylie has a lot of things going for him and I know he is going to be ok no matter what happens! :)

Thank god you followed your motherly instincts. Hopefully Wylie can now get the help he needs. I will keep Wylie in my prayers and please keep us updated on how he's doing.

I am so sorry! I defintely keep you both in my prayers!

Just reading this. I know you must be worried. Thinking positive thoughts for your babies.

Sending Prayers for Wylie! :aimeeyork:hands:
Thank goodness you got him the care that was needed! I hope u get the opportunity to tell the original Vet Wylie's story (in person) & how upset u r. This happened to me.....I always regretted never telling the doctor what he misdiagnosed or should I say didn't even try to diagnose. This was about my own health.
Hoping that the meds will now help Wylie & that it isn't anything worse. HUGS!

Ann, Ann, Ann....have we not discussed this today? He does not have cushings...step away from google, g-friend.

Sending prayers...crossing paws and fingers.

That's also what's odd about this...he's only 4.5 years old, so it's unusual - but not unheard of. Isn't that weird? I will say, he did not come from a good breeder, so there is no telling if this is in his line or what. It seems the cause of Cushing's is not really understood. :(

I've been reading about the sugery...and I agree, it looks very complex and risky - and the dog is at quite a risk for the 6 mths following the surgery; I will be sure I check out the surgeon if it comes to that. The "mecca" of clinics I'm going to has all kinds of specialties - this is where the derm is - and she is the one who recommended this specific Internist - so at least I feel good about seeing this new vet tomorrow. I will ask the Internist about the surgeon specialties they have there too.

I don't even know what to hope for...I mean, on one hand - I'd rather it was adrenal so we could remove it...on the other, I almost hope it's pituitary and tiny and he could live w/ it forever w/ meds. But then, you get into the medications to manage it - and those are awful medications too.

And then the prognosis is alllll over the board :(! Some say 2 years, some say a dog can live 10 more years. I think I need to remember that *most* dogs are diagnosed so late in life -- and that's probably why the prognosis numbers are skewed. Don't you think?

Thanks for all of your help and kind words...I know I'll get him through this...and I'm still holding out that it's only thyroid - but either way, it just helps to post about it and hear others' thoughts. :)

LOL! I know!! I was thinking "I hope Deb doesn't see this bc she had me ALL calmed down earlier today...and now I'm catastrophic AGAIN" -- seriously, I started googling again and I was right back in worst case scenario. I told you I needed you to lock me a dark closet! :D Thanks for making me giggle.

I'll be thinking of Wylie and hoping for the best.

Oh Ann! I am sorry to hear about this problem. I will keep Wylie in my thoughts. :hands: