Pseudo Cushings & Hair Loss

[dwerten]

Originally Posted by ladyjane

He was diagnosed with cushings by the first vet to see him. (But, I must add he did not do the testing he should have done.) I had someone else foster him for a couple of months before I could get him. I brought him to my home in December...when my vet saw him and reviewed his records, she immediately questioned the diagnosis of cushings.

She is confident it is not cushings and took his records to rounds a couple of weeks ago. She does rounds with other vets and specialists in the area and they agreed with her diagnosis.

She said that he simply would not have the normal blood and urine results that he has if he had cushings. I have questioned her a few times about this. I will consider whether or not to have her consult with someone else. I honestly believe she knows what she is talking about. I suppose she could be wrong, but my instinct tells me she is right. Yes, there is hair loss...but that is what happens with pseudo cushings. That is the only real sign he has. He has NO other symptoms at all.

this is very interesting as dd has had alot of hair loss and derm does not think it is steroid related as on low dose nor staph related - she wants thyroid checked to see if down and then go from there but all of her loss is mostly on back like this little one- here is another pic

[dwerten]

Originally Posted by ladyjane

We had hoped that after his skin infection cleared, he would grow hair, but it is not really happening .

He had a pathology report on the skin biopsies that indicated possible cushings or alopecia x.

yeah i was hoping so as well once staph was gone but she said sometimes if staph bad enough it kills the hair follicles and hair will not regrow. I asked about cushings and she said no as her allergies would be better not worse. It will be interesting to see what her blood work looks like but her urine was fine and had 2 urinalysis in last two months and blood work perfect in July when she had her dental - never heard of pseudo cushings so will read link anne sent as that is very interesting.

[dwerten]

Originally Posted by ladyjane

We had hoped that after his skin infection cleared, he would grow hair, but it is not really happening .

He had a pathology report on the skin biopsies that indicated possible cushings or alopecia x.

what about sebaceous gland excretion from hypothyroid as that is the greasy film stuff and did they test on skin biopsy for sebaceous adentitis as that could be it as well

[ladyjane]

Originally Posted by dwerten

what about sebaceous gland excretion from hypothyroid as that is the greasy film stuff and did they test on skin biopsy for sebaceous adentitis as that could be it as well

The dermopathology report said it suggested cushings or alopecia x. It was not typical for hypothyroidism. This is why we did the test...to rule anything else out.

The greasy skin cleared up with Anipryl which the first vet had put him on. My vet took him off of that med as soon as she saw him and his test results. She then put him on thyro tabs and after his hair loss did not improve and his skin still looked odd, she suggested other tests.

[dwerten]

Originally Posted by ladyjane

The dermopathology report said it suggested cushings or alopecia x. It was not typical for hypothyroidism. This is why we did the test...to rule anything else out.

The greasy skin cleared up with Anipryl which the first vet had put him on. My vet took him off of that med as soon as she saw him and his test results. She then put him on thyro tabs and after his hair loss did not improve and his skin still looked odd, she suggested other tests.

ok good to know as derm wanted blood work as she seemed concerned and if staph does not clear up on this second round of clinda then I have a feeling dd will be further tested as even ims made a comment on her hair loss - so thanks for posting this as it may be helpful in knowing about this as asked her about it as it came to mind but did not know about pseudo though. I will take some more pics as she does not have quite as much hair loss but if it keeps coming out it will look like yours as when i brush her hair comes out so i know she is losing more and it is only on the back area

[ladyjane]

Originally Posted by dwerten

ok good to know as derm wanted blood work as she seemed concerned and if staph does not clear up on this second round of clinda then I have a feeling dd will be further tested as even ims made a comment on her hair loss - so thanks for posting this as it may be helpful in knowing about this as asked her about it as it came to mind but did not know about pseudo though. I will take some more pics as she does not have quite as much hair loss but if it keeps coming out it will look like yours as when i brush her hair comes out so i know she is losing more and it is only on the back area

I had never heard of it either.

One thing good, though, is that this is really only a cosmetic issue. I don't care if he has hair on his body...he is still cute! Like I said: "Mom is a yorkie and Dad a traveling Chinese Crested".

[dwerten]

Originally Posted by ladyjane

I had never heard of it either.

One thing good, though, is that this is really only a cosmetic issue. I don't care if he has hair on his body...he is still cute! Like I said: "Mom is a yorkie and Dad a traveling Chinese Crested".

lol yeah dd wears tshirts anyway so as long as no more meds i am good lolll

[ladyjane]

Originally Posted by dwerten

lol yeah dd wears tshirts anyway so as long as no more meds i am good lolll

Sunny D wears them, too! They would make a cute pair.

[ladyjane]

Originally Posted by Wylie's Mom

Oh Linda, he is just PRECIOUS. Can I just say, once again, thank you for all that you do in rescue !!! I am so happy he is with you.

I wonder why they aren't Dx Cushings since he has the elevated cortisol along w/ some unique signalment (skin infection, hair loss - this fella's pattern loss is SO like Cushings - Wylie only had some thinning). Did they say they wanted more signalment (because you usually look for at least 3)? Dogs may only have a few at a time.

You have such a marvelous vet though - but it might be worth contacting Dr. Jack Oliver when cases are not clear cut - for Cushings/adrenal stuff. He is very responsive and he is incredible at dealing w/ the oddball cases (look at his published studies, just amazing). I can't recommend him enough - Wylie's internist (who specializes in Cushings, and her own dog has Cushings) consults w/ him often and my generalist just consulted w/ him in Dec. for Wylie again (for a med change).

Oh! And I forget to answer one of your original questions - yes, melatonin can work great for some dogs! And, there are Melatonin implants you can get, if it does work. It really depends on the Dx and/or if there is something going on w/ the sex hormones. See this Treatment sheet, and also #13 for Dr. Oliver contact info. And here is their endocrine lab - this is where blood is sent to test the intermediate sex hormones.



I didn't even *see* that ! I was tracking right with your description, and did not even see the "excessive" - my brain edited it out once I saw the poly, lol! That's funny . Excessive polyexcessiveness, I'm on board .

Oh, and thank you for the info on Dr. Oliver!

[Wylie's Mom]

Originally Posted by ladyjane

Oh, and thank you for the info on Dr. Oliver!

You're welcome .

Here is a more recent article (2009 Midwest Vet Conference) that better explains what I was trying to say last night, but wasn't doing a very good job . I still don't quite understand why your vet is saying he doesn't have Cushings when Pseudo-Cushings is a type of Cushings -- it's just not Typical Cushings. Another example is Wylie - he has HAC/Cushings (the umbrella disease term) -- but the type he has (out of Typical, Atypical, and Pseudo...and you could toss Iatrogenic in there too) - is Atypical Cushings.

It also explains how the U of Tenn can tell you exactly which intermediate steroid is causing the issue in Pseudo-Cushings...

Typical, Atypical, and Pseudo-Cushing's Disease: Diagnosis and Novel New Therapies

[ladyjane]

Originally Posted by Wylie's Mom

You're welcome .

Here is a more recent article (2009 Midwest Vet Conference) that better explains what I was trying to say last night, but wasn't doing a very good job . I still don't quite understand why your vet is saying he doesn't have Cushings when Pseudo-Cushings is a type of Cushings -- it's just not Typical Cushings. Another example is Wylie - he has HAC/Cushings (the umbrella disease term) -- but the type he has (out of Typical, Atypical, and Pseudo...and you could toss Iatrogenic in there too) - is Atypical Cushings.

It also explains how the U of Tenn can tell you exactly which intermediate steroid is causing the issue in Pseudo-Cushings...

Typical, Atypical, and Pseudo-Cushing's Disease: Diagnosis and Novel New Therapies

I suppose I am phrasing it incorrectly. What she means is full out cushings that requires treatment. His is cosmetic.

I will definitely read that article later. I have a bunch of things I need to do today. I have procrastinated long enough.

[Wylie's Mom]

Originally Posted by ladyjane

I suppose I am phrasing it incorrectly. What she means is full out cushings that requires treatment. His is cosmetic.

I will definitely read that article later. I have a bunch of things I need to do today. I have procrastinated long enough.

I'm procrastinating too . I didn't get *anything* done this weekend that I was supposed to get done (was up a lot Saturday night bc Tony had food poisoning - so was super tired Sunday...so that was my excuse for Sunday's procrastination ).

Ah...okay, I think I'm making the connection in my head what the vet is saying -- what she is really saying is "he has HAC/Cushings, just not Typical Cushings. The type of HAC/Cushings he has is Pseudo-Cushings."

If yes, I'm with ya now. Btw, flax lignans (specific type) may work for him too -- but if Melatonin worked alone, it would be just great bc it's so cheap and available.

[ladyjane]

I read that article and did not see how he would benefit from that test. My vet had talked about a blood test previously that we could do if we needed to....SO I called her today and found out that it is the one she had mentioned. She said if I want to do it that is fine; but she feels the outcome will be the same. She said we have done enough tests now to know that what he has is pseudo-cushings which she suspected from day one! She said that cushings dogs simply do not have normal alk phos. That is the number one clue in it all. Honestly, this is a very healthy, happy dog with very normal lab results! He does have hypothyroidism and it is not the cause of his hair loss. Hair loss is the only symptom he has that would lend anyone to think cushings. He has NO other symptoms at all.

Yes, it is HAC...yes, it is a type of cushings but not cushings as we know it. I asked her how many of these pups convert to full blown cushings and she said she honestly did not know....only that some do and some do not. SO.....I mentioned that I might email this vet at UT and she thought that was a great idea. So, when I get my act together, I am going to email him.

That blood test is $450 and I would spend that in a heartbeat if I thought it was absolutely necessary. YHR would approve that also....but, to do it without thinking it would tell us anything new would be taking money and throwing it to the wind imo. IF this vet at UT can give me some feedback convincing me that this test is going to offer something good for Sunny D, then I am sure we will do it.

[ladyjane]

Originally Posted by Wylie's Mom

I'm procrastinating too . I didn't get *anything* done this weekend that I was supposed to get done (was up a lot Saturday night bc Tony had food poisoning - so was super tired Sunday...so that was my excuse for Sunday's procrastination ).

Ah...okay, I think I'm making the connection in my head what the vet is saying -- what she is really saying is "he has HAC/Cushings, just not Typical Cushings. The type of HAC/Cushings he has is Pseudo-Cushings."

If yes, I'm with ya now. Btw, flax lignans (specific type) may work for him too -- but if Melatonin worked alone, it would be just great bc it's so cheap and available.

UGH...real honest to goodness food poisoning? YIKES! Hope he is doing better!

Don't worry....I totally trust my vet. She is a smart one! If she has ANY doubts at all, she consults with specialists. Always!

The above post explains a lot more...I think.

I am going to start him on Melatonin to see if he grows hair, but he is adorable without it!

[dwerten]

Originally Posted by ladyjane

I read that article and did not see how he would benefit from that test. My vet had talked about a blood test previously that we could do if we needed to....SO I called her today and found out that it is the one she had mentioned. She said if I want to do it that is fine; but she feels the outcome will be the same. She said we have done enough tests now to know that what he has is pseudo-cushings which she suspected from day one! She said that cushings dogs simply do not have normal alk phos. That is the number one clue in it all. Honestly, this is a very healthy, happy dog with very normal lab results! He does have hypothyroidism and it is not the cause of his hair loss. Hair loss is the only symptom he has that would lend anyone to think cushings. He has NO other symptoms at all.

Yes, it is HAC...yes, it is a type of cushings but not cushings as we know it. I asked her how many of these pups convert to full blown cushings and she said she honestly did not know....only that some do and some do not. SO.....I mentioned that I might email this vet at UT and she thought that was a great idea. So, when I get my act together, I am going to email him.

That blood test is $450 and I would spend that in a heartbeat if I thought it was absolutely necessary. YHR would approve that also....but, to do it without thinking it would tell us anything new would be taking money and throwing it to the wind imo. IF this vet at UT can give me some feedback convincing me that this test is going to offer something good for Sunny D, then I am sure we will do it.

thanks for the info as I will watch dd alp but she has always been normal on that as well - I am still hoping it is due to staph infection or possibly her thyroid is down and we need to increase meds so hopefully i will have some answers soon on this and can share as they look alot alike