Pseudo Cushings & Hair Loss

[ladyjane]

Originally Posted by hartygirl

L~ Does it bother him to wear clothes?

Nope...I put tshirts on him all of the time because I don't want him chilled.

[ladyjane]

Originally Posted by manolos mom

YEA...we love you Sunny D. Are you going to try a topical Melatonin?

Never really thought about it...she mentioned the dosage for the pills. I wonder if it would work? hmmm

[Wylie's Mom]

Originally Posted by ladyjane

Yes, it is different. Her Wylie has atypical cushings. Pseudo Cushings is a cosmetic issue...they look like they have it in that they lose hair, but they do not actually have it.

Cushings is a very complicated illness...and I have found pseudo cushings to be even more baffling. They have HAC, but do not have the clinical signs so it is not actually cushings.

They say Melatonin helps with the hair replacement...I just had never heard of it and wondered if anyone had done this. Cannot really hurt anything....just very curious about it.

Linda, just seeing all of this now. So, this kiddo *does* have HAC then? If yes, that means he does have elevated cortisol levels - so then, this wouldn't be "Pseudo-Cushings". To officially get a Dx of Pseudo, the main thing a vet has to do is rule *out* HAC / Cushings. Then, they can rule-in Pseudo-Cushings (more commonly known as Alopecia X) as a possibility.

Was a stim test done? What was the pre/post? That would be the most conclusive testing -- and if the post # is equivocal, that's when Atypical is suspected (depending upon signalment) - and that's when the blood has to go to Dr. Jack Oliver at U of Tenn.

If this is Alopecia X, then yup, Melatonin BID is a standard treatment to try - just make sure it is regular Melatonin and not fast release or extended. Melatonin is also used in Atypical Cushings btw (for some of the intermediate sex hormones). It can take a couple months to see results, btw.

Give this little fella some hugs for me, and bless you for taking him in .

[ladyjane]

Originally Posted by Wylie's Mom

Linda, just seeing all of this now. So, this kiddo *does* have HAC then? If yes, that means he does have elevated cortisol levels - so then, this wouldn't be "Pseudo-Cushings". To officially get a Dx of Pseudo, the main thing a vet has to do is rule *out* HAC / Cushings. Then, they can rule-in Pseudo-Cushings (more commonly known as Alopecia X) as a possibility.

Was a stim test done? What was the pre/post? That would be the most conclusive testing -- and if the post # is equivocal, that's when Atypical is suspected (depending upon signalment) - and that's when the blood has to go to Dr. Jack Oliver at U of Tenn.

If this is Alopecia X, then yup, Melatonin BID is a standard treatment to try - just make sure it is regular Melatonin and not fast release or extended. Melatonin is also used in Atypical Cushings btw (for some of the intermediate sex hormones). It can take a couple months to see results, btw.

Give this little fella some hugs for me, and bless you for taking him in .

I wondered where you were!

Actually, he does have HAC and was diagnosed with pseudo cushings by my vet and also the specialist. It is SO confusing to me. But....I found the following link that explained it well:
http://www.michvma.org/documents/MVC...s/Nichols2.pdf
My vet also gave me some stuff to read.

The stim test:

5.9 ref: 1.0 - 5.0
24.6 ref: 8.0 - 17.0

I really thought that with a diagnosis of HAC it was definitely cushings; but, because he has no other clinical signs it is considered pseudo cushings. He is young, has totally normal blood work (alkaline phos is normal) and does not have excessive polysypsia or polyuria, no enlarged abdomen, or any other of the typical signs of cushings. His urine specific gravity is also wnl. We did biopsies of his skin that also pointed to cushings or pseudo cushings.

Have you used or know anyone who has used melatonin for hair loss?

[Wylie's Mom]

Originally Posted by ladyjane

I wondered where you were!

Actually, he does have HAC and was diagnosed with pseudo cushings by my vet and also the specialist. It is SO confusing to me. But....I found the following link that explained it well:
http://www.michvma.org/documents/MVC...s/Nichols2.pdf
My vet also gave me some stuff to read.

The stim test:

5.9 ref: 1.0 - 5.0
24.6 ref: 8.0 - 17.0

I really thought that with a diagnosis of HAC it was definitely cushings; but, because he has no other clinical signs it is considered pseudo cushings. He is young, has totally normal blood work (alkaline phos is normal) and does not have excessive polysypsia or polyuria, no enlarged abdomen, or any other of the typical signs of cushings. His urine specific gravity is also wnl. We did biopsies of his skin that also pointed to cushings or pseudo cushings.

Have you used or know anyone who has used melatonin for hair loss?

Yes, that's the article where it mentions the role of 17-OHP (this is one in Atypical too) in Pseudo, and also the exclusion of of HAC and Hypothyroid. So, this is really a unique case....which does not surprise me, given it's related somehow to Cushings....see what I mean -- remember when we were PMing a little and I was telling you how Cushings is just crazy ? Diagnosis can be very tricky.

Just to compare, Wylie had a perfect little body (no Cushings pot belly) - but had hair thinning, polydipsia/polyuria, skin issue (pyoderma), and recurrent ear issues, some muscle wasting, more hungry than usual. He also turned out to have hypothyroid (not uncommon in Cushings dogs). Does your guy have any of the other symptoms (you've probably scanned the long list)?

Does his fur look like this, sort of?

I don't know...in the presence of high pre & post numbers, and at least 1 clinical sign (maybe more?)...makes ya wonder, doesn't it? {btw, let me know if you want the Cushings yahoo group info...}

[ladyjane]

Oh, he has skin issues. He was a mess when I got him. He had a nasty greasy looking mess that has since cleared up. Had a skin infection and it took a long time on antibiotics to clear it up. He has almost no hair on his trunk....some spots of hair and some peach fuzz.


The first pic is when I first got him.

ytsonny_rashbefore.jpg

ytsunnyjan2010cf.jpg

Oh...and no, he has no other symptoms. Is a very happy, healthy looking, playful pupster.

[ladyjane]

hahah I just proof read my other post....

I started to say excessive urination...then opted for poly.....

ended up with excessive poly...DUH

[Wylie's Mom]

Originally Posted by ladyjane

Oh, he has skin issues. He was a mess when I got him. He had a nasty greasy looking mess that has since cleared up. Had a skin infection and it took a long time on antibiotics to clear it up. He has almost no hair on his trunk....some spots of hair and some peach fuzz.

The first pic is when I first got him.

Oh...and no, he has no other symptoms. Is a very happy, healthy looking, playful pupster.

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.

Originally Posted by ladyjane

hahah I just proof read my other post....

I started to say excessive urination...then opted for poly.....

ended up with excessive poly...DUH

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 .

[dwerten]

Originally Posted by ladyjane

Yes, it is different. Her Wylie has atypical cushings. Pseudo Cushings is a cosmetic issue...they look like they have it in that they lose hair, but they do not actually have it.

Cushings is a very complicated illness...and I have found pseudo cushings to be even more baffling. They have HAC, but do not have the clinical signs so it is not actually cushings.

They say Melatonin helps with the hair replacement...I just had never heard of it and wondered if anyone had done this. Cannot really hurt anything....just very curious about it.

Thanks! He is actually not ill. He just does not have much hair! We are working on a new bio for him now that we know for sure what it is. Probably going to say his mother was a yorkie and dad was a traveling chinese crested.

yes i have heard of this as a holistic vet recommended it for dee dee - I personally did not use it as i went to atopica at that time as it was a few years ago when it was recommended to me. Also had thyroid tested and she was hypothyroid. But i find this interesting as dd has lost alot of hair and derm and ims both are concerned and want her thyroid retested - had never heard of pseudo cushings before. I asked about cushings and derm said no bc her allergies would be better if she had cushings due to more cortisol produced helping with allergies

[dwerten]

Originally Posted by ladyjane

Oh, he has skin issues. He was a mess when I got him. He had a nasty greasy looking mess that has since cleared up. Had a skin infection and it took a long time on antibiotics to clear it up. He has almost no hair on his trunk....some spots of hair and some peach fuzz.


The first pic is when I first got him.

Attachment 312717

Attachment 312718

Oh...and no, he has no other symptoms. Is a very happy, healthy looking, playful pupster.

not hypothyroid? This looks alot like dd but dd has more hair - did he have a staph infection could that have attributed to hair loss ?

[dwerten]

here is a pic of dd hairloss in same spot

[ladyjane]

Originally Posted by dwerten

not hypothyroid? This looks alot like dd but dd has more hair - did he have a staph infection could that have attributed to hair loss ?

He is hypothyroid and is on thyro-tabs. It has not done anything with the hair, though.

[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 .

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.

[ladyjane]

Originally Posted by dwerten

here is a pic of dd hairloss in same spot

Wow! Looks very similar!

[ladyjane]

Originally Posted by dwerten

not hypothyroid? This looks alot like dd but dd has more hair - did he have a staph infection could that have attributed to hair loss ?

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.