Medicated Cushing's Disease?!?!? HELP!! - YorkieTalk.com Forums

Ashlea979 · 07-19-2014, 01:53 PM

I'm posting this as a continued thread from my previous post! I've found more more research & have more questions!

Here's my previous thread to give you background on everything that has been going on:

http://www.yorkietalk.com/forums/sic...need-help.html

Here's pictures of his ears:

https://www.dropbox.com/sc/6dufy005j...Y1BpuvBO9KxTUa

Ok Ladies/Yorkie Lovers I still need your help!!

I have been washing Bear's ears with water & vinegar to see if that would help heal any and it has not! I have a referral for a Specialist/Dermatologist to see Bear, I'm just waiting for an opening in their schedule to fit him in ASAP.

So, in the meantime I've done a LOT of research! Do any of y'all know about Medicated Cushing's Disease? I'm thinking that his signs point to it.

When I first took Bear to the vet, it was because he was acting sick. They diagnosed it with a bacterial & yeast infection. They prescribed Gentizol (which is a topical corticosterioid). After a couple days, I noticed balding of his ears, & the next vet prescribed Predisone (which is an oral corticosteroid). He was using Gentizol in his ears for Yeast & Bacteria infection. Predisone was used because they said his immune system was low from allergies & he needed his immune system to be higher for him to heal his ear infection. Gentizol was used twice a day for 10 days (but kept being administered- as vet had to me to do- because his ears started peeling with his hair!), Predisone was taken 2 a day for 7 days and once a day for 3 days, & finished out the rest of the dosage every other day.

His ears only increased in peeling! They NEVER looked better, only got worse. But, ear infection was gone.

He seems like a totally different dog since then. He was just a sick dog from ear infection, & now is acting so weird. He's just not the same.

In my research, I've seen Cushing's Disease can be medically produced from the overuse of Cortisol. (Which Bear did have a lot of from Predisone & Gentizol).

His symptoms are:

lethargy
hair loss
insomnia
abnormal eating habits

I've also read that Medicated Cushing's Disease can be reversed. And, that it's NOT cushing's disease- just symptoms of it.

On Bear's Bloodwork the abnormal results were:
Low Cholesterol
Low EOS (said to be from stress)
High PCV (which could indicate kidney tumor from high levels of Cortisone)

Also, PCV read 60.4% which is high, but Manual test read 51? Not sure what that means!

Do any of you know about Medicated Cushing's disease? I'm going to take Bear on Monday to have him tested!

shelbysmom · 07-19-2014, 02:05 PM

I looked it up online, sure sounds like it. Bloating, which you mentioned in ear infection thread?, is also a symptom. Does he seem to be improving now that you have taken him off of everything?

shelbysmom · 07-19-2014, 02:20 PM

Did a search and found this. It's called Iatrogenic Cushing's.

Accidental (Iatrogenic )Cushing's

The same signs we see in pets with a malfunctioning pituitary-adrenal gland system (Cushing’s) can be caused by giving pets too much cortisol-like medication for too long a time.

Many common veterinary medications contain corticosteroid ingredient (cortisone, hydrocortisone, prednisone, prednisolone, dexamethasone, triamcinolone, etc.). These medications are very important in veterinary medicine; but given them in large doses or over long periods, can cause “accidental”( = iatrogenic) Cushing's disease.

Corticosteroids, given for short periods by your veterinarian, can be life saving. When your veterinarian prescribes them for longer periods, it is usually because there is no other treatment option available. For many sick pet, the mild to moderate Cushing's-like side effects of periodic, or intermittent corticosteroid use are preferable to the pain and debility of the condition being treated. But never give more than is absolutely necessary and be mindful of the side effects they might cause (many of these steroid treatments are for autoimmune or allergic diseases) .

Even topically applied, beclomethasone, betamethasone and budesonide, steroids have, on rarer occasions, caused Cushing's-like symptoms.

When iatrogenic Cushing's disease occurs , the compounds should not be stopped suddenly. Usually, when they are gradually withdrawn, the pet’s adrenal glands and pituitary will return to normal function.

Although it is generally not required, an ACTH stimulation test can distinguish between true Cushing’s disease and the Cushing's-like symptoms of steroid over use.

Ashlea979 · 07-19-2014, 02:55 PM

Thank you for your help!

Yes he did have bloating about 4 weeks ago.

He doesn't seem to get better, if anything it's worse

It seems neurological! He is a completely different dog now & NOT in a good way!

I have been weaning him off gentizol & he had gradually been off Prednisone.

The first time I took him was May 20. Last time was June 20. He ended Prednisone around June 17.

I quit using Gentizol on him the last week of June. Then I would take him running with me that week because he seemed to start feeling better! That's the best he's acted in a long time! Then it had rained for a while so I stopped running & he started acting more lazy. I gave him gentizol again to try to kill the "bacteria" on ear- I thought it'd make him feel better. That's when he started back acting crazy again. All the signs seem to align when he's taking gentizol, he gets worse! He's been of the medicine since Wednesday this week. Today has been one of the worse days he's acted.

Can he have a urinalysis to see if there is an excess of Cortisone? Just so I know for sure?

If it is, should I still take him to a specialist?

Do you think his hair will regrow?

TxVicki · 07-19-2014, 03:17 PM

Quote:

Originally Posted by Ashlea979

Thank you for your help!

Yes he did have bloating about 4 weeks ago.

He doesn't seem to get better, if anything it's worse

It seems neurological! He is a completely different dog now & NOT in a good way!

I have been weaning him off gentizol & he had gradually been off Prednisone.

The first time I took him was May 20. Last time was June 20. He ended Prednisone around June 17.

I quit using Gentizol on him the last week of June. Then I would take him running with me that week because he seemed to start feeling better! That's the best he's acted in a long time! Then it had rained for a while so I stopped running & he started acting more lazy. I gave him gentizol again to try to kill the "bacteria" on ear- I thought it'd make him feel better. That's when he started back acting crazy again. All the signs seem to align when he's taking gentizol, he gets worse! He's been of the medicine since Wednesday this week. Today has been one of the worse days he's acted.

Can he have a urinalysis to see if there is an excess of Cortisone? Just so I know for sure?

If it is, should I still take him to a specialist?

Do you think his hair will regrow?

They can run a Urine Cortisol/Creatinine Ratio Test, it can't Dx Cushings, but it can possibly rule it out.

Ashlea979 · 07-19-2014, 03:33 PM

@Tx Vicki- but it would show if there is high levels of cortisol, right?

Ashlea979 · 07-19-2014, 03:40 PM

There is not much information out there about Iatrogenic Cushing's. I can't find how to reverse the effects?

This is so stressful seeing my baby decline & not know what is really wrong. The doctors haven't help- if anything they've caused him to get worse

He's walking around in circles, Always pees with one leg cocked up- but now he just stands or walk while he pees. VERY odd for him! He LOVES to lift up his leg on every bush!

I appreciate y'all taking the time to help me figure this out!

TxVicki · 07-19-2014, 03:48 PM

Quote:

Originally Posted by Ashlea979

@Tx Vicki- but it would show if there is high levels of cortisol, right?

Yes, but there can also be a false positive.

Here is some info on Cushing.

Pet Owner's Crash Course in Canine Cushing's Disease

shelbysmom · 07-19-2014, 04:04 PM

Just to be clear, I am not a Vet. I am just the parent of a Yorkie and I found your original post interesting because my first Yorkie lost her hearing (temporarily) from the drops you were using. I eventually lost my girl to cancer so I question everything that goes into my new puppy.

That being said it sounds like all of the symptoms your little dog is experiencing COULD be related. They could also be something totally different but that would be quite a coincidence since all of this started with the meds for the ears. What would I do if it was my dog?

I would find a new Vet. A specialist would be nice if we knew what he need to specialize in? Find the best reviewed Vet in your area that is open on Sundays. They exist. If you need help finding, look at Yelp

Do you use Yelp? If you go there there are listings for Vets and you can read reviews and find someone new you can count on. Let me know if you have trouble, I can look and send you a link. Keep us posted.

Ashlea979 · 07-19-2014, 04:25 PM

@shelbysmom I am so sorry about the loss of your baby! How did the hearing loss start? bear is starting to act a little spacy & delayed in his hearing!

I take every comment as a personal opinion to help me figure this out & also for advice!

I appreciate anyone who takes the time to read & comment! I also try to give as much info as possible so everyone who reads can collaborate with me.

I've never used yelp, but I've heard of it! I'll see what I can find! Thanks!

shelbysmom · 07-19-2014, 04:32 PM

Here, some of them are not open on sunday and one is emergency 24 hour which means $$$

Veterinary clinic open sunday Concord, NC

this place has regular hours on Sunday (plus emergency hours)

Charlotte NC Veterinarian, Veterinary Clinic | Animal Medical Hospital, Charlotte NC

I hope you said NC ha. well you get the idea of how yelp works. Good luck

Ashlea979 · 07-19-2014, 05:36 PM

Oh wow! I get it now! Thank you so much! That was so nice of you!

Yes, NC!

I called the second place & am going to try to see them tomorrow!

Cat2861 · 07-20-2014, 08:06 PM

Hi Ashlea...I know about Cushing disease because my dachshund ended up having it at the young age of 7. It is a horrible disease to see a dog go through. Our Hershey started off getting a potbelly. We thought he was just getting fat but then he was losing hair in that area too. We took him to the vet and they knew right away that it was Cushing but they ran all the necessary tests and it was confirmed. We had to give him medicine twice a day but the vet had to keep adjusting the dose (upping it) until Hershey's body responded. Hershey lost the pot belly and grew his hair back. His hair actually grew in thicker than what is was before. Everything was going great for about 6 mths and then we noticed he was drinking a lot to the point where he would spend a lot of the day drinking. With drinking so much he was having accidents in the house right away. That never happened with him. He was potty trained at 4 months old. Took him back to the vet to be told he is now a diabetic which is very common with Cushing disease. We then had to give him insulin twice a day. He was such a trooper with it all until within 30 days he became blind. It happened that quick. That is when Hershey started going downhill. He wouldn't eat and was refusing to let us give him his insulin shots (we did though even though it was against his will). It was like he just gave up once he became blind. We also had a 16 year dachshund Fritz who then started going downhill. It was like everything was crashing in on my husband and I. Those two boys were the best dogs we ever had. Hershey at the age of 4 had to have back surgery because he woke up one day and couldn't use his back legs. Surgery and rehab was thousands of dollars but he was worth every penny. The doctors still couldn't guarantee us that he would walk again but he surprised them all and walked, ran and jumped again. We had to put both of them down in July of 2011. I still cry and miss them dearly. I hope your little one does not have Cushing disease. Does he have a potbelly, losing his hair on his back, belly, tail? Your vet can run a test to see if that is the case. I wish you the best and pray all will be fine with your little one.

Wylie's Mom · 07-21-2014, 04:51 AM

Quote:

Originally Posted by Ashlea979

There is not much information out there about Iatrogenic Cushing's. I can't find how to reverse the effects?

This is so stressful seeing my baby decline & not know what is really wrong. The doctors haven't help- if anything they've caused him to get worse

He's walking around in circles, Always pees with one leg cocked up- but now he just stands or walk while he pees. VERY odd for him! He LOVES to lift up his leg on every bush!

I appreciate y'all taking the time to help me figure this out!

Hi -- the effects of Iatrogenic Cushings resolve once you stop the med, and when the med is then metabolized out of the body. It will take some time for the adrenals to adjust and get things back to normal. My Wylie does have Cushings btw.

As far as hair, many Cushings dogs have to take Melatonin x 3mg BID to help regrow the hair; ferrets have to do this is as well. They even make Melatonin implants for this, lol.

Ashlea979 · 07-23-2014, 05:47 AM

Hey All!

Here's an update on Bear:

I took a urine sample to have them run a urinalysis & everything looked good except & trace of protein (which they said is normal because it was very concentrated & first pee of the morning)

I asked the doctor if he thought it was iatrogenic cushing's disease. He promptly said no because his blood work was overall very good. His ALKP should've been in the 2,000+ range if it was Cushing's & Bear's level was 35!

The vet wanted to do a biopsy to see if it was Auto immune, Cancer, or a microbial bacteria!

I decides to get a second opinion before we went through with it!

I took bear to a new vet & he said the Bear was hypersensitive to all the steroids & to STOP them immediately! He believes that's what's making him act so crazy! He really thinks that bear has a middle ear infection which would also be signs of his crazy behavior. All of this makes much more sense because he started acting crazy once he was on the steroids! His immune system was so low because he was having all kinds of side effects from the medicine!

So, currently Bear is on an antibiotic & seems to be improving!! He also has a cream to put on his ear (dr. Thinks it's fungal that spread upwards)

I'll keep you posted on his condition!

@wyliesmom I am SO sorry about your dogwith cushings! I know that has to be so worry some & heart breaking! I'll be praying for Wylie!

@cat2861- I'm sorry for your loss! It is so hard to lose an animal! They're like family!!!

07-19-2014, 01:53 PM	#1
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	Medicated Cushing's Disease?!?!? HELP!! I'm posting this as a continued thread from my previous post! I've found more more research & have more questions! Here's my previous thread to give you background on everything that has been going on: http://www.yorkietalk.com/forums/sic...need-help.html Here's pictures of his ears: https://www.dropbox.com/sc/6dufy005j...Y1BpuvBO9KxTUa Ok Ladies/Yorkie Lovers I still need your help!! I have been washing Bear's ears with water & vinegar to see if that would help heal any and it has not! I have a referral for a Specialist/Dermatologist to see Bear, I'm just waiting for an opening in their schedule to fit him in ASAP. So, in the meantime I've done a LOT of research! Do any of y'all know about Medicated Cushing's Disease? I'm thinking that his signs point to it. When I first took Bear to the vet, it was because he was acting sick. They diagnosed it with a bacterial & yeast infection. They prescribed Gentizol (which is a topical corticosterioid). After a couple days, I noticed balding of his ears, & the next vet prescribed Predisone (which is an oral corticosteroid). He was using Gentizol in his ears for Yeast & Bacteria infection. Predisone was used because they said his immune system was low from allergies & he needed his immune system to be higher for him to heal his ear infection. Gentizol was used twice a day for 10 days (but kept being administered- as vet had to me to do- because his ears started peeling with his hair!), Predisone was taken 2 a day for 7 days and once a day for 3 days, & finished out the rest of the dosage every other day. His ears only increased in peeling! They NEVER looked better, only got worse. But, ear infection was gone. He seems like a totally different dog since then. He was just a sick dog from ear infection, & now is acting so weird. He's just not the same. In my research, I've seen Cushing's Disease can be medically produced from the overuse of Cortisol. (Which Bear did have a lot of from Predisone & Gentizol). His symptoms are: lethargy hair loss insomnia abnormal eating habits I've also read that Medicated Cushing's Disease can be reversed. And, that it's NOT cushing's disease- just symptoms of it. On Bear's Bloodwork the abnormal results were: Low Cholesterol Low EOS (said to be from stress) High PCV (which could indicate kidney tumor from high levels of Cortisone) Also, PCV read 60.4% which is high, but Manual test read 51? Not sure what that means! Do any of you know about Medicated Cushing's disease? I'm going to take Bear on Monday to have him tested!

07-20-2014, 08:06 PM	#13
Cat2861 Donating YT 500 Club Member Join Date: Feb 2014 Location: Palm Harbor, FL Posts: 958	Cushing disease Hi Ashlea...I know about Cushing disease because my dachshund ended up having it at the young age of 7. It is a horrible disease to see a dog go through. Our Hershey started off getting a potbelly. We thought he was just getting fat but then he was losing hair in that area too. We took him to the vet and they knew right away that it was Cushing but they ran all the necessary tests and it was confirmed. We had to give him medicine twice a day but the vet had to keep adjusting the dose (upping it) until Hershey's body responded. Hershey lost the pot belly and grew his hair back. His hair actually grew in thicker than what is was before. Everything was going great for about 6 mths and then we noticed he was drinking a lot to the point where he would spend a lot of the day drinking. With drinking so much he was having accidents in the house right away. That never happened with him. He was potty trained at 4 months old. Took him back to the vet to be told he is now a diabetic which is very common with Cushing disease. We then had to give him insulin twice a day. He was such a trooper with it all until within 30 days he became blind. It happened that quick. That is when Hershey started going downhill. He wouldn't eat and was refusing to let us give him his insulin shots (we did though even though it was against his will). It was like he just gave up once he became blind. We also had a 16 year dachshund Fritz who then started going downhill. It was like everything was crashing in on my husband and I. Those two boys were the best dogs we ever had. Hershey at the age of 4 had to have back surgery because he woke up one day and couldn't use his back legs. Surgery and rehab was thousands of dollars but he was worth every penny. The doctors still couldn't guarantee us that he would walk again but he surprised them all and walked, ran and jumped again. We had to put both of them down in July of 2011. I still cry and miss them dearly. I hope your little one does not have Cushing disease. Does he have a potbelly, losing his hair on his back, belly, tail? Your vet can run a test to see if that is the case. I wish you the best and pray all will be fine with your little one. __________________ Catherine-Mommy to Remy 1 yr 9mths Roxy 6 years RIP Fritz & Hershey 7/2011 My little dog — a heartbeat at my feet. ~Edith Wharton

07-19-2014, 02:05 PM	#2
shelbysmom YT 1000 Club Member Join Date: Jun 2005 Posts: 1,394	I looked it up online, sure sounds like it. Bloating, which you mentioned in ear infection thread?, is also a symptom. Does he seem to be improving now that you have taken him off of everything?

07-19-2014, 02:20 PM	#3
shelbysmom YT 1000 Club Member Join Date: Jun 2005 Posts: 1,394	Did a search and found this. It's called Iatrogenic Cushing's. Accidental (Iatrogenic )Cushing's The same signs we see in pets with a malfunctioning pituitary-adrenal gland system (Cushing’s) can be caused by giving pets too much cortisol-like medication for too long a time. Many common veterinary medications contain corticosteroid ingredient (cortisone, hydrocortisone, prednisone, prednisolone, dexamethasone, triamcinolone, etc.). These medications are very important in veterinary medicine; but given them in large doses or over long periods, can cause “accidental”( = iatrogenic) Cushing's disease. Corticosteroids, given for short periods by your veterinarian, can be life saving. When your veterinarian prescribes them for longer periods, it is usually because there is no other treatment option available. For many sick pet, the mild to moderate Cushing's-like side effects of periodic, or intermittent corticosteroid use are preferable to the pain and debility of the condition being treated. But never give more than is absolutely necessary and be mindful of the side effects they might cause (many of these steroid treatments are for autoimmune or allergic diseases) . Even topically applied, beclomethasone, betamethasone and budesonide, steroids have, on rarer occasions, caused Cushing's-like symptoms. When iatrogenic Cushing's disease occurs , the compounds should not be stopped suddenly. Usually, when they are gradually withdrawn, the pet’s adrenal glands and pituitary will return to normal function. Although it is generally not required, an ACTH stimulation test can distinguish between true Cushing’s disease and the Cushing's-like symptoms of steroid over use.

07-19-2014, 02:55 PM	#4
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	Thank you for your help! Yes he did have bloating about 4 weeks ago. He doesn't seem to get better, if anything it's worse It seems neurological! He is a completely different dog now & NOT in a good way! I have been weaning him off gentizol & he had gradually been off Prednisone. The first time I took him was May 20. Last time was June 20. He ended Prednisone around June 17. I quit using Gentizol on him the last week of June. Then I would take him running with me that week because he seemed to start feeling better! That's the best he's acted in a long time! Then it had rained for a while so I stopped running & he started acting more lazy. I gave him gentizol again to try to kill the "bacteria" on ear- I thought it'd make him feel better. That's when he started back acting crazy again. All the signs seem to align when he's taking gentizol, he gets worse! He's been of the medicine since Wednesday this week. Today has been one of the worse days he's acted. Can he have a urinalysis to see if there is an excess of Cortisone? Just so I know for sure? If it is, should I still take him to a specialist? Do you think his hair will regrow?

07-19-2014, 03:33 PM	#6
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	@Tx Vicki- but it would show if there is high levels of cortisol, right?

07-19-2014, 03:40 PM	#7
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	There is not much information out there about Iatrogenic Cushing's. I can't find how to reverse the effects? This is so stressful seeing my baby decline & not know what is really wrong. The doctors haven't help- if anything they've caused him to get worse He's walking around in circles, Always pees with one leg cocked up- but now he just stands or walk while he pees. VERY odd for him! He LOVES to lift up his leg on every bush! I appreciate y'all taking the time to help me figure this out!

07-19-2014, 04:04 PM	#9
shelbysmom YT 1000 Club Member Join Date: Jun 2005 Posts: 1,394	Just to be clear, I am not a Vet. I am just the parent of a Yorkie and I found your original post interesting because my first Yorkie lost her hearing (temporarily) from the drops you were using. I eventually lost my girl to cancer so I question everything that goes into my new puppy. That being said it sounds like all of the symptoms your little dog is experiencing COULD be related. They could also be something totally different but that would be quite a coincidence since all of this started with the meds for the ears. What would I do if it was my dog? I would find a new Vet. A specialist would be nice if we knew what he need to specialize in? Find the best reviewed Vet in your area that is open on Sundays. They exist. If you need help finding, look at Yelp Do you use Yelp? If you go there there are listings for Vets and you can read reviews and find someone new you can count on. Let me know if you have trouble, I can look and send you a link. Keep us posted.

07-19-2014, 04:25 PM	#10
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	@shelbysmom I am so sorry about the loss of your baby! How did the hearing loss start? bear is starting to act a little spacy & delayed in his hearing! I take every comment as a personal opinion to help me figure this out & also for advice! I appreciate anyone who takes the time to read & comment! I also try to give as much info as possible so everyone who reads can collaborate with me. I've never used yelp, but I've heard of it! I'll see what I can find! Thanks!

07-19-2014, 04:32 PM	#11
shelbysmom YT 1000 Club Member Join Date: Jun 2005 Posts: 1,394	Here, some of them are not open on sunday and one is emergency 24 hour which means $$$ Veterinary clinic open sunday Concord, NC this place has regular hours on Sunday (plus emergency hours) Charlotte NC Veterinarian, Veterinary Clinic \| Animal Medical Hospital, Charlotte NC I hope you said NC ha. well you get the idea of how yelp works. Good luck

07-19-2014, 05:36 PM	#12
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	Oh wow! I get it now! Thank you so much! That was so nice of you! Yes, NC! I called the second place & am going to try to see them tomorrow!

07-23-2014, 05:47 AM	#15
Ashlea979 Yorkie Talker Join Date: Jul 2014 Location: Concord Posts: 21	Hey All! Here's an update on Bear: I took a urine sample to have them run a urinalysis & everything looked good except & trace of protein (which they said is normal because it was very concentrated & first pee of the morning) I asked the doctor if he thought it was iatrogenic cushing's disease. He promptly said no because his blood work was overall very good. His ALKP should've been in the 2,000+ range if it was Cushing's & Bear's level was 35! The vet wanted to do a biopsy to see if it was Auto immune, Cancer, or a microbial bacteria! I decides to get a second opinion before we went through with it! I took bear to a new vet & he said the Bear was hypersensitive to all the steroids & to STOP them immediately! He believes that's what's making him act so crazy! He really thinks that bear has a middle ear infection which would also be signs of his crazy behavior. All of this makes much more sense because he started acting crazy once he was on the steroids! His immune system was so low because he was having all kinds of side effects from the medicine! So, currently Bear is on an antibiotic & seems to be improving!! He also has a cream to put on his ear (dr. Thinks it's fungal that spread upwards) I'll keep you posted on his condition! @wyliesmom I am SO sorry about your dogwith cushings! I know that has to be so worry some & heart breaking! I'll be praying for Wylie! @cat2861- I'm sorry for your loss! It is so hard to lose an animal! They're like family!!!