Symptoms of Cushing's or Hypothyroid?

[Jenna AK]

Could someone please help me distinguish between the two of these, since most of what I read online just confuses me about either? I need to know what tests to insist on to confirm or rule out a diagnosis. And what drugs, if any, alter these tests enough to make them inconclusive?
Maybe some tips too on presenting the need to return to/seek a second vet's opinion in a convincing way to a spouse who thinks I'm a nutcase for 'making mountains from molehills.'
Many thanks.

[Patti]

My pom was diagnosed with Cushing's several years ago. The vet at first was treating her for Thyroid disease as the symptoms are similar and her thyroid levels were off. When thyroid medicine didn't help we went to a specialist. They did an ACTH stim test and an ultrasound to determine she had Cushing's. Maya's symptoms were loss of hair on sides and tail, a pot belly, sores on her body, excessive thirst and hunger and frequent urination. It is important to get them to a vet/specialist that is experienced in treating this disease. I hope you can get some answers and that is not Cushings.

[yorkygirl]

Hi. My last yorkie was diagnosed with cushing's disease. She had 3 seizures in a row so I took her into the vet. They thought it was Addison's disease but it turned out to be cushings which they said was worse for my girl because she also had CHF and could not be put on medications. They determined it be a blood test. So I went the natural route and gave her supplements. They were called cushix drops and I also gave her a supplement for liver support. My vet of course approved what I was trying. She never had another seizure nor lost her hair. She did however pass 2 months ago from CHF but her cushings was fine. Good luck with your baby!

[lillymae]

One of my girls has Cushings & her symptoms were excessive thirst, hunger and shaking. Cushings can often cause Thyroid problems. Also hair loss & a bot belly can also be symptoms of Cushings but each dog can present differently & some symptoms can be the same for Cushings & Thyroid problems so I would recommend testing for both. If you have her Thyroid checked , ask for the Full Thyroid panel to check the T-3's T-4's as well not just the TSH as in my opinion the TSH alone is a waste of time. I was in the middle of a Thyroid storm that almost killed me & my TSH was perfect.

[lillymae]

Originally Posted by Jenna AK

Could someone please help me distinguish between the two of these, since most of what I read online just confuses me about either? I need to know what tests to insist on to confirm or rule out a diagnosis. And what drugs, if any, alter these tests enough to make them inconclusive?
Maybe some tips too on presenting the need to return to/seek a second vet's opinion in a convincing way to a spouse who thinks I'm a nutcase for 'making mountains from molehills.'
Many thanks.

Your Tip can be that if she's having Any of the symptoms of Cushings, Addisons or Thyroid she needs to be diagnosed ASAP as the longer you wait the more dangerous it becomes & without treatment it can end her life. Early detection & proper meds is the key .

[AprilLove]

I would start by taking her to your vet, then describing every one of her symptoms, tell them your concerns and go from there. If you don't feel comfortable with what they diagnose/treat, then go to another vet or internal medicine vet and seek an alternate opinion. I would not try to diagnose over the internet. Cushings is not an easy diagnosis, and they generally will conclude it after ruling out other possiblitlies and proper testing for it.

[Jenna AK]

Thank you everyone for your replies. I'll get those tests done. Does just the thyroid panel show all three conditions? And why when I've Googled this stuff does it not even mention that it can kill your dog??

A few more questions and some background please?
Jenna had been seen by her vet about two weeks ago, and wound up diagnosed with atopy. She'd had stomach gas/itching and chewing for a week before that and had developed 'pimples' on her chin and little brown spots at the base of her hair on the neck and genitals that I'd thought were mites. She also chews/licks her feet. He took a scraping, I think, and said no mites. He didn't think it was food allergies. We were given sebozole shampoo to use for two weeks. All it did was dry her skin and gave her no real relief from the itching, plus now her coat is thinning/becoming brittle and she's lost fur on her stomach and the pits of her legs and tail just under the base. (Itching/chewing spots) Come to think of it she did have some red 'rashy' spots there also, just a few. Her skin on her stomach just ahead of the rear hock and under her front leg pits is wrinkling and looks like the skin on an old lady's hands. There are also some veins there I didn't see before...but not a lot of them and they are more red than green. Her genital area now seems to have more of those brown spots, moving to the inside areas and her rectum as well. I notice her inner elbows have reddish patches where she's licked at them that I can clear up with neosporin, but now I'm remembering seeing these before....
I'm wondering if she began displaying subtle signs of one of these problems back in early summer. She'd been seen for possible UTI and given amoxicillin but when they handed her back to me she had this 'road rash' in her inner elbow, I'd chalked it up to them having to hold her tightly for the urine aspiration then...but now I see it's where she's been chewing and licking herself there.

Anyway, her doctor has prescribed oral ketoconazole (for yeast dermatitis) and prednisone for itching (which hasn't been as bad since I switched her foods from DVPNB to Blue Buffalo on a hunch.) My question is; if she's actually had Cushing's or hypothyroid developing all this time (no testing mentioned for either of these by the vet, he's stuck on atopy) then wouldn't the prednisone (which I haven't started yet) make these diseases worse or screw up the tests? And what are the implications to her recovery as long as we test and confirm now if this may have been going on since summer?
I keep going over other behaviors for the last few months...yes it does seem like she's hungry more often, sleeping more, perhaps a bit more water consumption/urine output than in the summer, (still only goes twice a day though...just takes her a bit longer) and what also distresses me is her hair changes and that she seems more whiny at times than usual. Lots of what I call 'nose whistling.' Picking her up to take her for a walk makes her groan as if her stomach hurts. It bulges from time to time and the skin seems oddy colored when this happens, but by morning it's gone. (She used to nibble dry food a few times a night, we've stopped that now in case that was overfeeding.) She doesn't enjoy me carrying her as much but all this time I've thought it was due to how itchy she'd become and that her skin was sensitive. There's also some sensitivity to touch on her lower back, but since I tend to carry her like a baby, I thought perhaps I'd made her back sore holding her that way.
We live in Alaska and it's brutally cold and dark now, so these are also good reasons for her to be more tired and hungry and dried out. Our humidity doesn't even register. But I don't see how Cushings or thyroid could be mistaken for dermatitis?
I'll call my vet to schedule the tests. I just hope we're not too late. And if hubby doesn't like it, thinks I'm being paranoid...tough.
Thanks again for reading. Sorry it was so long but more things kept coming to me and at least now I have them all written down somewhere. Since her itching is not as bad I'm holding off on the prednisone unless otherwise indicated. Seems to me the ketoconazole would counteract it's effects anyway from what I've read.
If anyone feels like sending vibes for Jenna it would be much appreciated.

[Jenna AK]

Originally Posted by AprilLove

I would start by taking her to your vet, then describing every one of her symptoms, tell them your concerns and go from there. If you don't feel comfortable with what they diagnose/treat, then go to another vet or internal medicine vet and seek an alternate opinion. I would not try to diagnose over the internet. Cushings is not an easy diagnosis, and they generally will conclude it after ruling out other possiblitlies and proper testing for it.

Thank you. I realize this may take some time to diagnose, but I feel like we've wasted so much already.
We may have to change vets too. These folks used to be excellent, but I come away dissatisfied more often these days.
Not sure if we have internal specialists up here. You'd think we would with all the sled dogs.

[Taryn0405]

My Cairn had cushings and yes, she did pass away from it. It caused organ failure. She was diagnosed when she was 6 and passed away at 9. She has the excessive drinking and some hair loss, but the worst symptom was that she went blind.
Its best that your baby gets diagnosed and gets to a specialist (endocrine) and gets on a medication that'll help the symptoms.

Cammie lived 3 good years, even blind, after being diagnosed. And we believe that we probably could have spotted it sooner. Another thing that she got alot wasn't really sores, but cysts that she had to get removed often. I pray that you baby doesn't have this disease, however, know that it is not a death sentence and is very managable.

Good luck! And keep is posted!

[Jenna AK]

Thank you, Taryn. I'm sorry to hear about Cammie. I imagine it must've been so hard to cope with. Just reading some of the descriptions of the testing and medications for this disease...I have to admit I'm a bit despairing. I don't think there are any animal endocrinologists up here either.
I see that ketoconazole can have an effect on Cushings...I wonder if our vet does suspect it but hasn't said so for a reason? Either way even if the keto does help it won't last, apparently. We've got a 3 week course: 0.3 ml twice a day with food. Will this affect testing? We just started it today.

Poor thing, she's such a nervous girl. If she's got to stay at the vet all day for this 8 hour test I read about she'll be a wreck (and so will I!) She's been lounging with me all day wanting her belly rubbed (she wants these a lot lately, which worries me because it usually means she's feeling poorly or upset in some way.)

[Taryn0405]

Originally Posted by Jenna AK

Thank you, Taryn. I'm sorry to hear about Cammie. I imagine it must've been so hard to cope with. Just reading some of the descriptions of the testing and medications for this disease...I have to admit I'm a bit despairing. I don't think there are any animal endocrinologists up here either.
I see that ketoconazole can have an effect on Cushings...I wonder if our vet does suspect it but hasn't said so for a reason? Either way even if the keto does help it won't last, apparently. We've got a 3 week course: 0.3 ml twice a day with food. Will this affect testing? We just started it today.

Poor thing, she's such a nervous girl. If she's got to stay at the vet all day for this 8 hour test I read about she'll be a wreck (and so will I!) She's been lounging with me all day wanting her belly rubbed (she wants these a lot lately, which worries me because it usually means she's feeling poorly or upset in some way.)

No worries, you're doing the right thing. The reason that we didn't catch it sooner is that she was going blind, and we just attirbuted it to old age, and nothing more. We were ignorant first time pet owners.

Here's a webiste that was really good:
Canine Cushing's Information and Support Forums - Powered by vBulletin

What's good news is you're taking the active steps towards figuring this out. And like I said, if it is cushings, it's not a death sentence. I don't know if it'll effect the testing, especially if the vet has not mentioned Cushings yet.

[Taryn0405]

Also, I was doing some research of vets up by you and I found:
North Pole Veterinary Hospital

They seem to specialize in internal medicine which may be a little more proactive then your vet now. Like I said, please keep us updated! Lots of hugs and prayers.

[Jenna AK]

Thank you again, Taryn, for your well wishes and information. I was going to research vets last night but I have been so upset by all I've read already I'm afraid by the time I finally fell asleep from exhaustion it was forgotten. I've hardly slept in the last month for worry, not that I haven't already got sleeping problems. It was so nice of you to find those links for me.
Jenna got her second dose of keto last night and this is actually the first time in awhile that she hasn't gotten me up about three times a night to beg for kibbles or get a drink of water.
NP vet is actually closer to us than the one I currently frequent. I haven't been to them for about 12 years when a beloved cat contracted vaccine related sarcoma. The vet at that time could not give me a good prognosis so I looked elsewhere for assistance and never really went back. Not that he wasn't correct in his opinion but it devastated me. They did direct me to my current vet's practice for my exotics needs. I don't doubt they may be able to help Jenna so I will at least give them a call. They may actually have some record of my pup ironically, since the rescue I got her from is near there ( though I think the rescue organizer used the holistic vet there for the pets in her facility also.)
I was looking for images of dogs with Cushings and hypothyroid last night and was distressed to find one that indicated a similarity to what is happening to some of the folds in Jenna's belly skin above her hocks and in her armpits. It's called cutaneous atrophy and the image is on wikimedia. The picture is far advanced into the condition...Jenna is nowhere near that bad...but you can see some of the wrinkling forming. I can't find the condition related to anything but Cushings.
I hope that although these symptoms she has seem to have come on so suddenly, and she's young yet...supposedly only 3 1/2 years old...perhaps we have caught it early and can reverse any damage. I showed the picture to my husband and basically told him we need to prepare to have her tested. I'm sure he thinks I'm crazy but I can't care about that now. I just want Jenna's life saved. Since he has to do all the driving (in subzero cold and snow and with a questionable vehicle) I can understand his exasperation to a point, but right now all I can see are Jenna's big brown eyes in her tiny face looking to me for help. Something is not right and we have to find out what.
Sorry to just run on about this but I have nowhere else to go to take my worries and I've prayed myself to exhaustion for weeks already. Thank you all for being here. I don't know what I'd do without a resource like this.
God bless.

[107barney]

Usually alkaline phosphatase shows elevation in the blood. Then there are the vague symptoms which can become increasingly worse (thirst, urination in excess, etc). I had a suspicion in my dog Barney who was peeing a lot and his pee had a strange odor. I had my vet run a Cortisol:Creatinine ratio test before getting into other testing. Based on my research, thiis is a rule out test but not a rule in for Cushings. My dog's mild liver elevation was a benign age-related liver abnormality but at the time I was very concerned about cushings.

As for your husband, tell him that a stitch in time saves nine and that making a mountain out of a molehill is often a good way to save yourself money down the road for untreated or ignored conditions which will cost more to treat and/or cure later. BTW vets aren't always right, they are humans and make mistakes. If your gut tells you something is wrong, pursue it.

[Jenna AK]

Thanks again for all replies.
I do have another quick question...she's on oral ketoconazole, 0.3ml twice a day that's supposed to last 3 weeks. I just read that this drug can cause liver damage. Anyone have experience with this drug and yorkies? Anything specific I should watch for? She's only had 3 doses so far.
I've already poured over the NP vet website and I didn't realize the practice had changed hands. They seem well equipped for her care, so we have a back up doc.
I also think I'll be applying for Care Credit. About time too.
Waiting for a call from my regular vet to discuss testing.