CUSHINGS DISEASE -anyone treated their pet holistically/ natural/homeopathic remedies

[Franceen]

I wondered if anyone has tried the natural remedy/homeopathic/holistic approach to treating cushings disease in their yorkie? If so, was it effective?

[Wylie's Mom]

I looked into this when my Wylie was first diagnosed at age 4.5 (he's now 12) - and I did not find anything that reliably and consistently appeared to decrease the circulating cortisone levels. We've gone the medical route for about 8 years now, with no side effects at all.

[Franceen]

Originally Posted by Wylie's Mom

I looked into this when my Wylie was first diagnosed at age 4.5 (he's now 12) - and I did not find anything that reliably and consistently appeared to decrease the circulating cortisone levels. We've gone the medical route for about 8 years now, with no side effects at all.

Hi Ann,

Thank you for your reply. I am concerned about the drugs for treating cushings disease, as Tootsy is very sensitive to drugs of any sort and I hear that these drugs are harsh. However, I do realise that the results of not treating her effectively would have more serious consequences.

I see that in the USA they use mitotane to control the cortisol in the blood. Over here in the UK they use trilostane. I read the side effects of both. One thing that really worried me is that the incidents of sudden deaths, and deaths within a few days of starting therapy, have been reported with Trilostane, while there are no reports of mitotane-induced deaths. The overal incidents of side effects with trilostane is, however, lower. there are also a number of other issues with trilostane which I won't print out now. Nevertheless, I am concerned about this drug.

Did you find that Wylie suffered any side effects with mitotane or have you heard of any dogs suffering bad side effects? How much of the drug do you need to give Wylie? Tootsy has put on a lot of weight, due to excessive hunger, and has a pot belly. She now weighs 6.2kg!!! She is not a small dog but should weigh around 5.2 - 5.4kg.

I would also like advice from you regarding whether I should take her to a specialist, instead of just letting the vet treat her? The vet is likely to say that she will treated with the same drug, anyway, and that it is an unnecessary expense. Also, how do they tell whether she has a tumour and whether it is benign or cancerous?

Tootsy is having blood tests done and I would like to know what blood tests Wylie had done, and any other tests that he had done, to make sure it was cushings. I hope you don't mind me asking all these questions! I have to say that from posts on YT, I feel that veterinary treatment in the States is excellent. Over here in the UK people very seldom take their pets to a specialist.

Tootsy's symptoms are a pot belly, excessive hunger, having little accidents during the night, does not want to walk much, her tummy has a lot of 'black' skin - this developed over the years and the vet didn't think it was important, and she pants when she is not hot or tired. In the past I have pointed out these synptoms as they occured, but the vet just said she is getting old. I am now wondering if she had cushings for years and has not being diagnosed. She did have blood tests done last year (they do not do yearly blood work over here) and everything was normal, despite some of these symptoms. She has been drinking more, but I am wondering if I have caused this by putting some salt in her homemade meals. I am going to stop this immediately. Is Wylie on a special diet for cushings?

Thanks so much for your help, Ann. I appreciate it so much.

hugs,
Yvonne

[Wylie's Mom]

Hi Franceen,

I'm sorry you're going thru all of this. Believe me, I know just exactly how you're feeling bc I went thru this period w/ Wylie too. It's very overwhelming and confusing.

Yes, I think you're correct in that Tootsy has very likely had Cushings for a long time, given what you've described below. Generalist Vets misdiagnose (or miss completely!) Cushings when it's staring them in the face ALL the time...bc the symptoms can be so vague, unrelated, and diffuse.

As far as going to a specialist - I went to one bc my vet misdiagnosed Wylie for 1.5 yrs, when I *knew* something was wrong. So I finally went to a dermatologist (bc of all Wylie's skin issues) and she suggested we test for Cushings - sure enough, he had that along w/ hypothyroid (many Cushings dogs are also hypothyroid, btw). We then went to the Internist for add'l testing, the ultrasound, and for med titration....once we started to get meds on track - I then went to a new generalist vet for continuing care.

IF your own vet seems well versed and comfortable w/ Cushings, then I don't know if I'd go to a specialist. How do they feel to you w/ their knowledge?

As far as meds, Wylie is on Lysodren/Mitotane, 100mg, Mon Wed Fri - he's never had a single side effect. These are *very* toxic drugs, without a doubt, but they try to give them as low a dose as possible -- not a chemotherapy dose or anything. Wylie's been taking it for almost 8 years now.

I totally understand your fear with the meds...but the upside is that if your kiddo can tolerate the meds, she'll get her old self back - her energy, her liveliness, her healthier body weight, her fur (if she lost fur), she won't pant/wear out as much at all, she won't drink so much. And yes, drinking more (and peeing more) is a cardinal sign of Cushings.

As far as tests, Wylie had a couple ACTH tests and an ultrasound of his adrenal glands to see what they looked like (they looked totally normal, btw, which I think is often the case -- so this test can be a waste of $$$). We also had to send Wylie's blood to the University of Tennessee for even more specialized ACTH tests bc Wylie ended up having Atypical Cushings, which is even more complicated. So mainly, you just want the ACTH test and possibly the ultrasound if you want them to view the adrenals.

Btw..just so you know, it can take up to 1-1.5 yrs to really get the meds properly titrated. You may get lucky and nail the meds from the start. However, it can really take some time bc you start super low w/ the dose, give for 6 weeks, then do another ACTH to see what's happening w/ the cortisol. If you need to change the med at that point, then you give that new dosage for 6 weeks, and then ACTH test again...and so on and so on, until you get it right.

He is not on any special diet for Cushings. I feed all my kiddos raw by Primal or NV or Know Better Pet Food.

I don't know if any of that was very helpful - but just know you'll get her through all of this, and you'll get to her to a better place eventually ! Don't hesitate to ask more questions if you have them...

Save

[Franceen]

Hi Ann

Thank you so very much for all this information. It is really a comfort to discuss my fears with you.

I spent yesterday trawling the internet trying to find out everything I could about this disease. I had square eyes by the evening! I must say that I am still leaning towards using Lysodren, but I do not think that I will be able to get it, as they use Vetoryl (trilosone) in the UK and Europe. I read that you need to have prednisone available at home to give to your dog if it is having side effects from the drug as it can be so dangerous. It seems, from everything I have read, that there is no good treatment for this disease and you need to decide whether your dog could manage without the drugs. I think Tootsy has too many symptoms to not treat her. There is a vet in the UK who claims to have very good results with homeopathic remedies. He used them on horses, cats and dogs and many of them improved significantly. He did submit a paper on his results. The problem is how long do I try this type of treatment without damage occuring to her liver or kidneys, or worse, her heart. Also this sort of treatment only has a chance to work in the early stages of the disease, providing it works at all.

Did you have a urinalysis done? I see that this is an inexpensive test and can be a good indicater of whether your dog has cushings.

Toosy is terrified of going to the vet and when she notices that we are in the vicinity of the veterinary practice, she starts to shake and pant. By the time we park the car and go in, she is in an awful state with her whole body shaking very badly. The receptionists spray a hormone to try and calm her, but it makes little difference. The vet feels she would need to give her a big dose of a tranquiliser to calm her and is not keen to do this. I am wondering if she will have a high cortisol measurement in her blood from the stress, anyway, which would effect the test results?

Did Wylie suddenly become fearful when the Cushings developed? Tootsy has become incredibly fearful. At one point I suspected that she was seeing ghosts, LOL!

Thanks again Ann - you are a star!
hugs
Yvonne

[Wylie's Mom]

Hi Yvonne -

You're so welcome - I'm happy to help, especially bc I've been where you are, and know how overwhelming this all is !

I wish there was some way you could get the Lysodren, if that's the med you prefer; I would get it for you if there was some way to do it, but I can't think of how we'd be able to get it . But I've also heard very good results in dogs who use Vetoryl. Yes, you do keep Prednisone pills on hand, just in case (for some odd reason) the kiddo starts to show signs of too LOW cortisol as a result from their Cushings meds. I've never, ever had to do that. The vets are so cautious about increasing/titrating these Cushings meds, that it should be rare that you'd ever need the prednisone...but it's good to have it as a safety net.

The urine test is called the Cortisol-Creatinine Ratio Urine Test - this test is not diagnostic though. It's a first-line test you give if/when Cushings is just suspected; you then do this test. If the result is negative - then no Cushings likely, if positive - then you proceed to the more specific and diagnostic Cushings testing (ACTH Test), if borderline - the vet must look at the symptoms and assess whether or not proceeding with testing is warranted.

If the vets wants to tranq her, maybe they could just give a low dose of Acepromazine to calm her a bit - not a big deal at all.

Her own stress and natural fight-or-flight cortisol shouldn't be enough to actually alter the testing significantly...it should be okay in that way.

Wylie didn't become noticeably fearful w/ the Cushings, so no, I didn't see that. But their personalities can definitely change/alter w/ all that extra cortisol. You may also want to look in her eyes w/ a flashlight and be sure she doesn't have cataracts or anything bc I wonder if she is having any trouble seeing...and maybe that could be why she is spooked a bit...? I'm not sure on that one. Poor kiddo.

If you have any other questions, just ask!

Oh, and here are some of my fave links for Cushings:

Yahoo Cushings group that is FULL of exhaustive information (can be overwhelming): https://groups.yahoo.com/neo/groups/...mmuneCare/info

My favorite Cushings Overview: Cushings

U of Tennessee vet endocrine lab....if needed for further testing for Atypical Cushings etc: https://vetmed.tennessee.edu/vmc/dls...s/default.aspx

A great, supportive forum where you can read others' experiences, share your own, and ask anything: Canine Cushing's Information and Support Forums - Powered by vBulletin

Another no-reply forum that has a plethora of info in a nicely organized format: Important Information and Resources - Canine Cushing's Forums

[Franceen]

Hi Ann

Thanks again, for all your help and especially for all your fav links and the offer of trying to get the Lysodren for her. Like you, I don't see how that could be done, realistically, but I am, nevertheless, very, very grateful for your offer. You're such a Sweetie.

I will suggest to the vet that we try Acepromazine in order to calm her. The last vet practice did try a tranquiliser (don't know what it was, as it was so long ago), but found that it had very little effect. This vet does feel she would need a big dose of a tranquiliser to have a significant effect, as she gets herself into such a state, and the vet is not happy to give her a big dose.

I took her for her ACTH test this morning and I took a urine sample along as well, as, yesterday and today, she has been passing a lot more urine and I don't want to miss a bladder infection. At one point she passed urine twice in 5 minutes! I asked them to do a urinalysis and, as the Cortisone/Creatine ratio test is not expensive, I asked them to do it just as an extra for my peace of mind. They, too, think that it is not worth doing, but one link that I found on Cushings suggested that it was good at ruling out false positives in anxious dogs. I also asked them to do a hypothyroid test and to test for diabetes.

Do they do any test to see if the tumour on the adrenal or pituitary glands is cancerous? The vet never mentioned anything about doing any investigation to find this out. We did ask about scans to see if there is a tumour and she said that their scanner is not suitable to use for this purpose. I think I will ask for a referral to a practice that has got a suitable scanner.

Now for the wait for all the results! Although I am fairly certain that she does have Cushings disease - I feel that she has too many of the symptoms for it not to be so. You have been so great at supporting me through this, Ann, and I appreciate it so much.

luv and hugs
Yvonne

[Wylie's Mom]

Hi Yvonne,

You're very smart to also test for both thyroid and diabetes bc as you probably know by now, both of those are very common in Cushingoid dogs, unfortunately. Especially hypothyroid.

It can't hurt to do the Cortisol-Creatinine Urine test. Although it's not diagnostic, it would be just another marker to point you in a direction, one way or another - and that's helpful. The ACTH will really tell you some good info though - unless it's truly "borderline/intermediate", in which case you then have to consider Atypical Cushings (won't even start with that at this point, lol!). Keep us posted on the results...I hope it goes well and that the tranquilizer helps her too; I think it will. They get a bit loopy, for sure, and wobbly -- but it will keep her internally quieter and better equipped to handle the stress.

Ya know, they never do seem too concerned w/ the possibility of tumors themselves; I think mainly this has to do with the fact that even if there is one, they don't usually do anything for it. But usually, they don't even find one, to be honest. Wylie's glands looked totally normal! Weird, eh? But that's par for the course for the utter unpredictability that Cushings can bring. It can be so confusing.

When will you get the ACTH results, do you know? The wait can be tough. I also had to later wait for Atypical Cushings test results, which took FOREVER. Sigh! Could be worse though...at least it's a manageable disease. Wylie has now had it for almost 8 years, and he has thrived nonetheless.

Hang in there - hugs!

Ann

[Franceen]

Hi Ann

Yes, waiting is the tough part and they have not told me how long it takes for the results to come in.

I had a look at all your fav sites today and they are very helpful. I found the K9cushings.com had some particulary good info. Thanks so much for this, as it will be a great help when discussing Tootsy's treatment with the vet. I am feeling a lot more informed now.

I will let you know what the results are when I get them.

Luv and hugs
Yvonne

[Franceen]

Here are the first results from the lab.

TDDS LAB REPORT
BIOCHEMISTRY

Canine Profile

Total protein 63 g/L (54.0 - 77.0)
Albumin 34 g/L (26.0 - 40.0)
Globulin 29 g/L (20 - 47)
Sodium 151 mmol/L (139 -154 )
Potassium 5.0 mmol/L (3.5 - 6.0)
Na:K ratio 30 (25.0 - 35.0)
Chloride 109 mmol/L (99 - 125)
Total calcium 2.24 mmol/L (2.0 - 3.0)
Phosphate * 1.70 mmol/L High (0.8 - 1.6)
Urea * 11.9 mmol/L High ( 2.0 -9.0)
Creatine 64 umol/L (40 - 106)
Alk Phos 238 U/L High (0.0 - 25.0)
ALT * 29 U/L High (0 - 25)
GLDH * 18 U/L High (0 - 10.0)
Total biliruben 0 umol/L (0 - 9.0)
Bile acids * 11 umol/L High (0 - 10.0)
Glucose NO OXF RECEIVED
CK * 375 U/L High (0 - 190)
Cholesterol * 10.0 mmol/L High (3.8 - 7.0)
Triglycerides * 4.6 mmol/L High (0.45 - 1.9)
Amylase 922 U/L (0 - 1800)
Lipase 39 U/L (0 - 150)

SERUM SLIGHTLY LIPAEMIC

HAEMATOLOGY

RBC * 8.59 x10^12/L High (5.0 - 8.5)
Hb * 19.3 g/dl High (12.0 - 18.0)
HCT * 62.7 % High (37.0 - 55.0)
MCV 73.0 fl (60.0 - 80.0)
MCH 22.5 pg (19.0 - 26.0)
MCHC 30.8 g/dl (30.8 - 37.0)
RDW 17.7 % (12.9 - 17.8)
Platelets 361 x10^9/L (160 - 500)
WBC * 5.45 x10^9/L Low (6.0 - 15.0)
Neutrophils 3.95 x10^9/L (3.0 - 11.5)
Lymphocytes 1.10 x10^9/L (1.0 - 4.8)
Monocytes 0.24 x10^9/L (0 -1.3)
Eosinophils 0.16 x10^9/L (0 - 1.25)
Basophilis 0.00 x10^9/L (0 - 0.2)
Reticulocyte % 1.3 %
Reticulocyte count 111.67 x10^9/L
Platelet comment PLATELET COUNT APPEARS NORMAL IN FILM.
RBC comment SLIGHT POLYCHROMASIA. SLIGHT ANISOCYTOSIS.

Leukocyte comment LEUKOCYTE MORPHOLOGY UNREMARKABLE

MICROBIOLOGY

Urine creatinine 14.45 nmol/L

ENDOCRINOLOGY

Basal cotisol 118 nmol/L ( <125 )
Cortisol Post ACTH 146 nmol/L ( <800 )
Urine cortisol 241 nmol/L
Urine cortisol : creatinin 16.7 (<20 )
Total T4 22 nmol/L (13.5 - 50)
cTSH .16 ng/ml (0.0 - 0.6)

CLINICAL COMMENTS
Serum lipaemia may be artefactually elevating CK , bile acids and phosphate.
Elevations in liver results are mild - moderate - ALP is moderately elevated in contrast to mild elevation in ALT, which may represent a steroid influence (I note your clinical suspicion of Cushing's syndrome), but other causes such as primary hepatobiliary disease are not excluded.

There is mild hypercholesterolaemia - was this a starved sample? Fasting hyperglycaemia may lend support for Cushings disease or other endocrine disease - has glucose been checked in house?

Haemogram is largely unremarkable - neutrophils are lower than expected for Cushings disease ( which usually produces a 'stress' leukogram of neutrophilia with lymphpaeria ), but it does not exclude it. Given your clinical picture, ACTH stimulation may be useful. Monitoring liver enzymes and futher liver investigations (e.g. abdominal imaging, bile acid stimulation ) may also be considered.

__________________________________________________

I find this all a little confusing, so if anyone can tell me what it all means, I would be grateful!

The vet has decided to do a SHAP test - not sure what this is, but blood has been sent to the lab for this test and we await the result. The vet is also going to do a scan of her adrenals and of her liver on Monday morning. They will be looking for masses anywhere in the tummy area as well.

It is scary, as I know they are looking for cancer, as well as benign tumours. I am just praying that they don't find any malignant tumour.

I did ask for a test for diabetes, but it seems that it has not been done!? I will speak to the vet about it on Monday.

With regard to her been starved before the blood taken for the ACTH test, she had not eaten for approx. 11-12hrs.

I am trying not to worry before I have the results of all the tests etc. but it is so hard! I just want to cuddle her and carry her around all the time and I have to be firm with myself.

[Franceen]

I did a copy and paste of the blood results, but it has bunched up the results! It will be uncomfortable to read now! How can I prevent this happening?
luv
Yvonne

[Wylie's Mom]

I know...it always bunches up spaces unless you use the "indent" button itself.

So it looks like they're suggesting an ACTH Stim test due to the results...but then it also look as if you actually did do one too. Did you do one? Or is that part just the Urine cortisol test? To me, it looks like the ACTH stim was done w/ normal results. Is that how you understood it too...?

[Franceen]

Hi Ann

At least I know about using the indent now!

I was told was that they did a ACTH test which I assume is ACTH Stim.? I brought in the urine and asked for them to do a urine cortisol creatine ratio test. The result of that test appears to be normal to me? One site I was on told me that the urine cortisol creatine ratio test is good for ruling out cushing? I just wish I could remember the site I found that info. on. I read so much that day. I also asked for a diabetes test, but that does not appear to have been done! I have no idea about this SHAP test? What could it stand for, I wonder?

I really don't know what to make of these test results. The vet said she spoke to the lab and they told her that they have seen results similiar to these with adrenal tumours.
Hugs
Yvonne

[Wylie's Mom]

Yes, the urine ratio test is not, per se, considered truly "diagnostic" -- it's more a point-me-in-the-next-direction sort of test, if that makes sense. It can't diagnose Cushings, but it can tell a clinician whether or not to keep on poking in that general direction.

Okay, wow, learned something new today - thank you ! SHAP is some sort of sex hormone adrenal imbalance / hyperplasia. In a way, it kind of reads like how they describe "Atypical Cushings" here in the US (which is what my Wylie has). For the US when this is suspected - we have to send the blood in to a University in Tennessee as they have a highly specialized endocrine lab. It appears you too have a kind of specialized endocrine lab over there -- this one (see page 16 forward).

So it appears they want to investigate further as they still highly suspect adrenal gland involvement, but don't know exactly, yet, where it's originating from. Is that how you're seeing their direction too...?

I know it's confusing, the adrenal issues always are ...but hang in there. The good thing here is that they seem to be SO very thorough in their diagnostic avenues here...that's a smart clinician, pulling out all the tools.

I agree on getting the diabetes / fasting glucose test too -- always smart to test for that in the presence of possible Cushings.

Sending lotsa good thoughts! Hugs!

Save

[Franceen]

Hi Ann

Thanks for finding out about the SHAP and for the link to that laboratory.

Yes, I think they are still suspecting adrenal gland involvement.

I am very concerned about what they may find during the ultra sound scan. I am terrified that they will find a malignant tumor. I know that this is a possibility. I will be doing a lot of praying.

It is a comfort to know that you feel that they are being thorough in their diagnostic avenues.

Thanks for your continued support, good thoughts and hugs at this time, Ann, it means a great deal to me.
luv and hugs
Yvonne