CUSHINGS-PETS Digest 2
Topics covered in this issue include:
1) cushing's: extra meds
by Leslie Lawson <lolawson@uts.cc.utexas.edu>
2) Re: Cushings: Heaven's Birthday
by LynneYoung@aol.com
3) Re: Cushings: Heaven's Birthday
by "Dillon Pyron" <dillon.pyron@amd.com>
4) Re: Cushings: Heaven's Birthday
by delausa@mailbox.syr.edu (Del Lausa)
5) Treatment of cushings and renal disease
by Tom White <twhite@law1.law.virginia.edu>
6) Introduction
by Wendy & Brian Duggan <kyzylkum@cruzio.com>
7) Re: Introduction
by delausa@mailbox.syr.edu (Del Lausa)
Date: Wed, 01 Oct 1997 12:32:37 -0500
From: Leslie Lawson <lolawson@uts.cc.utexas.edu>
To: cushings-pets@mcfeeley.cc.utexas.edu
Subject: cushing's: extra meds
Message-ID: <3.0.1.32.19971001123237.006c3404@uts.cc.utexas.edu>
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Greetings friends-
Sadly, with Missy's passing, we are left with several bottles of medicine
that we no longer need. Perhaps one or more of you could use them. We
have Rimadyl, Lysodren, and Prednisone pills--all are in their original
prescription bottles with the name and amount of medicine per pill clearly
marked.
If you would like to have any of these--with the understanding that,
of
course, you'll use them only under the supervision of your vet--I'm more
than happy to mail them to you. Just drop me an e-mail with your snail-mail
address.
On a bittersweet note, we picked Missy's ashes up from the vet today.
It's
nice to have her home. Scot wrote a very sweet note of thanks to our vet
which we delivered with a picture of Missy and a bag of bagels (on one of
our visits, Dr. Kelly shared his bagel with Missy).
Thanks again for all the kindness and support, and if you'd like to have
Missy's leftover meds, please do let me know.
-Leslie
Date: Wed, 1 Oct 1997 14:40:48 -0400 (EDT)
From: LynneYoung@aol.com
To: cushings-pets@mcfeeley.cc.utexas.edu
Subject: Re: Cushings: Heaven's Birthday
Message-ID: <971001143950_421312297@emout08.mail.aol.com>
HI...thought with all the sadness lately it might help to report that
Heaven,
our sheltie will be 7 yrs old on thursday. She was diagnosed at age 4, and
thanks to our wonderful vet is doing really well. I think we noticed her
symptoms earlier because we had the other dogs to compare to...and even
though I had to switch vets to pursue the diagnosis ( they wanted to just
put
her on hormones for the urination problem)
our persistence paid off, and now it might help others to know that this
disease can occur in a younger animal, with no genetic history or obvious
symptoms.
We will certainly celebrate her birthday, as we do with all of our precious
animals.
Give your guys a hug for us... Lynne Young, Chalfonte Shelties
Date: Wed, 1 Oct 1997 15:12:15 -0500
From: "Dillon Pyron" <dillon.pyron@amd.com>
To: cushings-pets@mcfeeley.cc.utexas.edu
Subject: Re: Cushings: Heaven's Birthday
Message-ID: <9710011512.ZM3154@dvorak.amd.com>
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Ivan wishes a Happy Barkday to Heaven, the youngster. He'll be 14 on the 12th.
--
dillon pyron
dillon.pyron@amd.com
PADI OWSI-54909 USPSA TY-26031
Corgis are big dogs in small suits.
Date: Thu, 2 Oct 1997 00:15:24 -0400 (EDT)
From: delausa@mailbox.syr.edu (Del Lausa)
To: cushings-pets@mcfeeley.cc.utexas.edu
Cc: cushings-pets@mcfeeley.cc.utexas.edu
Subject: Re: Cushings: Heaven's Birthday
Message-ID: <v01540b01b05892e7df9f@[128.230.1.61]>
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Well, Willie is a farm mut that i got via an ad in the paper, so I don't
know his exact birthday. But, when I picked him up eleven years ago this
Thanksgiving, they said he was about 7 weeks old. So let's just say his
birthday is this Thursday, and celebrate together!
Happy birthday, Heaven!
del
At 2:40 PM 10/01/97, LynneYoung@aol.com wrote:
>HI...thought with all the sadness lately it might help to report that
Heaven,
>our sheltie will be 7 yrs old on thursday. She was diagnosed at age
4, and
>thanks to our wonderful vet is doing really well. I think we noticed
her
>symptoms earlier because we had the other dogs to compare to...and even
>though I had to switch vets to pursue the diagnosis ( they wanted to
just put
>her on hormones for the urination problem)
>our persistence paid off, and now it might help others to know that
this
>disease can occur in a younger animal, with no genetic history or obvious
>symptoms.
>We will certainly celebrate he birthday, as we do with all of our precious
>animals.
>Give your guys a hug for us... Lynne Young, Chalfonte Shelties
Date: Sat, 4 Oct 1997 18:37:06 +0000
From: Tom White <twhite@law1.law.virginia.edu>
To: cushings-pets@mcfeeley.cc.utexas.edu
Subject: Treatment of cushings and renal disease
Message-ID: <7966BA570E@law1.law.virginia.edu>
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Hi everyone. We thought we would jump right in and introduce
ourselves. We have had three dogs with Cushings (each with a
different set of symptoms/problems in diagnosis and treatment), and
we still feel as though we know very little about this horrible
disease.
Maria's black Afghan Auroboros (diagnosed 1986, we think). Boros
had a benign adrenal tumor which was surgically removed. But he never
stood up again, and died about one month later from pneumonia. He was
then 11 years old.
Tom's black longhaired dachshund Dapper Dan (diagnosed, May
1994). Dapper had a brain tumor which began, probably, as a pituitary
tumor, but became enlarged to the size of a golf ball. He died from
complications of the tumor in November 1994. He was treated with
lysodren, but the Cushings symptoms were swamped by the effects of the
brain tumor. He was then six years old.
Maria's red longhaired dachshund Cleopatra (diagnosed May 1997).
Clea had her "sweet sixteen" birthday in August and is Dapper's
mother.
Clea's problem is caused by an adrenal tumor, which was
undiagnosed for what we think must have been about 8 months, at a
minimum. Our vet first thought about Cushings when Clea appeared to
have become noticeably weaker (at first, thought to be the effects of
"old age"), and a blood panel showed that her liver values had
become
elevated. A dexamethasone suppression test, given for diagnostic
purposes on May 15th, practically flattened her for four or five days,
and she has never regained her full strength since then.
Because we had been unsuccessful with lysodren in treating our
first two dogs with Cushings, we tried to treat her condition with
Anipryl (Eldepryl by prescription). That drug did not appreciably
improve the Cushings symptons and seems only to have lost time (about
two months). We then switched to lysodren on July 22 and, briefly, it
seemed to have some effect. But it really has been downhill since
then. Now, she is also fighting renal disease.
In reviewing our journals and calendars on the progress of her
treatment, we suspect that her kdineys may have already started going
sour by July 14th. Her kidney values (BUN, creatinine, phosphorus)
were fine before we stared the anipryl. We don't know for sure if
anipryl had anything to do with her kidney problems, since bladder and
kidney infections apparently are common side effects of Cushings. We
recently found out that anipryl is effective only in treating Cushings
caused by pituitary tumors, and not adrenal tumors, which is what Clea
has. Cushings caused by an adrenal tumor is independent of the
pituitary. So the 2-month regime of using anipryl to treat Clea was,
of course, useless!!
Clea's story is long, 3 chapters so far, which can be found on
Dr. Mike's website. (See "Ask Dr. Mike" at TierVetInfo
(http://www.vetinfo.com/askDrMike.html).)
Since July 27, we've had great difficulty trying to regulate a
dosage of lysodren for her. Even 1/2 of a tablet (1/4 of a tablet, 2
x a day) seems to make her go flat. She is so weak now (after a
couple of days on an IV to help clear her kidneys) that we abandoned
the lysodren (and administration of baytril for generalized
infections) a couple of days ago in hopes that she might regain a
little strength.
Has anyone else experienced this "coma-like" effect when
administering lysodren? We explored the possibility of an overdose
with our vet, but he says it is not possible with the small amounts of
lysodren she has been given and the fact that her cortisol level
remains high at 7.4. That is, she has never reached her "maintenance
level."
We have two more of Clea's pups, now age 10: Chairman of the Ways
& Means [Committee] (also known as "little Rosti") and Sir
Timothy of
Munchkin ("Timmy"). We have learned that not only are dachshunds
susceptible to Cushings Disease, but it is probably inherited-OH,
NO!!! Rosti is showing what might be early signs of Cushings
(panting, hair loss), but Timmy (who has a thyroid deficiency) appears
to be fine.
Well, that's all for now. Hope all your doggies remain strong.
Tom, Maria and Clea, Timmy and Rosti
E-mail us at trw@virginia.edu
Date: Sat, 4 Oct 1997 19:17:46 -0500 (CDT)
From: Wendy & Brian Duggan <kyzylkum@cruzio.com>
To: CUSHINGS-PETS@mcfeeley.cc.utexas.edu
Subject: Introduction
Message-ID: <v01510125b05c2481a457@[165.227.212.39]>
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Hi out there,
We're Wendy (and Brian) Duggan of Santa Cruz, CA, owned by numerous Salukis
(we breed and show them, as well as performance events). Our Cushings
patient is Flyssa.
Flyssa is a smooth Saluki who will be 9 years old this month. We bred
her
ourselves, as well as her dam and granddam, and her g-grandsire was our
first Saluki many years ago. There has been NO instance of Cushings in any
of her ancestors for quite a ways back, nor any other close relatives,
including her children and grandchildren (so far....). I do know of about
3-4 other Cushingoid Salukis (everyone who has one seems to call me, as
it's pretty well known in the fancy about Flyssa) but none are from related
lines.
Flyssa was officially diagnosed with pituitary Cushings in February 1995.
The official diagnosis came from UCDavis, Dr. Edward Feldman, who as I
understand it wrote the protocol for treatment of Cushings with lysodren.
Flyssa had suffered from several of the symptoms for close onto a year
prior to diagnosis, and we went through all the "what can it be?"
trial and
errors. She did not present many of the "classic" symptoms (leave
it to a
Saluki to be unusual...); the only really noticable ones were PU/PD. She'd
always been a voracious eater, there was no real change in her eating
habits, no pot belly, no hair loss, no noticable lethargy. It was the PU/PD
that alerted us. Of course every test for everything but Cushings was
tried, and she seemed to get better during the summer, then when she had
another season (the PU/PD have become evident during her previous season,
when she was in the house all the time without access-at-will to the yard)
it seemed to flare up again. More inconclusive tests, then a casual
discussion with an acquaintence who is not only a vet but also a Saluki
breeder. Something "clicked" and she told us she had an idea--bring
Flyssa
in for some tests (she's not our regular vet, she's a ways away). Well,
I
don't have the tests at my fingertips (I know they included dex/meth
supression and ACTH) but they were pretty conclusive to Cushings. She
recommended we see Dr. Feldman. We made an appointment with Davis and up
we
went. Dr. Feldman re-ran tests for his own satisfaction, but also concluded
Cushings immediately. She received an abdominal ultrasound which ruled out
adrenal tumors, and then a CAT scan to examine the pituitary. No tumor was
visible so it was concluded that she had a microtumor under 3mm causing
the
Cushings.
Flyssa has been on Lysodren (since the initial "massive dose"
she's been on
1/4 tablet twice a day, six days out of seven) and ACTH tests indicate her
cortisol levels have remained in the normal range for the past 2.5 years.
She is peppy and full of bounce, and clearly happy and healthy, except for
one thing....the PU/PD has never abated more than slightly. Dr. Feldman
suggested using a human med for diabetes incipitus (DDAVP) on her to treat
the PU/PD. It has no effect on her health other than her comfort (and ours)
and of course lessens the chance of her bloating due to excessive water
consumption.
The problem with the DDAVP is expense. It's VERY expensive. We use the
minimum amount we can to make any difference, so she can go through the
night without having to pee or leaking. It comes in an inconvenient
packaging for the way we need to use it (it's a rhinal tube for humans but
she gets it as eye drops) so precious drops get wasted. If we are
extrememly careful and nurse the bottle, we can get at most 3-4 weeks out
of it....and it's $79/bottle. We contacted the manufacturer to try and see
if there was any way we could get sample bottles, etc. but since it is
technically NOT for veterinary use, they were unable (or unwilling) to help
me.
We don't plan to discontinue the DDAVP, for her comfort as well as ours.
She's a very tactile beast, and wants to spend time cuddled up on the couch
or on the bed--and certainly enjoys it when it's her night to sleep on the
bed! (we alternate). BUT we want to explore any other avenues--since the
lysodren alone does not treat the PU/PD, if Anipryl was as effective as
the
Lysodren on her cortisol levels AND treated PU/PD more effectively, it
would be worth exploring....or, does anyone know how we could get DDAVP
more reasonably or in a larger bottle where we could dispense it with a
syringe?
Dr. Feldman is skeptical about Anipryl. His answer to me was that I could
take one of two courses--either "save your money" or "try
it--who knows, it
might work after all?". Not really very helpful. My current GP vet
asked me
to get Dr. Feldman's opinion, but I haven't discussed this with her since
I
did so (she is not the vet who was involved in the original diagnosis--that
one moved). Dr. Feldman feels that Anipryl is unproven, that the only
positive tests came out of the company that manfacturers it. When I first
mentioned it to him some time ago (when it was still in testing in Canada,
before testing started here) he was even more skeptical and at that point
said it couldn't be used on a patient that HAD been on lysodren, but he
never mentioned that when asked this time....so you can see I'm
confused....
What to do, what to do?
One other comment--Flyssa was spayed AFTER she'd been under treatment
for
Cushings for about a year--two seasons--and her PU/PD got noticably WORSE
during her seasons. Clealry the hormones had an effect on the Cushings.
Anyone else notice this?
Wendy Duggan
Kyzyl Kum Saluki - Smooth & Feathered
kyzylkum@cruzio.cm
Date: Sun, 5 Oct 1997 14:09:13 -0400 (EDT)
From: delausa@mailbox.syr.edu (Del Lausa)
To: cushings-pets@mcfeeley.cc.utexas.edu
Cc: CUSHINGS-PETS@mcfeeley.cc.utexas.edu
Subject: Re: Introduction
Message-ID: <v01540b00b05c773e9952@[128.230.1.171]>
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Hi--welcome!
Just a brief comment on this issue (below): This is almost exactly what
my
vet says. When he called the company, their on-staff vet even told him that
he probably should *not* put a dog on Anipryl who is doing well on
Lysodren. The Anipryl sounds really good to me--the "logic" of
it working
with the body rather than against it. But the lysodren, for all the hassle,
and the occassional over- or under-dosing and adjustment, has given Willie
about three quality years that he wouldn't have had without it. So, for
now, we are staying on the lysodren.
BTW, the company does have a protocol for moving a dog from lysodren
to
Anipryl if you decide to go that way.
del
>Dr. Feldman is skeptical about Anipryl. His answer to me was that
I could
>take one of two courses--either "save your money" or "try
it--who knows, it
>might work after all?". Not really very helpful. My current GP
vet asked me
>to get Dr. Feldman's opinion, but I haven't discussed this with her
since I
>did so (she is not the vet who was involved in the original diagnosis--that
>one moved). Dr. Feldman feels that Anipryl is unproven, that the only
>positive tests came out of the company that manfacturers it. When I
first
>mentioned it to him some time ago (when it was still in testing in Canada,
>before testing started here) he was even more skeptical and at that
point
>said it couldn't be used on a patient that HAD been on lysodren, but
he
>never mentioned that when asked this time....so you can see I'm
>confused....
>
>What to do, what to do?
>