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Discussion Starter #1
Wiley was diagnosed hypothyroid about six months ago. He's an old fellow, and I just contributed his symptoms to old age and arthritis. His coat, always soft and shiny, had become so dry, and had thinned to nothing around his neck and especially his tail. Oh, and the skin on his nose, too. He had a weird tremble in one of his back legs, and if he was outdoors for any length of time, I would look out the window to see him shivering all over, no matter how warm the day. As it worsened, he slept most of the time, but the worse thing was that he became so detached from the family, like he inhabited his own little world. He didn't come to us for affection anymore, or take much interest in what was going on around him. Nothing wrong with his appetite, though. He was hungry ALL the time (but then aren't most dogs?) and he had always been a picky eater before. First thing I took real notice of was his increased volume of urine. I couldn't believe a dog's bladder could hold that much, and sometimes he couldn't make it the door in time and had accidents. Then I realized how much water he was drinking...I have three, so I didn't realize it till I began watching for it.

My first thought was that it was Cushings disease or diabetes. While we didn't do all the testing needed for Cushings...as I understand it, it is difficult to diagnose AND treat correctly...what we did find was that he was low on thyroid hormones, and had elevated liver enzymes. So we put him on thyroid meds, and I saw an immediate improvement in him as far as participating and relating to us, and I was very pleased. For 16 years old, I don't expect a lot from him. My main goal is just to keep him comfortable, but because of his liver, the doc didn't want him on arthritis meds. Well, after awhile, I decided he had to be on some pain meds, regardless or I was going to be forced to put him to sleep. He's on Previcox now, and it is helping, though I know it further damaging his liver. But the only other alternative was putting him to sleep, and he and I are not ready for that step yet.

Well, maybe I wasn't paying close enough attention, but he sure got OLD FAST. I mean, a year ago you would never have guessed he was sixteen, but now he looks about a hundred. He had a little arthritis before this year, but now it's awful to watch him stand up and walk, and his whole body feels as hard as a board, and in spite of being hypothyroid, he is so painfully thin, though he hasn't really lost weight...that doesn't make sense, does it? He has always stayed right around fifty pounds. You can't feel his ribs but you can count every vertebrae in his spine, and I think that is rather recent. He is so STIFF and HARD all over his body that sometimes when he's sleeping, I think he has died.

Anyway, sorry for the long post, but it might be helpful for everyone to know the symptoms. I originally came on this site for a dog food recommendation that would help him gain weight, but in writing I just realized that he hasn't actually lost much weight. But I will go ahead and post it anyway. Maybe something else is going on with him that someone can shed some light on.

Thanks for listening.
 

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My heart goes out to you. Trying to figure out what is wrong with our furry friends who can't convey to us exactly what is wrong, is very hard. My prayers are with you and Wiley.
 

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Discussion Starter #4
Thank you both for your kind words. I am trying him on some Glucosamine for his creaky old joints and milk thistle for his liver. I'm not really trying to extend his life. I just want him to be comfortable until its time to go, but I have to admit, it's going to be really tough to let him go even when he does let me know its time.
 

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I'm sorry that your boy is having a rough time of it. Does Wiley still have a good appetite and is he still drinking and urinating excessively? If yes, then I suspect he does have cushing's. The boney spine and weakness in his hindquarters is due to muscle wasting. If he does have cushing's then the adrenals are producing excess cortisol which is a natural steroid that actually masks any symptoms of arthritis. So, Wiley may not be feeling any arthritic pain but rather is having difficulties due to weakness brought on by the muscle wasting.

As I recall, Previcox should not be used concurrently with prednisone (steroid) which is the same thing as uncontrolled cortisol in a cushingoid dog so please be very careful.

I have two cushingoid dogs and one cushingoid foster dog so I've lived with the disease for four years and have done a lot of research in that time. By the way, hypothyoroidism and cushing's go hand in hand a lot of times. One of my dogs has both conditions.
 

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Discussion Starter #6
His appetite is voracious. That's one of the changes I saw in him, because he was always such a picky, delicate eater before. Actually, I remarked to the vet just recently that he has not been drinking as much. Maybe because he is feeling a bit better, and so getting up to drink more often? I also suspect Cushings, but the vet and I have decided not to pursue it. Sometimes I am not sure that is the right decision since we based it mostly on his age (and liver.) He's not on prednisone, so that's not a problem with the Previcox.

Did you have difficulty getting the diagnoses? A bunch of labs were done, but I don't know that we were specifically looking for Cushings at the time, even though it was the first thing I suggested to the vet.
 

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Hi Again.

After going through a number of vets who obviously never heard of cushing's, my first cushdog was finally diagnosed by an internal medicine specialist who ran about every test there is so we got a definitive diagnosis. My second cushdog was a shelter rescue that we adopted because we knew he had cushing's and would be unadoptable. Luckily, the rescue paid for most of his testing which was done at a teaching hospital that did a tremendous job in diagnosing.

As I mentioned earlier, if your dog truly has cushing's, then I doubt that he suffering from arthritis and the weakness you are seeing is a result of the muscle wasting caused by the excess cortisol. Cortisol is a steroid, just like prednisone and prednisone is used to treat arthritis. Since Cortisol is a natural form of Prednisone, treating with Previcox may be a problem. Previcox is an NSAID which can cause some GI problems, including ulcers and perforations. If you are not going to pursue a cushing's diagnosis, then I highly recommend that you talk to your vet about the implications of using Previcox in a dog with uncontrolled cortisol.

There is a simple urine test called a urine cortisol:creatine ratio that can rule out naturally occurring cushing's. If the ratio is within normal range, then you can rule out cushing's. If the ratio is high, then cushing's is a possibility but you would have to further testing to reach a confirmed diagnosis. The test is pretty inexpensive too....definitely less than $100 and you don't have to stress out your boy. All you do is collect a urine sample, preferrably his first pee of the day, prior to eating and taking any meds. I've used a soup ladle in the past and it worked well. Just make sure you don't use that ladle for cooking again.....it would bring an all new meaning to split "pee" soup. :Dn You only need about a tablespoon and just get it to your vet within four to five hours.

FYI, uncontrolled cushing's will continue to assault the liver so not treating is not always prudent. I am glad to see that your vet has him on liver support. This will help and hopefully, you'll see the liver enzymes drop.

There is a drug called Anipryl (Selegiline/L-Deprenyl) that is the only FDA approved drug for canine cushing's. Unfortunately, it is one of the least effective; however, it has been proven to help those dogs with a tumor in the pars intermedia lobe of the pituitary gland. About 85% of dogs with cushing's have a microtumor on the pituitary but unfortunately, a very small percentage of dogs have a tumor in the pars intermedia lobe. The drug usually does not have any effect on the cortisol; however, some pet owners have seen improvements in symptoms. This could be because it is metabolized to amphetamines so it stands to reason that the appetite would be curbed and the pot belly would get smaller. There are very few side effects and if my dogs were too old and were physically unable to treat with the more effective drugs, I would certainly give Anipryl a try.

I hope this helps.

P.S. I am such a ditz sometimes. Now I can't find where you actually mentioned liver support. I really recommend that you put him on SAM-e and milk thistle. Both are excellent supplements. Your vet probably has the prescription version but otherwise, you can buy this at online veterinarian pharmacies.
 

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Discussion Starter #8
You are a wealth of information, lulusmom! What the world needs more is more big hearted people like you. How wonderful that you rescued one with medical problems. It just breaks my heart to think of all the dogs sitting in shelters with no hope of adoption. I wish I could adopt them all.

I did not make the connection between Previcox and steroids, and I actually read up on it! Must have missed something. I wonder if it's the same with Rimadyl? I have my old girl Teddi on that, and I started Wiley on it too till the vet called with the results of Wiley's test and told me to stop giving it to him. I was the one who insisted on trying something for arthritis, and the vet ordered Previcox because he seemed to think it was not as toxic to the liver as Rimadyl. Maybe it isn't arthritis, and I jumped to conclusions. I think you are right. It's likely muscle atrophy that is making it difficult to walk.

Oh, I am giving him milk thistle, but over the counter. I read about it somewhere, and asked the vet if I could try him on it. I didn't know there was a prescription version though. Hmmm. Last labs showed no improvement though.

I think I'll reconsider because if it is Cushings then I am not only damaging his liver by giving him Previcox but making the Cushings worse, and that's not what I want to do. Think I will talk to my vet about this, and at least get the test you told me about.

Thanks again. You've been very helpful.
 

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Here is a link to public information on Previcox on the FDA website.

http://www.fda.gov/cvm/Documents/N141230cis.pdf

You will see that it specifically says that Previcox should not be given to a dog on corticosteroids. This is the equivalent of cortisol. Previcox doesn't make the cushing's worse. The problem is that the combination increases the risk of GI ulceration and other problems.

One of my cushdogs has severe arthritis which really flared up once we got h is cortisol down to normal levels. He take dasuquin powder with his morning meal and I also give him Tramadol which I prefer to use if his pain gets too bad. I have a bottle of Metacam, also an NSAID but I prefer to use them only when necessary.

Yes, over the counter milk thistle is fine. I think you can get SAM-e over the counter too but I'm lazy and purchase mine online. I believe the prescription liver support is Denosyl and Marin. I think you'll get good results and save money with SAM-e and milk thistle.

Keep us posted okay?
 

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Discussion Starter #10
Oh, I understand now! So if he has Cushings, his cortisol levels are high, which would be the same if were on a steroids. Duh. I get you.

Tramadol, huh? I wonder why the vet didn't offer that instead. I'll ask him about it.
 

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Discussion Starter #11
Update on Wiley.

He collapsed on me over the weekend. He could not stand or sit up at all. Left him overnight at the vet on IV fluids to see if we can't get him back on his feet again, but I am not hopeful. The vet wonders if he had a stroke, but he is mentally very alert, and very distressed that he can not walk. I think his hindlegs are just too weak to support him any longer. He had a very high fever, also.

The vet is going to do the cortisol-ratio urine test this morning if possible, but at this point it probably doesn't matter. If we can't get him back on his feet I will likely have to euthanize him, and that is what I've been hoping to avoid. This is really tearing my heart out, and I am having a hard time resigning myself to losing him. I have had to make this decision before, but it was always a sudden thing, not something I had to think about so far in advance. Maybe that's why it so much harder this time.
 

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I am so sorry to hear this latest news about Wiley. In addition to his inability to walk, did he have other issues going on that required IV fluids, such as vomiting, diarrhea, not eating or drinking, etc.? What is Wiley's breeding?
 

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Discussion Starter #13
Wiley is a Border Collie.

Well, I left him overnight this weekend with very careful directions to my 13 year old nephew, who is generally a very reliable boy. I told him to withdraw water at night because otherwise Wiley has accidents. When I came home Sunday afternoon his water dish was still empty, and he didn't get his meds that morning. I don't know if that had anything to do with his collapse. Likely it would have happened anyway because his muscles are so weak. I have seen IV fluids work miracles. I thought to bring him out of it just long enough for...I don't know. Just a little bit longer. Today he is much the same, and I am waiting for the vet to call with results of tests. Likely, I will have him put to sleep today. But a part of me wants to bring him home for a few more days but that will just prolong the inevitable. I will be with him when he goes. I've always stayed with my dogs.

My nephew grew up with Wiley, and wants to be with us. His mom and I discussed it a few months ago, and decided that we would let him. Any thoughts on the wisdom of this? He is 13.

Thanks for the support.
 

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If Wiley is drinking and peeing large volumes (which is common with cushings), it is dangerous to withhold water!! Dogs with polyuria (excessive urination) and polydipsia (excessive drinking) drink water to keep up with the urination, not the other way around and if water is withhold, a dog can dehyrate very quickly and die. This could very well be the reason that Wiley collapsed. Hopefully, the IV fluids will bring him back around. Please keep us posted.
 

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Discussion Starter #15
I decided to bring Wiley home yesterday. It felt like the right decision. It gave me a feeling of peace at the time. The IV fluids did not revive him, but they were able to get his fever down. The Vet believes Wiley had a stroke, and witnessed several smaller ones while he was there.

Within the next few days I will have him euthanized. He does not appear to be suffering. The tears are endless.
 

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I am so, so sorry that you have had to make one of life's most difficult decisions. It is the final act of love and is one of the most selfless decisions one can make. Words are so empty at times like this but please know that my thoughts and prayers are with you and Wiley.
 

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Discussion Starter #17
Wiley went to the Rainbow Bridge November 19th. He was part of my life for sixteen years and now it feels like a part of me is missing. I feel so lost without him. I wish I had come to this website sooner. Maybe I could have kept him with me a little while longer, though I know it could never have been long enough. I was expecting this, and even thought I was prepared for it but I am finding it much harder to accept it.

I want to thank lulasmom for her amazing knowledge about Cushings and for her compassion, and all of you for your support.
 
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