Any experience with these troubling symptoms?

[sanford]

Roughy is approx. 13-14 y/o. He seems to have the classic symptoms of Cushings disease and my vet gave him the standard day-long test, but it came back negative, which Is a good thing, but his dramatic, troubling symptoms persist, so a course of treatment eludes us... 

Approx 1 - 2 weeks ago he developed a huge thirst and voracious appetite. I take him out many times during the day, but still he has accidents. For more than a year he has developed episodes of uncontrollable trembling and shaking, but 2 vets have been unable to diagnose this, although he does have arthritis. His back legs have become very weak and he can only walk a short distance and no longer climb onto sofa or bed. He wanders through the night, pants heavily and is uncharacteristically clingy during the day... following me constantly and trying to climb up on me. He sleeps more than usual during the day. He also tested neg for diabetes. 10 days ago he was prescribed Gabapentin, Lasix at bedtime to no avail. He is also maintained on Enalapril, Pimobendin/Vetmedin and Rimadyl for his arthritis and heart condition. His bloodwork is OK. My main concern is that the shaking and trembling might mean that he's in pain, but how to know for sure? He has intermittent brief bouts of energy and playfulness.

The vet will be contacting me on Tuesday to discuss further.

Does any one have a similar experience? Any suggestions would be greatly appreciated.

[pkcrossley]

i am so sorry to hear of this. my older dogs have had symptoms like this, but they are vague. i'm glad the vet is examiniing this further. the wandering and panting sounds to me like an increase in cranial pressure, maybe from rise of cortisol ("sundowning", which is also caused by a variety of symptoms). if so, it is better in the day, comes on in late afternoon and then gets worse through the night. meds to help him sleep through the night would manage it. how sure are they about the Cushings test? it sounds definitive, but it also sounds like he has Cushings. has anybody suggested treating him for it to see if it helps? 

[Hillscreek]

So sorry to hear this. Unfortunately I have no experience with anything like you describe. Can only send words of sympathy and hope you and your vet can find a way to help Roughy 

[Sam I Am]

 

Have Ruffy tested for Addison’s disease...potentially  mimicking other diseases with similar symptoms. https://vcahospitals.com/know-your-pet/addisons-disease-in-dogs-overview

https://www.akc.org/expert-advice/health/addisons-disease-in-dogs-symptoms-treatment-prevention/

I would insist on testing for this disease . If he has tested positive for this disease it is manageable with drug therapy. If not then at least it rules that out. You don’t want it to reach an Addison’s crisis if he does have it. Happened to a Personal friend of mine and was diagnosed to have it. it took 2 years for her Drs to rule out everything until it became critical. She is,now living a normal life on the appropriate meds.

Edited February 13, 2021 by Sam I Am

[sanford]

Thanks for above input and responses.To address your points:

• Sam: Prior to DEX Suppression Test, the vet ruled out Addisons -- but I will ask if we need to revisit this possibility and test for it.

• PK: Because Ruffy tested negative for Cushing's, Vet cannot treat him for it. Treatment is based on which of the 2 types of Cushing's the dog has: adrenal or pituitary. The drugs are very different and not interchangeable.

• PK: I will ask about relationship of panting to cranial pressure.

When I speak with vet on Tuesday, among other things, I will ask about meds for sleep (for both of us)! I will give you updates.

Edited February 14, 2021 by sanford

[pkcrossley]

we will be waiting to hear. good boy Ruffy!

[bradl]

Thinking about Ruffy and you with high hopes. 

My only experience with anything similar would have been Haggis and sundowning. We too tried gabapentin without effect. Eventually we found relief for him and for us with trazadone. 

We also added acupuncture at the holistic vets. Coming from a fairly conventional technical background I sort of just went along with it because why not? Despite my skepticism I have to say the spring in his step — for several days — after each visit was notable and made my heart soar to see. I didn't find acupuncture helpful for me when I tried it, but for Haggis is was clearly a positive thing. 

Regarding trazadone. The vet we used, encouraged by our success, reported that it had not worked as well for one of her subsequent patient. So I guess as with so many things mileage may vary; so much depends on what's going on with each individual.

Hang in there, both of you. 

[Kathryn]

I can't offer any advice, other than to say my cousin's swiss mountain dog had great results from acupuncture. But I just want you to know we are crossing fingers and paws in this household hoping for a good diagnosis and treatment for Ruffy.

Getting old sucks...

[sanford]

Thanks for the suggestions re Trazodone. I’ll ask vet on Tues. Ruffy already on gabapentim . Perhaps increase dose if it won’t make him to too woozy.

In the past, acupuncture didn’t seem to work for Carrington (or myself for that matter), but every case is different so I’ll check with vet.

Edited February 14, 2021 by sanford

[Catalyzt]

Thirst and incontinence, my first thought is always kidney problems, particularly given the Enalapril-- yeah, it can lower blood pressure and slow down kidney damage, but it can cause kidney problems too.  Given that kidney issues go hand-in-hand with heart problems, and I assume that's what he's taking the Pimobendan for, that also makes me think kidneys.  You mentioned blood work, but did he have a urine culture?  You might want to double-check the creatinine, have them send you the report, look up the reference ranges, couldn't hurt.  Lasix is really hard on the kidneys, I think.

My experience has been when they're on that many meds, they do start to have problems over time.  Our Bichon did really well on Pimobendan and Lasix for about six months after four days in the ICU from a left atrial tear-- he nearly died in the car on the way to the vet (and God bless everyone else on the road that day, because they all did the right thing, and I was probably doubling the speed limit.)  He bounced back and took a bunch of road trips with us, good quality of life.  Eventually, though, the meds caught up to him, and he crashed and went into kidney failure; at that point, the vet withdrew the Lasix and cut back on some meds, we gave him subcutaneous fluids-- very tricky-- and he bounced back again for another four or five months!  

The rear legs sounds more like a neurological issue, but it's hard to say.  (Spike had two episodes of his hind legs going out, and in hindsight, that looks very much like a seizure disorder, we're still working on it.)

Good luck and let us know how he's doing.  

[Toto-lee Cairn]

Sanford, I am so sorry.  I have NO experience with what you are describing, but can be keeping you and Ruffy in my thoughts.  I hope you find some answers,  and some relief for him.

[CamilleatGaelforce]

Sanford, it sounds to me as if Roughy has Atypical Cushing's Disease, which mimics Typical Cushing's, but does not produce positive results in the Dexamethasone Suppression test, because it is not cortisol that is elevated, but instead some of the other hormones the adrenal glands produce.  The University of Tennessee's Endocrinology department can test for a full adrenal steroid profile, their website is  https://vetmed.tennessee.edu/vmc/dls/endocrinology/   .  There is a website that also adds info, and they do sell the OTC supplements used to treat Atypical Cushings, it is "Lignans For Life", you can find it if you google it, I am sure. ( Since it's a commercial website I won't include a link.)  The good news is that flaxseen lignans and melatonin don't require a prescription, and do offer relief of symptoms, even if they don't work as aggressively and quickly as Trilostane works to reduce cortisol production.   One of my Scotties, years ago, was given Lysodren and it destroyed her adrenal glands, and she was an Addison's dog for the last 5 years of her life, which was much harder to treat, and much more dangerous.   Cushing's kills slowly, Addison's kills FAST, so by all means don't use Lysodren or even Trilostane if you don't have to, there have been rare instances of Trilostane causing adrenal necrosis, although not as readily as Lysodren does.  I hope your vet will help you decide if treating for Atypical Cushing's is a safe plan for Roughy!

[DogsSmarterThanMe]

On 2/13/2021 at 9:29 AM, sanford said:

Roughy is approx. 13-14 y/o. He seems to have the classic symptoms of Cushings disease and my vet gave him the standard day-long test, but it came back negative, which Is a good thing, but his dramatic, troubling symptoms persist, so a course of treatment eludes us... 

Approx 1 - 2 weeks ago he developed a huge thirst and voracious appetite. I take him out many times during the day, but still he has accidents. For more than a year he has developed episodes of uncontrollable trembling and shaking, but 2 vets have been unable to diagnose this, although he does have arthritis. His back legs have become very weak and he can only walk a short distance and no longer climb onto sofa or bed. He wanders through the night, pants heavily and is uncharacteristically clingy during the day... following me constantly and trying to climb up on me. He sleeps more than usual during the day. He also tested neg for diabetes. 10 days ago he was prescribed Gabapentin, Lasix at bedtime to no avail. He is also maintained on Enalapril, Pimobendin/Vetmedin and Rimadyl for his arthritis and heart condition. His bloodwork is OK. My main concern is that the shaking and trembling might mean that he's in pain, but how to know for sure? He has intermittent brief bouts of energy and playfulness.

The vet will be contacting me on Tuesday to discuss further.

Does any one have a similar experience? Any suggestions would be greatly appreciated.

 

[DogsSmarterThanMe]

Dixie developed exactly those symptoms as a puppy and was diagnosed with a porto-systemic shunt.  In her case she was having a severe liver toxicity and once they put here on Metronidazole and Lactulose she picked up within three days. 

Sadly, despite surgery, her liver continues to trouble my poor year old puppy....

Good luck with Roughy!

[hi1pockets]

I realize this is a older discussion but I am curious what ended up being Ruffy's diagnose? I believe my 13 year old Zeus is going through the same. Vet just started him on Trazadone but still not sure what where going on...