Need Advice for Cushings Disease

First off -- let's hope it is NOT Cushings.  Cushings is not easy to treat and at best you "manage" it -- essentially the body is producing too much of it's own cortisone ("cortisol";) and most of the Cushings drugs essentially disable or kill part of the adrenals to get them to produce LESS Cortisol.

 I've had two different dogs with really horrific skin problems (Muffin the Intrepid and Billy) -- and early on, I decided that If I EVER had a dog with Cushings I would treat it homeopathically.   At this point I might entertain TCVM (Traditional Chinese Veterinary Medicine). 

Why?  Because Cushings is a body balance problem and most dogs actually respond really, really well to alternative treatment for this.  Before I even "go there" with you, I want to encourage you to read a book:  The Nature of Animal Healing by Martin Goldstein, DVM -- I linked that to the Amazon page for the book. 

It is probably THE most life-changing book I ever read.  Simply because it was the book that introduced me to both homeopathy and "alternative" stuff -- but mostly because he makes so much sense.  You will want to zoom to the pages on Cushings.

The other book I'd encourage you to read would be "Four Paws Five Directions" by Cheryl Schwartz, DVM (that's the TCVM primer for the lay person).

There are others that talk about homeopathy and alternative stuff -- but those two are gold.  Particularly Goldstein's book.

I want to make a huge point here - I am **NOT** talking about you treating this yourself, nor am I talking about you just following something you read online.  I am encouraging you to find a ****GOOD**** vet who does homoepathy (often to the exclusion of all else because if they are GOOD they're known for it and often don't have a whole lot of time for anything else).  Or  find a vet who does TCVM (again one who does ONLY TCVM or it is the bulk of their practice - not just a vet who dabbles in a little of this and a little of that.

 Typically vets like this charge differently than regular vets.  There is typically no "testing" (because they have different criteria and the look at the body differently) but the vet will take far more time with the dog -- rather than a 5 - 15 minute vet visit -- it may be more like 90 minutes to 2 hours.  so the intial consult is often more expensive.  But ... in the long run, you spend far less on tests, and meds but you will need the occasional "tune up" visit to the vet and you will need the remedies or herbs (depending on which you opt for) prepared.  In particular, homeopathic remedies are very very individual -- Dog A and Dog B (or Human A or Human B) who take a homeopathic approach to Cushings likely won't have identical remedies.

Aside from the fact that it treats Cushings with literally NO bad side effects, Homeopathy is going to be a lot cheaper.  Now there are various different "types" of homeopathic and even TCVM treatment and if you are interested, email me.  Essentially the goal is to restore the animal to health, rather than merely "maintaining" the disease. 

However, the **first** thing I would suggest -- and suggest EVER so strongly -- is for you to do another thyroid panel.  But this time, ask the vet to send it either to Dr. Jean Dodds, directly at Hemopet (http://www.hemopet.org) **OR** send it to Michigan State Vet School. 

Why? 

 Because either of those is going to give you a breed specific thyroid panel.  Yes, I realize this dog is likely a mix, BUT the breed specific panel could literally completely change this whole scenario.  I did FIVE thyroid panels on Billy back after we got him.  He had, without exception, the absolutely WORST skin I have ever seen in my life.  We also did at least five, or more, Bile Acids tests (which is one of the most definitive tests for Cushings -- or at least it was 5 years ago) because Billy ALSO was "Cushingoid".

"Cushingoid" is a phrase vets will use when a dog exhibits the classic symptoms of Cushings -- but maybe doesn't actually 'test' to have Cushings.  OFTEN there are other factors that actually cause the skin to be so bad.  One of those can be low thryoid. 

The breed specific test is simply more accurate.  The typical thyroid test a vet sends out measures every dog against the same chart.  So a beagle is held to the same criteria as an akita ... or a sheltie ... or a St. Bernard or a rottie ... or a bulldog or a chihuahua.

We all know that different dogs have different metabolisms and a LOT of that is because different breeds have different energy levels (which is tied TO metabolism).

When we tested Billy all those times for thyroid it always came back 'within norms' but maybe a little low - but not low enough for them to supplement.  However -- when we had his little buffy cocker butt tested at Michigan State?  WHOA - IT CAME BACK ****LOW****.  We began to treat the thyroid and hallelujah.  SUDDENLY something began to work.

Billy's Cushingoid appearance came mostly from the steroids and immune-suppressors he took for IMHA.  But even then I didn't just use regular vet medicine -- he also saw a holistic vet who treated him homoepathically **in addition** to the big drugs he took for IMHA.  Literally the holistic vet viewed himself as "complimenetary therapy"

Doing both wasn't cheap.  I won't lie to you.  But IMHA is terminal (and often times so fast you can't even get it treated)

But looking at Cushings in your situation -- it's possible because of the longer term diabetes. (it's all the endocrine system here) -- HOWEVER -- the thyroid could be exacerbathing it far far more than need be.  And once you start treating for Cushings you can't really stop, if I recall correctly.

I don't know how open you are to alternative stuff -- but in this case it could be far far better simply because the meds themselves are so much less harsh.    That is what prompted my mental decision all those years ago --

The interesting thing is, that my interest in homeopathy has grown -- not just because it's "alternative" but because I've used it to treat my own problems.  Altho not on my own -- I have a homeopath I visit who treats the auto-immune problems I have (asthma, psoriasis and rheumatoid arthritis).  So I've seen an incredible degree of success.  As it happens -- I found the guy *I* go to by asking my homeopathic vet who HE goes to. 

Sorry this is so long -- feel free to email me.  I know this is a scarey thing -- some people are terrified of being able to "trust" alternative medicine.  But the biggest challenge is honestly to find the right practitioner.

I took your advice and called a local TCVM vet. I explained everything to her and what she basically told me was that she could give me things to give to Cody that would control the symptoms, but wouldn't actually treat the Cushings.

She said that to effectively treat Cody, if he does in fact have Cushings, we should use the TC medicine in conjunction with the medications prescribed by my vet. She said that the Cushex drops I found online would most likely work in the same way, that they would help control the symptoms but not actually make the adrenal or pituitary glands start functioning normally again.

The medications used today to treat Cushings actually control/kill the glands responsible for the disease, whereas the TC medicines just help promote hair growth, reduce drinking, etc.

She said that it was in fact pretty similar to treating dogs with Cancer, in that the best treatment often involves both TCVM as well as more modern medicines.

She told me to call her later this week after I found out for sure what my vet's diagnosis was, and that we'd discuss options then. She was VERY friendly and very easy to talk to, which was pleasant :)

I'll keep doing research until Cody's appointment, and talk to my vet about all of the options then. Thanks again!

Here's a picture of the troublemaker :)

The homeopathy actually *treats* the Cushings.  That why that would be first on my list.  You can ask that TCVM vet if they know someone who is a *good* homeopath.  Actually I know a woman who will treat long distance -- she is VERY good (in fact she's the one that has taught most of the vets who do homeopathy in the US -- everyone knows her). 

If you are interested, email me.  Homeopathy is a totally different modality -- it is probably the most solidly based in "science" of any alternative medicine. 

I'm not knocking TCVM -- heaven knows I use it every single day.  But for a problem like this -- I would choose homeopathy every time *first*.  If it doesn't satisfy you then you can always try the other route.  But you have to do it with a vet's help -- and homeopathic vets are as uncommon as you might think.  The trick is to make sure it is a good one.

calliecritturs

  Homeopathy is a totally different modality -- it is probably the most solidly based in "science" of any alternative medicine. 

I'd love to see some of the scientific studies you refer to in regards to homeopathy.  

JackieG

I'd love to see some of the scientific studies you refer to in regards to homeopathy.

Jackie, I did not say "studies" -- I said it was probably the most solidly based in "science" of any alternative medicine. 

Both Heel and Boiron have veterinary divisions and I don't have access to their proprietary stuff -- so I didn't include them.

These might interest you:  I tried to first give you a bit of introduction.  It's easy to find all sorts of articles trying to dismiss homeopathy -- but at the same time it's really hard to refute something that has as many testimonials as it does.  And everyone is entitled to their opinion.

http://www.abchomeopathy.com/detail.htm

and this is another good descripton to give you a basis for reference:

http://www.abchomeopathy.com/scientific.htm

This one is a PDF you have to download but it gives a good description of the scientific basis homeopathy was founded upon. Dr. Hahnemann, generally credited as the founder of homeopathic principles, was developing a cure for smallpox in Europe. You'll see if you read this article why I said homeopathy is,probably the most solidly based in "science" of any alternative medicine. It is where it all began.

http://downloads.hindawi.com/journals/ecam/2005/757651.pdf 

This is from the Journal of American Holistic Veterinary Medicine Association   It's specifically homotoxicology which is a blend of homeopathy and TCVM but relying on the homeopathic principles.

This discusses water memory and the basis of the use of dilutions in homeopathy: (not veterinary -- simply about homeopathy)

http://college-of-practical-homeopathy.com/scientific-basis-of-homeopathy.html

Again specific to homotoxicology -- you have to be a licensed medical practitioner to access part of this but it demonstrates my point:

http://www.positivehealth.com/article/case-studies/case-study-homotoxicology-for-migraine-relief

This is specificially homotoxicology and is from a lecture re: pediatric use

http://www.the-cma.org.uk/cma_images/Claire%20Haresnape%20shorter%20version%20(3).pdf

 This is a specific case study on treatment of migraines (included simply because it so well demonstrates my contention of scientific basis and again it's not "adverising" but is an educational body). Because I used to be plagued with migraines it's of particular interest to me.

http://www.positivehealth.com/article/case-studies/case-study-homotoxicology-for-migraine-relief

calliecritturs

at the same time it's really hard to refute something that has as many testimonials as it does

Not to say it doesn't work, but data is not the plural of anecdote. And whoever wrote the second page doesn't get why a placebo is used as the control comparison in a double blind study. Additionally. blaming the testing when you know your method won't do well, or when you see it doesn't do well, is a fairly common tactic for those whose methods don't hold up under rigorous scientific evaluation. The public loves positive case studies, but they're not useful in the evaluation of treatment effects.

I'm not saying you shouldn't talk to these people, or try it, but be aware when you are reading scientific information, or information purporting to be scientific, how to evaluate that information. Typically, the biggest harm involved in these things is to your wallet.

griffinej5

but be aware when you are reading scientific information, or information purporting to be scientific, how to evaluate that information. Typically, the biggest harm involved in these things is to your wallet.

Yes, it's usually not going to cause any harm to use homeopathic remedies, despite the lack of confirmation of their efficacy.  The possible harm is that a person will abandon traditional treatments/medications in favor of homeopathic ones to treat serious illnesses whether it's for themselves or their pets.  Combining homeopathic treatments with the recommended traditional medications and treatments may cost more but it may give some people the belief that they are doing everything possible for their pet. 

Callie, I've read several of the articles you posted and many others.  You might be surprised how much I know about homeopathy which is why I'm not a believer.  Bad science is bad science whether it's alternative medicine or traditional.  There are many traditional treatments touted that are based on bad science.   I do believe there is a placebo effect in regards to homeopathy.  The power of the human mind is very astounding. 

Callie, this is the person that I called: http://www.wellnesspathvet.com/holisticvet.html  She does do homeopathy as well, which is why I called her.  I'd be interested in calling the person that you suggested, but I feel like they're probaby going to tell me the same thing regarding using homeopathy in conjunction with the more conventional drugs.

Hopefully the vet visit tomorrow is enlightening and I can get some useful information out of it.  Thanks again everyone for your responses!

No where above did I say homeopathy was based on studies, nor did I say anything about the validity.  I simply said it was more based on science than other alternative medicines. 

Given that I've seen postive results (working with three different vets) using homeopathy on dogs, I use it and have found it extremely effective.  When you give a homeopathic to a dog it's not the power of their mind that makes it work or not work.  Not even owner "encouragement" is going to resolve allergies, or stop itching.  Nor any other thing. 

I have a family history of asthma on both my maternal and paternal side.  I've been medically treated for asthma nearly my entire life.  However, 7 years ago I was taking four breathing treatments a day, three inhalers, and was nearly incapacitated by the steroids the doctors had given me.  My body reacted so badly to them and I had such severe muscle spasms using them that I couldn't even dress myself nor go about any of my normal daily activities.  Treated wtih homeopathics, I was able to stop all breathing treatments within a week, and within two months I was breathing normally with no steroids, nor inhalers.  I still have some asthma but it's controlled with homeopathy -- I do use some antihistamine and I continue to be monitored by a regular doctor and my homeopath.   

And incidentally -- the homeopath I see was recommended to me by my vet.  Because I used homeopathy on my dogs before I used it on myself.  Again the dog isn't going to be swayed because they took me to this neat new guy who is nice and who tells them they are going to feel better.  They may be anxious to get there because the treats are good -- but that's not going to sway the health outcome.

It works.  I'm not going to get into a contest here about the veracity of homeopathy -- she asked for suggestions and I gave them.  But I would suggest that simply reading about something doesn't make it so or not so.  I offered my own experience. 

If you have something further about Cushings to offer the OP that might be helpful to her. 

crouchingcheese

He's had recurring skin infections that we've had to treat with steroids

And just to be clear....you did mean hyPERthyroidism and not hyPOthyroidism?

  Your pup is so cute! I'm so sorry he's having such a rough time. As I'm sure you know by now, long term use of steroids can cause Cushing's, so it's best to avoid them if possible. Obviously that's not as option when your pup's scratching himself raw. In addition to diabetes, which your pup already has, Cushing's can lead to other problems such as liver or kidney disease, hypothyroidism, heart problems, and dogs with Cushing's are more prone to developing calcium oxalate stones. They are also at a greater risk for developing pancreatitis.

  You can be proactive with his diet; high quality protein reduces the workload on the liver. You want to feed him a food that has meat meal or meat as the first ingredient. Vegetable proteins such as corn gluten or wheat gluten produce more waste products for the liver to deal with. For the kidneys, you want to avoid feeding a high protein and high phosphorus diet. However, you need to ensure he's getting enough protein to avoid muscle wasting. To help avoid oxalate stone formation, do not supplement his diet with vitamin C. To help avoid pancreatitis, it's best to feed a moderate to low fat diet. Adding fish body oil is good for the kidneys and also his skin. It may not be possible to do all of these things but doing some of them may help avoid more problems.

  Has he been tested for environmental allergies? My dog used to have numerous skin infections until I had her tested and found that she was allergic to several grass and weed pollens, as well as to house dust mites and storage mites. She's been on allergen immunotherapy for about 7 years now and it has really helped. They can only put about 12 allergens in the serum, but it's enough to reduce her total allergy load to where she's not itching. I really hope he doesn't have Cushing's and will keep him in my thoughts.

Lysodren does have side effects.  Did your vet consider Trilostane?

http://www.peteducation.com/article.cfm?c=2+2097&aid=416
"The use of Lysodren is somewhat like chemotherapy. It works by destroying cells of the adrenal gland that produce the corticosteroid hormones. As the number of corticosteroid-producing cells is reduced, even though the pituitary gland continues to produce excess ACTH, the adrenal gland is less able to respond, so the amount of glucocorticoid being produced is reduced. The problems arise when too much of the adrenal cortex is killed off. The animals may then need to be placed on prednisone, either short or long term."

http://www.kateconnick.com/library/cushingsdisease.html
"Lysodren is effective, yet it carries a great potential for serious side effects. If too much adrenal tissue is destroyed, a dog can be given permanent Addison's disease, hypoadrenocorticism (the opposite of Cushing's). This occurs inadvertently in approximately 5% of dogs given lysodren. A small minority of veterinary practitioners actually do this intentionally, and then they maintain the dog on daily medications for life. The risk of untreated Addison's is that a hypoadrenocorticoid dog can't manage stress the way a normal dog can, and can die from shock and heart failure. A normal body requires steroid hormones in order to survive.

More typically, a dog will experience a lysodren reaction in which cortisol levels are acutely too low. This occurs in approximately one third of canine patients and can be reflected in inappetence, vomiting, diarrhea, muscle weakness, wobbliness, lethargy, or even collapse and death. Less than 1% of dogs experience fatal complications. Owners must carefully monitor dogs taking lysodren and respond to such adverse reactions by stopping the lysodren and administering prednisone. Also, dogs on lysodren must receive periodic ACTH stimulation tests to monitor their blood cortisol levels. Thus, treating with lysodren requires a greater than average owner commitment to monitoring their dog."

An alternative, newer drug is Trilostane (brand name Vetoryl)
http://en.wikipedia.org/wiki/Trilostane

http://www.2ndchance.info/cushings.htm
"Trilostane is a relatively new option for pet owners in the USA. It has been used longer in the UK (It was licensed by the US FDA in 2009 for canine Cushing's). It works equally well for pituitary (PA, PDH) and adrenal (AT, ADH) Cushing's cases. It is, perhaps, somewhat safer than Lysodren and its success rate is about equal to Lysodren.

Its effects are quite similar to lysodren although it does not appear to be as severe in its effects on adrenal tissue as lysodren is. It should not be given when your pet’s kidney or liver tests are abnormal or when certain heart medications have been administered in the recent past. It seems to work best when the suggested daily dose is divided and given every 8-12 hours with food (no more than one calculated total daily dose per day)."