Dog trains man

Saturday, March 5, 2011

Viva has Cushing's

Helping Viva to get better and improve health is a lot like peeling the layers of an onion. Just when we think all bases are covered and all issues addressed, we find out we are looking at yet another layer.

Warning signs

ear-nibble please?
The warning signs have been around all the time. High liver numbers returned from her very first blood-work. Not too high to worry about, treat or investigate further. But we kept on monitoring her regularly just in case. The first external signs came about one month ago. Viva was slowing down on our daily work-out. We gave her some rest, an additional acupuncture session - maybe she was in pain ? - but to no avail. She rapidly became more lethargic, and stopped playing and ear-nibbling with Kenzo, her favorite past-time!

We did a round at our vets and found out her spondylosis had not gotten worse, but her liver numbers had exploded. High liver numbers could be caused by just about anything and further testing was needed. We were in for a couple of painstaking weeks of further testing, investigating, and discussing theories. Our regular vet started suspecting Viva of having Cushing's disease after some additional testing. Although not all the signs have been adding up. She turned out to be spot on.

Cushing's disease

Cushing's is caused by a tumor in the pituitary or the adrenal gland, causing an over production of ACTH hormones which in turn triggers an overproduction of cortisol. A life threatening condition affecting inner organs like kidneys and liver. Some of the most common signs are hair-loss, a pot-belly, lethargic behavior, incontinence, and being overly interested in food and water. Apart from being lethargic, Viva had none of those signs. Yet she always had been overly interested in food and water as a former obese dog. Testing Viva for Cushing's sounded like a wild-goose chase, but I am happy to have followed our vet's gut feeling on this one.

To diagnose Cushing's we started with a urine test to measure cortisol levels. They were sky high. Next was an ACTH stimulation test, which was conclusive. Now it was final, Viva has Cushing's. The diagnosis was actually a huge relief, a month had already passed and I was so worried for Viva being in discomfort for so long and not being able to help her.


We started treating Viva with Vetoryl (Trilostane). Already after 5 days Viva was feeling better. Kenzo got his first ear-nibble in a month, which we celebrated with the whole family that day. It was awesome to witness.

Vetoryl is a very aggressive medicine, that messes with the hormone level. Administering the correct doses is extremely important, as Viva can die when we administer either too much or too little. Viva will need Vetoryl for the rest of her life. The doses can vary over time, and Viva has to be tested quarterly to ensure the doses is correct. Those quarterly tests include an ACTH stimulation test and 3 different blood-work tests.

The onion

It was a hard month with no blogging but we are back! Just wondering how the onion is doing. We are three layers down: allergies, spondylosis and Cushing's. Maybe we are done, maybe we are not. Yet another lesson Kenzo and Viva taught me. Health is not a shopping list with items you can check off and wrap up.

A big thank you to all my anipals for all your kind words and your support on Twitter and Facebook during the last month. It meant a lot and was a huge help getting through all of this. You guys rock!


  1. Well, Leo, I am so glad to hear you now know what it is - it is truly hell not knowing! I am so sorry to hear she has such dangerous medication to take, but on the other hand, at least there *is* medication. Your story about the ear nibbling after such a long hiatus with all the family celebrating was truly heartwarming!

    I wish the best for your and your family after this long and emotionally draining process of pulling back the layers to discover Viva's problem.

  2. Hello, it's good to hear from you again after such a long silence. Not being connected to you by facebook or Twitter, I was beginning to wonder if all was alright. The thought had crossed my mind that, perhaps, Viva had not been well. Cushing' that's yet another "human" disease that dogs can get. Sigh. Lucky for Viva she has a good and caring family. It can't be easy for any of you, dog or human.

    My best wishes for a good recovery for Viva and some rest for all her carers xox

  3. I'm sorry to hear about Viva's diagnosis. I've had two dogs with Cushing's and I know how tough the management can be. But it's great to hear that the treatment is giving Viva some of her pep back.

    After conventionally treating Christie with mitotane, I opted for homeopathic treatment with Agatha and no drugs. I'm not recommending you do that for Viva. It was just something I thought I'd try since Agatha was already 14 years old. Our main treatment was making her a homemade diet. Agatha thrived under the homemade regimen.

    I wish you and your family good luck in monitoring Viva's condition. I know you must be really relieved to know what's going on.

  4. I am glad Viva is doing better, but boy have you guys been through a lot! I am so sorry it's Cushings (I have a friend who's dog lived a long life with it). I was unaware that the meds were so dangerous. How absolutely frightening!. Let's hope this is the last layer!

  5. Welcome back, Leo! As someone whose dog requires lifetime management for diabetes, I feel your pain, but I assure you, you'll get the hang of it.

    Getting the correct dosage for regulation -- or diet, as Pamela recommends -- is the most difficult. It took several months for me to get Frankie's insulin dosage correct, and then I learned that this is not atypical; in fact, the average is seven months. I don't know how long it takes with Cushings, but don't despair if you don't get it right immediately. Just err on the side of underdosing (with insulin it's the same).

    Best of luck and ear scratches to Viva!

  6. One of our dog trainer's dogs was recently diagnosed with Cushings ... and the pot belly was a major tip-off ... in such a small, athletic dog (a Jack Russell).

    I know it was a rough month. All of us here send our best wishes for good health and peace of mind.

  7. Happy to know that Viva is feeling better. I'm sure that Kenzow is delighted to have his ear nibbling pal back :)

  8. @Mary
    Glad there *is* medicin: Absolutely! As it turned out Vetoryl is a newer medicine and before it hit the market an even more agressive medicin was in use. Best compared with chemotherapy. We are not complaining :) Thanks for you wishes and kind words!

    Sorry to make you worry, it was a long silence indeed. I did try to write something, but things just didn't came out right :) Anyway, glad you know now, and we have been missing you and Mr. Thumper too. Btw, are you on Facebook or Twitter?

    I also prefer holistic before medicine, but I couldn't find a treatment that also the vet could recommend (or put me through to one that did). Although the Vetoryl is an agressive medicine it is a huge improvement compared to Mitotane that was used before Vetoryl was invented. We do worry though what many years of Vetoryl will do. Most experiences is based on dogs older than Viva. We keep on researching and always open to a valid and trustworthy holistic alternative!

    Thanks, lets hope this is the last layer indeed. Our main concern will be how to balance this with her spondylosis. As the cortisol (stress hormon) have always acted as a natural pain killer for Viva, that we now take away. But we and the vet are on top of that. Thanks for you kind words and support!

    Thanks Edie, glad to be back too! I thought of you and Frankie when we discussed with the vet how to balance the dosage: "Thats how Edie feels...". And you are absolutely right, the real danger is in overdosing, we will keep far away from that. Thanks for all your support and ear scratches to Frankie too!

    Thanks for the wishes. We are glad we came through it. Hope everything turned out ok for the Jack Russell.

    She is still a cheat. Kenzo only gets a little ear-nibble she uses to get him started :)

  9. I am happy you guys caught it, figured it out and that the Viva is responding to treatment so well.

    Did you notice any changes in mobility or comfort since you started the Cushing's meds?

  10. Thanks so much for sharing Viva's journey with this so far. I know you're going to help others by relating this experience. It sounds like you've started dealing with Cushings at an interesting time what with Viva on the newer medication. It's great to know the treatment is advancing in that way.

    Love the ear nibble photo with the post! Hope you all are having a wonderful weekend!
    -Chandra at Daley's Dog Years

  11. I have never experienced Cushings, but I am glad you have found out the reason for her behavior. Sounds like the medicine is working and I hope contines to help.

    So glad she is ear nibbling again. Sounds like you are all thrill, especially Kenzo.

  12. @Jana
    Not yet, but that could also be because it is too early to tell. It is possible that a part of her muscle weakness is also caused by Cushing's and her behavior towards other dogs affected by the high cortisol levels. But we havn't seen a change here.
    Thanks for the tweet chats where you paid a listening ear to all my theories and came with suggestions what the cause could be. You are a great friend.

    Thanks for all you support! Glad you liked the ear-nibble photo. It is actually already an older one from last year. We are hopefully going to make a lot of new ones, and cherish them a little more :)

    Thanks, glad I could share this with you. I think the main danger with Cushing's is that it is often mistaken for common aging signs in dogs. And people either go to the vet too late or not at all.

  13. re: twitter and fb - no, i'm not, Mr Kenzo. My Typist is, but she's a stingy so&so and refuses to share! i DO have a fb account that i started to join Ms Pamela's Forum for Tech Idiots, but i think My Typist is going to close it soon because she has no time to check all my mail anymore :( very sad. i think she's just cross that i'm getting more mail than her these days.

    have a great week! :) xox

  14. I am so sorry you have had to go through all this. What a terrible ordeal. But I am glad you now have a solid diagnosis and options to work with. Knowing is always better than not knowing. I hope this treatment works and Viva continues to improve. With luck the worst will be over and you can go back to enjoying life with your wonderful dogs.

  15. AWw...I am glad that you have at least gotten to the point of knowing what is going on. One of my pups had Cushings..It's good that it is diagnosed. Paws & Prayers to you and your pack!

  16. I'm glad that you know what you're dealing with now and that Viva's feeling better. Will keep sending positive thoughts your way!

  17. I am so sorry to hear about Viva's medical issues.
    I can only hope that road gets easier for her and for you.

  18. @Kristine
    Thank you for all your kind words. We spend a week in Holland and Viva continues to improve. She is playful and happy. The worst seems to be over!

    Thank you and hope your pup also did great despite the Cushings.

    @Pup Fan / @Jen
    Thank you!

  19. Wow. I'm so glad you have a diagnosis - not knowing is always the scariest part - and it sounds like she's already starting to feel better with treatment! Sending lots and lots of happy thoughts your way!

  20. Oh no! We are so sorry to hear about all you and your pup are going through. :( We are glad she is getting the treatment she needs though!


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