Losing Weight & Hair

[MogaMax]

Does anyone know what this could be? Or recommend a treatment.

7yr old desexed male cross (shih tzu x maltese) who is loosing weight, constantly hungry and losing his hair.

Prescribed creon tablets for 2 weeks but no positive change was seen.

Next thought was Cushions Disese or diabetes but blood tests have come back all clear, all major organs are working normally.

Vet now saying saying its possibly a hormonal deficiency.

[Nekhbet]

what about thyroid function? If the dog is going to be on Creon it should have been on a special diet and eating at least twice a day. What is the current diet?

[poodlefan]

what about thyroid function? If the dog is going to be on Creon it should have been on a special diet and eating at least twice a day. What is the current diet?

My first thoughts were thyroid too... but bloodwork doesn't support that?????

[MogaMax]

The vet advised us to feed him twice a day, he was happy for him to continue to have dry food in the morning and wet food at night ( meat with vegies & pasta or rice). The only thing that has changed is the volume of food, he gets at least twice as much as he use to before he started losing weight.

[Erny]

My first thought was thyroid issue too.

With Cushings, doesn't the belly distend, making the dog look bloated and weight gained?

Would the test for Cushings show up thyroid issues if it wasn't Cushings?

If not, I'd be venturing that track. And if you know me well enough I'd be using Dr Jean Dodds for the testing and analysis.

Is the hair loss symmetrical?

[Nekhbet]

depends if they did thyroid or not it's a separate test - if the vet is now saying it's hormonal obviously did not test for that when in fact it should have been the first thing to look for.

Cushings can result in weight and hair loss as well Erny, there is a special test to confirm it which I'll have to rememeber ... it involved the dog taking a course of tablets then having blood tests done.

[Erny]

depends if they did thyroid or not it's a separate test - if the vet is now saying it's hormonal obviously did not test for that when in fact it should have been the first thing to look for.

That's (sort of) what I was thinking (wondering). I would go the "thyroid" track too - and like I said, I'd run them through Dr Jean Dodds in the USA for testing and analysis.

Cushings can result in weight and hair loss as well Erny, there is a special test to confirm it which I'll have to rememeber ... it involved the dog taking a course of tablets then having blood tests done.

Didn't realise that Cushings could result in weight loss or weight gain .... thought it was just the latter. Thanks for clarifying.

[MogaMax]

They tested for Cushings which came back negative.

So far the hair loss is only to the tail, the lower back and slightly on the rump of the leg.

[Erny]

What is the skin like where there is hair loss? Is there any darkening of the skin?

[MogaMax]

I rang the vet and asked about the Thyroid, he said that he tested for that and it was negative.

Yes the skin does appear darker.

[dogbesotted]

what tests have actually been carried out??? if you do not know ask your vet for specific details and also for the results ie a copy of the report.

it is not possible to diagnose cushings disease from a standard blood test.

The most commonly recommended test is a low dose dexamethasone suppression test (LDDS). This test takes most of a day to run. A blood sample is drawn early in the morning and immediately afterwards dexamethasone is administered intravenously. In four hours a second blood sample is drawn and after 8 hours a third blood sample is drawn. The cortisol levels of the samples are compared. If Cushing's disease is not present, the cortisol levels should go from normal levels to very low levels (they are suppressed). If Cushing's is not present, the cortisol levels remain high after the injection of the dexamethasone. An alternate test is the ACTH response test. This test is less sensitive to the presence of Cushing's disease but can be run much more quickly, making it more convenient at times. To do an ACTH response test, a blood sample is drawn any time during the day and then a hormone, adrenocorticotropin (ACTH) is administered. An hour later (two for some ACTH preparations) a second blood sample is drawn. If the results of the second sample show markedly elevated levels of cortisol, it indicates that Cushing's disease is present. There are other tests that help to determine what type of Cushing's disease is present but one of these two tests is a good idea to determine if Cushing's disease is present.

the tests required to definitively diagnose addisons disease involves the ACTH stim test

but these examples are indicative:

BUN (Blood urea nitrogen) 47 mg/dl (normal = 7-27 mg/dl)

Creatinine 2.1 mg/dl (normal = 0.4-1.8 mg/dl)

Sodium 113 meq/L (normal = 141-156 meq/L)

Potassium 5.9 meq/L (normal = 4.0-5.6 meq/L)

Sodium/Potassium ratio 19 (normal = 27-40)

Thyroid diseases also cause these problems.

just testing T4 alone is not an adequate indicator.

http://www.petplace.com/dogs/weight-loss-in-dogs/page1.aspx

http://www.peteducation.com/article.cfm?c=2+1593&aid=421

read read read up on endocrine diseases. also i recommend getting bloods tests carried out and interpreted by Dr Jean Dodds whi is an acknowledged expert is this area.

Good Luck

Helen

[Dog Sense]

G'day, not a regular poster here but someone pointed me towards your question. Have had a Cushings dog, it took three yrs of stuffing around to get diagonised and then vets were saying things like "text book case, should have been picked up ages ago". If I had not pushed for a diagnosis, she would never have been diagnosed and we would have continued to treat symptoms, uselessly to her detriment.

I agree with those who've suggested specific thyroid function testing using Jean Dodds protocol, TSH alone is useless as only tells you what pituitary gland is saying to thyroid. T4 alone is useless as gives incomplete picture. I also concur that Cushings / Addisons cannot be diagnosed with routine bloods - need low dose dexamethasone suppression test OR ACTH stim test. Sometimes both are required, especially in the case of Addisons. Thes tests are frequently only performed by specialist vets' surgeries or university vet hospitals so if your vet is not prepared or unable to do them, you need to ask to be referred. Lack of appetite and emaciation usually is indicative of Addisons, excessive appetite and thirst with or without weight loss/gain is generally indicative of Cushings. Further testing may be required in either case to differentiate between pituitary or adrenal Cushings (or Addisons) as treatment is different.

Hypothyroid dogs can get fat because their metabolic system is broken. Cushings dogs don't generally get fat unless they have free access to food constantly - i.e., indulgent owners. Addisons dogs get skinny because they're not producing any / very little cortisol and they're just not hungry so they don't eat. Cushings dogs do get distended abdomens (which can look like a fat tummy) but not until after the liver is affected - would be nice to have it diagnosed before a dog gets liver enlargement! They also can get calcium deposits in their skin which starts off looking like dandruff and over time develops into crusty sores (calcinosis cutis), the hair loss and calcium deposits form a t-section, across the shoulders and down the length of the back (this is a Cushings trademark). The skin where hair is missing can turn a darker colour and elsewhere such as on underbelly and legs, skin is tissue thin, it tears like an elderly person's. The skin is not greasy as it can be with a thyroid condition unless the dog has a fungal/yeast skin infection which is a common complication, as are fungal/yeast infections of the ears, which will not resolve, despite treatment for that symptom, until underlying condition is treated and begins to improve. These infections smell bad, and differently to the greasy skin of a hypothyroid dog.

Big clue - Cushings dogs are not itchy because they are producing so much of their own cortisol it has same effect as cortisone treatment given to suppress itching from flea bites. They may have a heavy flea and/or worm burden because their immune system is suppressed and if so, regular treatments will be ineffective again until the underlying condition is treated and starts to resolve.

Other complications are connective tissue (ligament, tendon) breakdown, calcification of soft tissue (i.e., the feet), the front feet turn out like a ballerina's, the pasterns fall (i.e., walking on ankles rather than on feet) whic can also occur in hypothyroidism. By the time your dog is showing all these symptoms, it's a long way back, so if your dog is a Cushings case, the sooner you start treatment the better, both cost-wise and for your dog's health.

I'm generalising now but treatment for Addisons is steroids, treatment for Cushings is Trilostane (chemotherapy drug) which is reasonably user-friendly or Lysodren (cytotoxic chemotherapy drug) which has serious side-effects if not monitored very carefully. Occasionally in the case of pituitary Cushings, surgery is recommended but (again generally) surgery to either pituitary or adrenal glands is expensive and highly risky. If your dog has either Addisons or Cushings he will need specialist veterinary care, it's not a GP vet condition until stabilised.

You may have to be a pain in your vet's backside to get this resolved. You know your dog best, so if you feel he's not himself, don't get fobbed off, keep at it. Best wishes,

Donna.

[Erny]

There's also Adrenal sex hormone responsive dermatosis (mind you, that's not to say there's not 101 other things it could be either). I suspect (but don't know) that this, being hormonal, could be connected to the thyroid as well.

Link to the above (and other things) relating to hair loss conditions is :

http://www.lowchensaustralia.com/health/hairloss.htm

Me? I would insist on a Dr Jean Dodds Thryoid 5 Plus test above all else. I won't push or harp, but I do offer you to contact me should you need some help on how to arrange this, or to ask me any questions about it - I'm more than happy to assist where I can :D.

You may have to be a pain in your vet's backside to get this resolved. You know your dog best, so if you feel he's not himself, don't get fobbed off, keep at it. Best wishes, Donna.

You are so right, Donna. I've had a couple of Vets roll their eyes at me for insisting my young boy be tested for Hypothyroidism. There he was, looking a picture of health with shining coat; tonnes of energy; and lean. His problem was/is digestive issues but the initial Vets I saw did not see a dog whose clinical symptoms fitted Hypothyroid. But I went ahead and as it turns out, he was hypothyroid and although we're not completely resolved yet, he is much, much better. I felt a bit stupid along the way, but I am very pleased with my decision to insist. If I had been wrong .... - yes, I would have done my dough.

Edited April 7, 2011 by Erny