Labrador: Cushings, Addisons And An Itchy Belly

[Kerry C]

Hi everyone, has anyone got experience with Cushings disease and liver issues? Sorry this is long, apparently she is a complex case.

I have a labrador retriever (Engel) who will be 13 in July. Since she was 10 she's had a spate of injuries and illnesses: torn cruciate ligament, attacked by another dog, arthritis, and a supposed growth on her liver and some other internal organs (after invasive and painful internal examination it came back with nothing and Cushings disease was diagnosed). She was having 110mg Trilostane every morning to treat the Cushings (as well as a ACTH test every 6 months).

In the last 6 months she has been coughing/dry retching increasingly at times throughout the day, probably between 8 - 20 times and not related to eating. Eating sticks and bark in the park - like chewing and swallowing the whole thing (regardless of me stopping her from eating most of it), very lethargic and tires easily, not interested in other dogs, drinking excessive water, sleeping all day and has developed serious anxiety. Her regular vet did a blood test and the ALT liver enzyme came back at around 800 and the AST was also a bit high. The vet suggested she have an ultrasound, chest X-ray and ACTH at around $800-$1000. Aside from the money, my dog is old and I will only consider putting her through surgery if it's completely necessary, so I took her to another vet for a second opinion. They ran the liver enzyme test and it came back ALT around 500. The second vet then suggested just running the ACTH test and it showed her dose had become too high - she was diagnosed with Addison's (the opposite of Cushings).

Since coming off her Cushings meds she instantly decided she was a puppy again, has started running, sniffing other dogs, is so alert, stopped eating bark and coughing, drinking less, no panting and is generally less anxious.

Aside from feeling guilty about overdosing her for the past 6 months, I'm wondering if anyone has been trough a similar experience? Or is anyone knows why she could have developed an itchy/irritated belly that she scratches all the time? I've looked at the skin but it looks fine. She has a distended belly (symptom of Cushings and Addisions) and there's a few old lady lumps in there. I'd like to put her through the stress of being poked and prodded as much as possible.

Thanks in advance,

Kerry

[*kirty*]

Not much help sorry, but I know liver problems cancause itchy skin.

[Erny]

I'm not going to be much help either, other than a stab in the dark guess that the itchiness might be related to toxins her liver finds too much to deal with and so they are being excreted via the skin. As I said .... a guess.

Use calendula tea on the itchy area (all over, if you wish) and leave it on to dry (i.e. don't rinse off). This usually soothes, has antibacterial and anti-inflammatory qualities about it. I find it a boon to keep the discomfort levels down and also helps to keep the skin clean (without affecting natural oils/pH levels) to avoid secondary skin infections, at least whilst you are working out what might be the driving cause of the itchiness.

ETA: Don't beat yourself up for the medication dosage. Things change. That, and we are guided by our Vets in these matters. Hindsight makes us experts. Pity foresight wasn't as easy. Sounds to me like you're doing a great job working to look after her and keep her as well as she can be .

Edited April 25, 2014 by Erny

[Lhok]

The distended belly is more a Cushings thing then an Addison's thing. The ACTH test is the only test that is able to diagnose Addison's but it can't tell you which type of Addison's your dog has, For Addison's you will need to run Electrolyte tests every few weeks once they start on their meds which once they get a dose that evens them out then it is every three months.

The itchyness is a bit of a worry but it could be something she is eating or a contact allergy I never noticed any real itchyness with my boy Treble before, after and while we were getting the meds sorted. His Addison's symptoms were depression, legarthy, lack of eating, drinking excessively and urinating excessively. In fact before he was tested I thought he displaying signs of kidney failure, only a full blood test and the ACTH test confirmed Addison's.

--Lhok

[Kerry C]

Thanks for your advice Erny, will get the calendula tea and give it a go. :)

[Kerry C]

The distended belly is more a Cushings thing then an Addison's thing. The ACTH test is the only test that is able to diagnose Addison's but it can't tell you which type of Addison's your dog has, For Addison's you will need to run Electrolyte tests every few weeks once they start on their meds which once they get a dose that evens them out then it is every three months.

The itchyness is a bit of a worry but it could be something she is eating or a contact allergy I never noticed any real itchyness with my boy Treble before, after and while we were getting the meds sorted. His Addison's symptoms were depression, legarthy, lack of eating, drinking excessively and urinating excessively. In fact before he was tested I thought he displaying signs of kidney failure, only a full blood test and the ACTH test confirmed Addison's.

--Lhok

Great, thanks for clarifying the belly as a Cushings thing, and that your dog didn't have an itchy belly. My dog had all the same symptoms as your dog (except for the "lack of eating", my lab has NEVER slowed her eating). I didn't know there was more than one Addison's, maybe I should do some more research on these.

[Lhok]

Treb displayed these things after he had been through something stressful which is something else that Addison's dogs do. They don't produce enough cortisol so when they get stressed their body doesn't cope with it.

When Treb was first diagnosed I went looking for things that would help me understand what Addison's was this was one of the best articles I found that explained what was the difference types were.

http://www.addisondogs.com/addisons/helpers/small/difference.html

--Lhok