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I have a question about cushings disease, muscle wasting and digestive issues with my 14 y/o dog.


Posted by dgj

I have a 14 year old mixed breed female dog who has recently been diagnosed with Cushing Disease. We are currently in the loading phase with Lysodren at 250 mg per day. I have no idea how long she's had it but over the past year, she has had significant muscle loss all over her body. To make matters worse, the Lysodren is making her sick and she isn't eating as much as has lost more weight. We've went from 18 lbs to 15.5 lbs and her muscle loss has gotten worse since the Lysodren. I understand that it is basically "poison" and that it's to be expected for her to be slightly sick. But, I am concerned about her getting too weak. I have two questions/concerns. What could I do to help put some weight on her and help build muscle back up after we finish the loading dose of Lysodren? She is fed a high-quality organic diet but is there a food or supplement that could help build up those amino acids the Cushings has been "stealing" from her muscles? Second, and I'm not sure if this has to do with the Cushings at all...is some kind of digestive issue. Prior to the Cushings diagnosis, she had an eye ulcer and had to be put on two different rounds of two different antibiotics, which she has never done very well on. She tends to get diarrhea. Now, I don't know if the antibiotics have to do with this digestive problem but that is what I suspected. So, for the problem...she defecates a lot. She's gone from about 2 times per day to about 6. She is eating more (a common symptom of Cushings) but it seems to me that she is "going" much more than she's eating. When she goes, it's a lot more than normal. I dare say about twice the amount she usually does. And, it doesn't look normal either. It looks lighter than normal and looks "lighter" in consistency. Almost like whipped butter. Almost "airy". Not diarrhea at all as it's "formed" but much softer looking. I guess I'd have to say her normal "poo" was harder, like the consistency of refrigerated butter while the new poo is more the consistency of whipped butter at room temperature. And, she has started eating it! She's never done this before. I get the feeling she's doing it because nutritionally, she's not getting what she needs and is trying to supplement in some way. Or, that the poo is not digested properly, which may make it seem "appetizing" as dogs like to eat on rotten stuff anyway. I have been giving her probiotics specifically for dogs, thinking her bacteria is out of balance due to the antibiotics. But, I've been doing this for about 3 months and the poo really hasn't changed it's look. I'm wondering is there is something secondary doing on with her digestion. I suppose it could be related to Cushings but I have found nothing to suggest this is a symptom. My vet doesn't say that either. She kind of pushes it to the side, wanting to focus on the Cushings. I understand that but I can't help but wonder if by going so much and so often if her food is not just "running" through her system so fast she isn't getting the proper nutrition, making her loose weight, become malnurished and cause muscle wasting. I guess the reason I think it's not to do with Cushings is this problem has is more recent than her other Cushings symptoms (excessive drinking, loosing fur, pot-bellied appearance, etc.). And, since it's started, she seems more hungry and is eating more but loosing weight. And, of course, eating her poo, which she's never done before. Just so you know, she's been tested for parasites and has none. They did a ACTH (I think that's what it's called) to diagnose Cushings. Her baseline number was 6.5 for cortisol and her number after stimulation was 42.7 for cortisol. Her liver enzymes have been elevated for about 2 years now. They have been up and down but always above normal. Her TSH (thyroid) was only slightly above normal but the vet seems to think it may be because of the Cushings and wants to get that under control to see if that normalizes. All the other bloodwork they've done has come back normal. They will be ultrasounding the liver tomorrow. So, my two concerns are... What and how soon can I start supplementing or feeding a specific food that could build up those amino acids the Cushings has been stealing, exasperating the muscle wasting? I do think I should wait until the loading dose is complete as she's sick to her stomach and being even more finicky than normal about food right now. (I am doing steamed white rice, baked chicken, chicken broth and a teaspoon of pumpkin right now to keep the diet bland because of her being sick. She is a finicky eater and I'm terrified she will just stop eating altogether!) Second, what could be causing this excessive poo? If you have any suggestions, I would be greatly appreciative! Thank you so much, Dedra dedra@studio193.com
 
Answers (4)
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hello, are you using a generic of accutane?
Hello, I don't want to make things more complicated for you, but many of the symptoms you are describing were present in my dog Woody as well. In addition he had started having seizures last year, possibly because his pituitary tumor was a macro rather than a micro tumor. He had actually progressed to the point where he developed diabetes and is now blind.  We started him on Retinoic Acid 6 months ago, and he has improved markedly. His stool is normal, he is full of energy, no longer depressed, able to eat regular food - most he was unable to tolerate before. His sezures are controlled, but he is still on medication for them. He is also still blind and diabetic, but that is okay. Prior to the retinoic acid I think he was dying.  It is very expensive, $700 for three months worth from a Canadian pharmacy (the generic version).  Good luck, Stacey Krenelka

To add to Dr Myrna's great reply,  you may want to put her on some probiotics and digestive enzymes with the antibioics having killed off even the friendly, necessary bacteria in her intestines and obviously her own digestive enzymes pretty much depleted.     

You could also totally eliminate the rice in her diet.  Dogs do not NEED carbs and she should be getting what she needs fiber wise and carb wise from the pumpkin you are feeding her.   That will be one less thing her tired digestive system will have to try to digest.  :-)

As you surmised, it does sound like she is unable to digest what she's being fed. Consequently, she's eating her stool because it's not waste so much as partially digested food. Then the question becomes whether this is because she's not producing the necessary digestive enzymes to do the job or if she's not capable of absorbing the digested food from  her gut for some reason.  I assume her pancreatic function is normal?

 As far as feeding goes, running the food through a processor might make it easier for her to digest if digestive enzymes are in short supply and boiled skinless chicken breast rather than baked might be easier for her to digest than baked. Also multiple very small meals rather than 2-3 larger ones might help. 

 Also, even though I know you're very concerned about her, do try not to let any anxiety show. Instead, do everything in your power to communicate your confidence in her and yourself to make it through this. Dogs are very good at picking up physiological changes in humans and if we're stressed, that stresses them. And because that stress can cause secretion of hormones whose production taxes the adrenal and thyroid glands as well as causes increased motility of the gut, this isn't what she needs right now. Unfortunately, sometimes there's a tendency to treat sick animals like infants using a higher tone of voice that in dog terms communicates subordination. To check your own approach, talk to a mirror the same way you do to your dog and ask yourself if what you're seeing and hearing conveys confidence or something else. 

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