? Any one have a cat with or know about cushings in cats

I'm trying to find real people information about cushings in cats. Not whitewashed propaganda.

How do you manage and how did you find out your cat had that?

 

@Tuxedo Mom has a kitty with cushings

 

The least invasive test for Cushing's is the UCCR test ( urine cortisol creatinine ratio) You would collect a urine sample at home and take it to the vet where they would prepare it and send it for testing at am outside lab. Mine was done at IDEXX....I believe it was around $120 Cdn including shipping. The reference ranges they use are for dogs, since there has never been an accurate range set for kitties, but it will give a good indication of whether further testing is in order. Depending on whether the UCCR test shows whether further testing is needed, other tests can be done afterwards.

Usual clinical symptoms are overall body hair loss, a pot-bellied appearance (almost looks pregnant), thinning skin, increased appetite, and increased drinking and urination ( which are also signs of diabetes) and difficulty regulating glucose levels. Some kitties will lose weight, but it not unusual for Cushing's kitties to gain weight. Thre have been at least 6 kitties I have seen on here and one other site with Cushing's in the last 2 years and I personally think that it is under-diagnosed since vets consider it rare.


There are 2 types of Cushing's..pituitary dependant is caused by a tumour on the pituitary gland ( similar to Agromegaly but causing different hormome "over-loads") and adrenal dependant is caused by a tumour on the adrenal glands. PAD (pituittary based) is the most common type. An ultra sound can be done to check for enlarged adrenals (PAD both adrenals are enlarged) enlarged liver and enlarged pancreas ( one or both depending on which type of Cushing's) which are common findings with Cushing's.

Cushing's is especially hard on the heart, liver, pancreas and kidneys, since they are in a constant state of "over-drive". With Pituitary based Cushing's trilostane (vetoryl) can be used to help lessen the effects of the excess cortisol being produced. It is used quite successfully in dogs and has shown some promise with kitties. When on this medication a kitty needs to be careful monitored and regular ACTH blood testing done to make sure the dose is correct, Too high a dose can lead to Addison's disease, insufficient cortisol, which is life threatening if not caught in time....similar to a hypo with insulin. I personally chose not to use trilostane.

If you need more information just ask.


ETA I don't see a spreadsheet so I can't comment on the numbers and your profile doesn't allow for finding past threads so I don't know the whole journey you have had to date.. One thing I do find is that Tuxie can go from an extreme high to a hypo in the same cycle (On AT2 pet meter 551 PS to 25 @+7...using Levemir). I am presuming this is when the tumour becomes less active and the excess cortisol is not produced. This is a link to another member whose kitty had Cushing's and she started trilostane, Unfortunately her Zoe crossed the bridge shortly after she started, but she kept good notes if you want to read through her story.

http://www.felinediabetes.com/FDMB/search/4253973/

 

a tuxedo mom
Did your cat's skin change color?
Literature clearly states dex can cause cushings. He is dosing off of dex after surgery. Has the pot belly, losing hair on his belly , diabetic.

He's had a ct and MRI of his head, and nobody mentioned tumor. He had an ultrasound on his belly last week (or two weeks) for his pancreas. He did barium through his digestive system. Nobody has said anything about cushings.

The direct connection, in literature about dex =cushings has me worried.

Iatrogenic hyperadrenocorticism
This one is can be caused by dex. Now I'm worried I was told to out him on dex and nobody told me this could happen.
I've discussed the hairless belly, pot belly over and over with vet and just get told its natural when on steroids. Vet even wants to keep him in dex.

How did you come to cushings? Your own suspicion or vet told you before you knew?

Did your cat get a dx of diabetes or cushings first?

I don't know which thinks to click to undo my profile.

 

Thank you for the information.

 

Since he is on dex, would that give false reading for the urine test?

 

Exogenous Cushing’s (caused by steroid use) can certainly occur. Dexamethasone is a very potent steroid and not commonly used after surgery. Also it can persist in the body for some time before totally clearing out. Cushing's caused by steroid use can (sometimes) correct itself over time as the steroid is weaned off, but insulin treatment would still be needed. I really don't know why your vet is using dex since it is much more potent than the usual steroids such as prednisolone.

My Tuxie was diagnosed as diabetic first...no real reason for it...he was not overweight and had been on a low carb home made wet food for years...he actually NEVER ate dry food. I was concerned about his pot belly but the first vet ignored it. I changed vets a month or so later ( for many reasons) and eventually talked my new vet into running the UCCR test after ultraounds showed the enlarged organs. The U/S vet said that it was consistent with Cushing's, but he had only done one U/S on a Cushing's kitty. Most vets do not even consider Cushing's in kitties since it is "supposed" to be rare. I have the UCCR done which was borderline and then the HDDS (high dose dex suppression test) and LDDS )low dose suppression test) both of which were positive/borderline. They use Dexamethasone for these tests since it is such a powerful steroid. My Tuxie does have some hair colour changes...tinges of red through his black hair and he does not go out so it is not a bleaching from the sun. Tuxie had his first U/S over 2 years ago and the hair has never grown back where they shaved him.

I would question your vet using Dexamethasone as a post surgery treatment. If an anti-inflammatory is definitely needed prednisolone would be a much better choice since it is less stressful on the system. What surgery was done that he requires a steroid??

The Dexamethasone can affect the results of the UCCR test since it is causing an overload of steroids in the body which will affect the urine.


ETA Tuxie is PAD (pituitary affected Cushing's) I have not had the MRI done which would pinpoint the tumour, due to cost and distance to travel (8-10 hour) car ride, but clinically and test wise he is Cushing's

 

All I will add is that I had a kitty on dexamethasone many years ago for suspected neurological issues that could never be properly identified. She was on it a long time but - luckily - never became diabetic. The other problems arising from dex were numerous and serious though: corneal ulcers, demodex skin infection, major interruption of hair growth/shedding cycle such that she underwent a massive shed when the dex was stopped. Ingestion of all this hair created GI upset, she stopped eating completely and ended up on a feeding tube for three+ weeks. Somehow she made it through all this and whatever the neurological issue was disappeared.

Dex is a very powerful steroid. Surely post surgical pain and inflammation would respond to something else?

 

I was told dex was equal to pred, dex is just the liquid form.

I've been wondering how long it takes to grow hair from a shave. Your kitty still hasn't grown the hair back.....

 

Kris and Teasel, how long was your cat on dex?

Vet wants him to stay on dex. I keep getting told it's okay for him and now I'm worried.

 

http://www.nadf.us/downloads/adrenalhormone.pdf
This chart compares a long list of corticosteroids. You can see that dex is a very potent one.

 

This converter shows that dex is much more powerful than prednisolone. For instance if you are giving 2.5mg of pred you would only use 0.38mg of dex


http://www.globalrph.com/steroid.cgi

ETA the dex is about 8 times more powerful than the equivalent dose of pred

 

My cat was on it for over 2 years. At the time it was the vet's "shot in the dark" to treat a very mysterious, perhaps brain-based, neurological issue. My cat was having very strange spells of seizure-like activity.

 

Does a mg equal a ml?
His dex is a liquid that is injected?

 

Mg is a unit of mass / weight. Ml is a unit of volume. There is no direct conversion like millimeters to inches, which are both units of length. More math is involved.

 

http://www.thecalculatorsite.com/articles/units/convert-mg-to-ml.php

It looks like the answer is no, so I don't know how to figure what he's getting.

 

No, a mg doesn't equal a mL. When I had dex it was in pill form. When they make it in injectable form there'll be a certain amount (mg) of dex dissolved or suspended in a liquid. When you draw up a certain volume (mL) of that liquid into a syringe the amount of dex (mg) you're getting will depend on the concentration of the dex: more concentrated = more mg of dex, less concentrated = fewer mg of dex.

 

Ok, now I'm going to go cry. I think I broke my cat.

 

What is the concentration of the dex solution? - should be on the prescription label. What amount do you draw up into the syringe per dose? From this the mg of dex per dose can be calculated.

 

You're doing what you think is best and following your vet's advice. There are folks out here in FDMB land that have a ton of experience with a myriad of medical conditions. The more detail you can give us about what's going on with your kitty - and that includes your spreadsheet - the better we can help. We ALL understand the worry and anxiety of deviating from a vet's guidance. Some vet are very knowledgeable about treating feline diabetes and some are not.

 

I'm working with someone on tgr spreadsheet. I still didn't get it right.

 

As Kris said you should be able to calculate the mg per dose from the information on the label. If that is not clear then call your clinic and ask what "mg" is given with each dose.

What surgery did your kitty have that the vet decided to give dex? And how long was your vet planning on giving it for? If your vet thinks dex and pred are the same I would be questioning what they are doing and why. There were a number of good reasons I "fired" my first vet, once I became more educated with feline diabetes. I can say without a question of a doubt that I knew more about FD within a month of starting than the first vet did.

 

How many ml do you give and how often. The best I can find is that liquid dex comes as 0.5mg/5ml liquid preparation. Is there any of this information on the label?

 

He has 4 vets at the u
3 Er vets
4 general vets

His tests are carried in his go bag and all vets know and work with each other.

Thanks, fir the info. I'm in the middle of a good cry.

I can't fire them, they are the best in the area and the other options would give him poorer medical care. I have left vet practices before. He is getting the best that I have found.

 

His dose varies.

 

His starting dose was .20ccs per day.

 

The label says 4 mg per mL. 1 cc = 1 mL. That means he was getting 0.2 mL x 4 mg/mL = 0.8 mg per dose then.

 

Is that a high or low dose. I don't know.

 

I don't recall what dose I gave my cat all those years ago so I can't say. You said the dose was changing. Is there a reason for that?

 

In theory, he is a transient diabetic due to dex. DVM say he will no longer be diabetic when dex is gone. That said, there is dealing with all the dex helps with, and what happens to those things when the dex is removed.

It's finding a balance of +/- dex and weighing what happens with it and what happens without it. And then there is the fact that he (cat) has not read the text books and research and he may do something else entirely.