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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 24367
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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I have a 12 yr old cocker spaniel who was diagnosed with Cushings.

Customer Question

I have a 12 yr old cocker spaniel who was diagnosed with Cushings. She was given Vetoryl and started to stop eating loosing quite a bit of weight. For various reasons we changed to another Practice who following a scan suggested we stop the Vetoryl as this is known to suppress the appetite. It was then discovered she had pancreatitis so was put on a low fat biscuit food or chappie, for a while she would eat this now she won't. So we then gave her skinless chicken and rice which for a while she ate now she won't. Last night I tried her with some prawns....is this ok? Also her front right paw keeps getting little blisters and she limps quite badly. She has been given antibiotics which only worked for a week. Our vet has said he would normally take a biopsy of the liver but with her weight having fallen to 6kilos he believes she would not survive the anesthetic. I am concerned as it is obviously causing her pain...any suggestions...noted on this site there is mention of immune suppressing medication
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry for the delay in responding to you. I believe that many vets were puzzled by Payne's history. I'll need for you to clarify a few things for me...

Payne was diagnosed with Cushing's and the Vetoryl caused inappetance and profound weight loss. If Payne were truly Cushingoid, a proper dose of Vetoryl would reduce the voracious appetite of a Cushingoid dog but shouldn't cause inappetance. Either Payne wasn't Cushingoid or was being overdosed with Vetoryl. What did her new vet have to say about this?

Pancreatitis is often a concomitant finding in Cushingoid dogs. The relationship between the two diseases, however, is unclear. How was pancreatitis diagnosed - by a specCPL blood test (the test of choice) and/or abdominal ultrasound?

Yes, you can feed an inappetant dog anything and everything. It's better that she eat the "wrong" food than not eat the "right" ones.

The blistering if found interdigitally (between her toes) that responds to antibiotics but relapses without them is likely to representant canine pedal furunculosis (also called interdigital bullae or interdigital pyogranuloma). The cause of this disease is unclear but one hypothesis is that it's an immune-mediated response to ruptured hair follicles. Her prednisolone is a common manner in which to address immune-mediated diseases.

My primary concern at this time, however, is not her skin but her inappetance and profound weight loss. A 6kg Cocker Spaniel must be considered critically ill and suffering from an end-stage disease process such as liver and renal insufficiency as well as malignancy. I would be pleased to review any test results you might have. I'm quite concerned for Beth's quality of life at this time.

Please respond with additional information and further questions or concerns if you wish.
Customer: replied 2 years ago.

Thank you for your time. Unfortunately Beth (dog's name) is 12 years old which does not help. All the way through some of her symptoms have matched those related to Cushings such as hair loss but in other ways she presented did not point to Cushings. However the blood tests she had carried out point to her being Cushingoid. However her disinterest in food did seem to stop after the Vetoryl was discontinued. This was following a scan which showed her vital organs to be in a reasonable condition for her age. They carried out the scan to see if she had cancern. This came back negatitive. The new vets (there are 2 "working" on her case) were concerned about her weight which at the time was about 7.2kg. But even though we were giving her food such as sausages to try to increase the weight nothing happened. She then went off food again and they tested for pancreatitis and also gave her a quarter of a 15mg tablet of Mirtazapine to increase her appetite. She was put on a low fat dry food or in the UK Chappie wet food. For a while she would eat this but was "picky" as to when and what we offered. It really seems at times she wants to eat but doesn't want what we are offering. As an example we have kept our other cocker spaniel of his normal dry food and although in 12 years she has never tried to take food from another dog's bowl, she will try to eat his food. Yesterday I purchase a food which can be given to dogs with pancreatitis and she ate the whole pack 390g (not in one go obviously but over the course of the day). This morning she has eaten some again. For all her problems she is still very alert and follows us around. If given the chance she will still chase her ball although we obviously don't throw this around like we use to. I shall be returning to the vet's on Monday regarding her limping and see if anything can be done. Obviously if she is in pain this could also put her off eating. Once again thank you for your help and please rest assured I would not leave her to suffer it and when it gets to that stage. Regards Elaine Payne

Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for the additional information, Elaine. I'm glad that the Vetoryl was discontinued. Unless my patient is egregiously polyphagic (increased hunger) and egregiously polydipsic (increased thirst), Cushing's shouldn't even be considered. Pancreatitis makes more sense at this time and her eating as she's currently doing is encouraging. You're welcome to share our conversation with her vet - particularly in reference to the blistering you've mentioned and my comments concerning it.

I'm going to check back with you in a week for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

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