cushing cat problem

Ronnon

Ronnon

Member
I need a recommendation on how to treat and how to prevent the skin from opening even a cat with cushing. It is also diabetic and increasingly thinner, I need to know how to fatten a diabetic cat with cushing and how to improve the fragility of the skin so that it does not open. Each month has a new skin opening

Best
 
Hello and welcome. Sorry about the Cushing diagnosis. We have had a couple of active members with Cushings kitties, tagging @Ana & Frosty (GA) and MaryAnne @Tuxedo Mom

Ana's kitty was on vetoryl and I think it helped his skin tears. She also had him wearing a onsie to protect his skin. Here are a few posts that might provide more information:
http://www.felinediabetes.com/FDMB/threads/how-to-diagnose-cushings.207776/#post-2302697

http://www.felinediabetes.com/FDMB/threads/week-3-of-vetoryl-frostys-acth-stim-test.197328/

http://www.felinediabetes.com/FDMB/...ks-on-vetoryl-vomiting-back-to-im-vet.200266/

She also discusses the surgical option for treatment: http://www.felinediabetes.com/FDMB/...mccue-at-animal-medical-center-in-nyc.200594/
 
"It´s sure my cat has Cushing disease.
My vet did the blood test and other medical testings and the diagnostic was lump adrenal glands.
My cat has also diabetes but it is controlled although the shymtoms must be the same that diabetes. Each month and lately each week the cat has a new skin tear and injury.
We are treating the skin tears with Clorhexidina Antisept and Blastoestimulina 2% powder.
Two months ago a deep skin tear based in backbone was removed because it was infected.
I am worried because my cat is very thin, he only eats high protein low carbohidrates (Leonardo´s brand food).
I need to know how to prevent the skin tears and injuries. He is always covered with a soft body, not compressed yet.
Could you give me advices and recomendations, please?
I attach the tests by link
https://1drv.ms/f/s!AmnpCMjSZ1dLhEy3uHm02HGuz8Up"



I am not on the site too often so I missed the original tag. I have reposted above your conversation that you sent so that the additional information can be seen by all. @Marje and Gracie is very knowledgeable at reading test results so she can give better input on those.

If I understand correctly the diagnosis is adrenal based Cushing's (ADH) Was this confirmed with an ultrasound? There are 2 types of Cushing's...one caused by tumours on the pituitary gland ( PDH) and the other caused by tumours on one or both of the adrenal glands. Both myself and Anna's kitties had the PDH form.

With PDH vetoryl...also called trilostane can help reduce the overproduction of cortisol which will alleviate some of the symptoms of Cushing's including the skin tearing. However vetoryl (trilostane) has not found to be effective with ADH Cushing's. The best approach to ADH is removal of one or both of the adrenal glands ( depending on where the tumours are ) followed by daily supplementation of cortisol since the adrenals are the organ that produce cortisol. However surgery with a kitty that has reached extreme skin tearing is difficult because the skin is difficult to suture or heal. So it is extremely important to know WHICH type of Cushing's your kitty has.

The skin tearing is caused by the excess cortisol that the body is producing. Cortisol is normally produced by the body and is needed for proper functioning. However with Cushing's the usual controls to turn on and off the production of cortisol do not work and the body is constantly producing cortisol. This causes weakening/tearing of the skin and constant wear on certain organs, especially the heart, kidneys, pancreas and adrenals.

I cannot find a spreadsheet with current readings so I can't comment on how well the diabetes is being controlled. My Tuxie never had manageable levels and would go from extreme highs to extreme lows even in the same day. PDH Cushing's can have an 'off and on' type of cortisol production and is not always consistent. I am not really sure if ADH Cushing's has the same effect on the 'pulsing' effect of cortisol production.

I did not treat My Tuxie with vetoryl for a few reasons, but @Ana & Frosty (GA) did treat Frosty with vetoryl and found good results with the skin tears. However as I stated above knowing WHICH type of Cushing's is very important in making decisions on how to treat. Ana used the onsies to cover the body in order to help with the skin tears. Hopefully she can give you some more information on this.


I hope this information is of some help and I will monitor this thread if you have more questions. My heart goes out to you..Cushing's is a terrible disease and I know the difficulties you are going through.


:bighug: :bighug: :bighug:
 
Last edited:
Thanks for linking his labs. Other than the glucose and fructosamine being abnormal, I’m also seeing low hematocrit which indicates anemia. Because his kidneys look good, the anemia is not attributed to that and my theory is that it is, then, regenerative anemia. His red blood cells can make more iron but they aren’t right now. I would discuss that with my vet. His hematocrit is not dangerously low but it’s certainly lower than it should be. I’d want to figure out the source of it and find out if, perhaps, some iron might help. All of that needs to be done through your vet.

Interestingly, his platelet count is high. High platelet count in cats is not very common but one of the things that can cause it is Cushing’s.

I wouldn’t worry about the higher cholesterol. Most diabetic cats have a higher cholesterol level and, for where his is, it’s not a concern.

@Tuxedo Mom Thanks for tagging me, Mary Ann. I hope you are well. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
Ronnon said:
Thanks for your replay @Marje and Gracie .
I have seen this article about iron and food . what do you think ?
https://www.cuteness.com/article/foods-cats-give-iron
Click to expand...
When dealing with anemia, I always suggest you work with your vet. Raw liver is helpful but too much can be harmful. Liver supplements can help but you have to get to the source of the anemia to address it correctly.

While some of the info on the linked page is correct, some is inaccurate. For example, dogs are prone to pancreatitis when fed fatty meals but cats are not. I feed my cats raw pork loin, including the fat, with a supplement that provides a balanced meal. It’s been known a long time that cats are not prone to pancreatitis after fatty meals as dogs are.
 
I don't get on here all that often any more unless I'm tagged. But we have recently been dealing with ADH Cushing's for Roxi. @Tuxedo Mom has it correct - trilostane is of no use in these cases. The only solution for ADH Cushing's is removal of the affected adrenal gland - this is even more important because this type of Cushing's is caused by a tumor on the adrenal and these tumors are almost always malignant. They are not prone to metastasis, but they do spread locally. And given where the adrenal glands lie, that can turn into a big problem if the tumor starts to infiltrate the vena cava. That information is from Roxi's IM specialist with whom we had significant lengthy consults as our regular vet could see the tumor on ultrasound but couldn't figure out what it was or why it would be there (ADH Cushing's in cats is very rare). I would strongly suggest you consult with an experienced Internal Medicine specialist to discuss your options. If you do the surgery, even if only one adrenal is removed, it's likely that you'll need to give supplemental steroids temporarily because the adrenal without the tumor tends to shut down cortisol production and shrink as it's not needed when cortisol is already being overproduced. However, usually the remaining adrenal does re-start cortisol production after a few weeks and you should then be able to taper off the steroids gradually.

The anemia you're seeing does look to be regenerative - the retic count is reasonably good. One thing that may be happening is that Ron may be having GI bleeding - this is something that can happen with excess cortisol in his system. Again, the fix for that would be to remove the adrenal and cure the Cushing's.
 
manxcat419 said:
I don't get on here all that often any more unless I'm tagged. But we have recently been dealing with ADH Cushing's for Roxi. @Tuxedo Mom has it correct - trilostane is of no use in these cases. The only solution for ADH Cushing's is removal of the affected adrenal gland - this is even more important because this type of Cushing's is caused by a tumor on the adrenal and these tumors are almost always malignant. They are not prone to metastasis, but they do spread locally. And given where the adrenal glands lie, that can turn into a big problem if the tumor starts to infiltrate the vena cava. That information is from Roxi's IM specialist with whom we had significant lengthy consults as our regular vet could see the tumor on ultrasound but couldn't figure out what it was or why it would be there (ADH Cushing's in cats is very rare). I would strongly suggest you consult with an experienced Internal Medicine specialist to discuss your options. If you do the surgery, even if only one adrenal is removed, it's likely that you'll need to give supplemental steroids temporarily because the adrenal without the tumor tends to shut down cortisol production and shrink as it's not needed when cortisol is already being overproduced. However, usually the remaining adrenal does re-start cortisol production after a few weeks and you should then be able to taper off the steroids gradually.

The anemia you're seeing does look to be regenerative - the retic count is reasonably good. One thing that may be happening is that Ron may be having GI bleeding - this is something that can happen with excess cortisol in his system. Again, the fix for that would be to remove the adrenal and cure the Cushing's.
Click to expand...


April so sorry to hear that Roxie has ADH. Most of the Cushing's cases that have arisen over the last number of years appeared to be PDH so it may be that ADH is rarer...or it could be a case of being under-diagnosed. Back when I first joined there were very few cases of Cushing's, but that number has increased a lot over the last 4+ years. Doing an U/S of the adrenals on a kitty is more difficult because of the positioning of the glands. With the first U/S I had done they were only able to visualize one of the adrenals, but the second U/S was able to show both glands ( no tumours as Tuxie was PDH).

The OP has not been back on since April 24 so I am not sure how things are going. Sending :bighug::bighug: and prayers for you and Roxie.
 
Thank you. :bighug: Roxi is actually about 7 or 8 weeks post surgery at this point - she's on low-dose pred and is having another follow-up early next week to see if we can stop the pred altogether. Her glucose has been kind of shocking - she had been a high dose cat, but now even 1 unit is taking her way too low. I've had to break protocol with her completely and give big reductions, and even skip shots to make sure we stay ahead of her numbers. To the extent that we're starting to wonder if her diabetes, back when we adopted her, was already due to Cushing's rather than being a standard case and we just had no idea until we started seeing skin issues. According to her IM, ADH is very rare in cats, although rather more common in dogs - our vet had an ultrasound specialist do the initial u/s on her to make sure the adrenals could be visualized. Thankfully, our vet is great to refer us or find a specialist if they think it's something they may not be able to get us accurate answers on. Although ADH actually requires surgery, I can't honestly say that I'm sorry that was the form that Roxi had - simply because the surgery does provide a cure in one attempt for the most part. Her tumor was malignant, but that was to be expected and the surgeon is certain it hadn't spread beyond the adrenal, so apart from a single follow up u/s in about a month to make 110% sure, that shouldn't be an issue for her either. :)
 
manxcat419 said:
Thank you. :bighug: Roxi is actually about 7 or 8 weeks post surgery at this point - she's on low-dose pred and is having another follow-up early next week to see if we can stop the pred altogether. Her glucose has been kind of shocking - she had been a high dose cat, but now even 1 unit is taking her way too low. I've had to break protocol with her completely and give big reductions, and even skip shots to make sure we stay ahead of her numbers. To the extent that we're starting to wonder if her diabetes, back when we adopted her, was already due to Cushing's rather than being a standard case and we just had no idea until we started seeing skin issues. According to her IM, ADH is very rare in cats, although rather more common in dogs - our vet had an ultrasound specialist do the initial u/s on her to make sure the adrenals could be visualized. Thankfully, our vet is great to refer us or find a specialist if they think it's something they may not be able to get us accurate answers on. Although ADH actually requires surgery, I can't honestly say that I'm sorry that was the form that Roxi had - simply because the surgery does provide a cure in one attempt for the most part. Her tumor was malignant, but that was to be expected and the surgeon is certain it hadn't spread beyond the adrenal, so apart from a single follow up u/s in about a month to make 110% sure, that shouldn't be an issue for her either. :)
Click to expand...


I think the Cushing's and FD connection is like the question of the chicken and the egg...which came first?? Tuxie with his PDH only got up to 6 units (Levemir) BID but his numbers were like a major rollercoaster ...from high blacks to low greens in the same cycle. I don't know if ADH has the same 'pulsing' 'on and off' effect that PDH but it made it very hard to figure out dosing. Personally I think even more so with Cushing's a lot of the dosing protocols end up by the wayside. I had considered changing to prozinc so that I could better dose what was happening each cycle but never did as my other kitty was also on Levemir.

Glad to see that Roxie is doing well after her surgery. I can understand your point of being 'pleased' (poor choice of words) that it was ADH rather than PDH. Doing a hypophysectomy on a kitty is risky and often there is residual left behind which can cause the tumour to reoccur. A adrenalectomy is less 'risky' (again poor choice of words) and offers a good chance of a cure.

Roxie is indeed fortunate to have you as a Mom and I wish you and Roxie all the best in the recovery process.

f2b4510c50838ead6acb91d9725e80ab--prayers-kitty.jpg
 
The adrenal tumors do pulse too - the IM confirmed that. I'd asked because, like you, we'd seen drops (as low as the low 20s) followed by days of high numbers, although not often into the black range thankfully. Her maximum dose was 10.5 units of Lantus, but although she'd earn reductions we never felt we had full control even on the good days.

I honestly feel we were lucky that we found the tumor when we did (before it spread) and that we were able to track down an excellent team of IM and surgeon who work closely together to keep things safe but still effective. But I agree - an adrenalectomy, especially a right-sided one like Roxi had is still risky, but nowhere near as much as a hypophysectomy. And after being given little option on treatment, we were able to go from diagnosis to surgery in just 5 days which didn't give me too much time to worry about it! :)

Thank you for the kind words - we try our best...as do you and everyone here. Even when our cats don't ever seem to make it easy on us. :bighug:
 
You must log in or register to reply here.
Back
Top