Cushing's Syndrome

[KellyS]

Hi Tuuli

Sorry to hear about Bailey being ill, If it was me, I would seek a second opinion from another vet before I committed to such an operation.

I hope he feels better soon.

[Penel]

2.5mg of pred a day is not much for a 10kg dog.  OK its not great and yes will have long term side effects but I cannot see for the life of me how the vet thinks its has caused the problem with the paw.  Are they sure there isn't a foreign body in there - grass seed / thorn ?  why do they want to remove the pad - I really think you ought to get a second opinion too before having this operation done.  Sounds to me like your vet is having a little trouble deciding what is wrong - first Cushings, now blaming the swollen paw on the pred suppressing the immune system !  I had a cocker on pred and other immune suppressing drugs for two years - much higher doses than you mention - and she had various infections that antibiotics helped - she sliced one of her paws once and although it did take longer to heal, it did heal.
Another question, why is Bailey on steroids for facial twitching ??
I really think you ought to see a different vet.

[PennyB]

2.5mg of pred a day is not much for a 10kg dog.  OK its not great and yes will have long term side effects but I cannot see for the life of me how the vet thinks its has caused the problem with the paw.  Are they sure there isn't a foreign body in there - grass seed / thorn ?  why do they want to remove the pad - I really think you ought to get a second opinion too before having this operation done.  Sounds to me like your vet is having a little trouble deciding what is wrong - first Cushings, now blaming the swollen paw on the pred suppressing the immune system !  I had a cocker on pred and other immune suppressing drugs for two years - much higher doses than you mention - and she had various infections that antibiotics helped - she sliced one of her paws once and although it did take longer to heal, it did heal.
Another question, why is Bailey on steroids for facial twitching ??
I really think you ought to see a different vet.

I agree with all this. Get a 2nd opinion now!

[suzysu]

The vet nurse said that I should take Bailey to the "Waggiest Tail" competition as
Bailey can hardly keep his balance - he wriggles his bum and waggs his tail so much! 

 Aww bless him!   No experience I'm afraid, but I think if it were me I would do as others have said and get a second opinion.  

Please give Bailey a big hug from us xxx    

[scoobie]

Tuuli sorry to hear Baileys paw  isn't improving If it was me I would certainly look for another vets opinion or even look at homeopathic vets I wouldn't agree to any operation to remove his pad unless that was the only option given by other vets instead of the one you are seeing at the moment..please take everyones advice on here and get a second opinion I feel really sorry for you and Bailey having to go through this but Im sure you will get to the bottom of this
take care and let us know how you get on

[Pammy]

Tuuli - how I feel for you.

I tend to agree that I'd look for a second opinion here. Suggesting Cushings where nothing seems to fit the pattern for Cushings and now suggesting removing a significant portion of the pad without knowing what's what looks like they don't know what's wrong at all. To be fair though - this is often the case  and vets like doctors often never find what the problem was - but by trying different approaches manage to cure it.

It seems a bit extreme performing surgery of this nature without having explored other avenues first.

Have they done an x-ray of Baileys foot to see if that shows anything?

[Tuuli]

Thank you all for your replies.  I will definitely have a second opinion.

Some answers to your questions:

When they first operated Bailey's paw they could not find any foreign body there.

Bailey is in steroids as the neurologist in Cambridge  suspected that he has inflammation in his nervous system.  If not treated it could lead to total fascial paralysis.  He was 3x 5mg steroids per day for two weeks, which was a huge dose for a dog under one year old - or any age dog.  ( If you are interested it is all in topic Fascial twitching).

Now we are trying to get Bailey off from steroids but it has to happen very slowly and that is why he is 2.5g per day.  Hopefully soon - no steroids at all.  

 They x-rayed the paw and said that the infection in his pad might have gone into his bones as there was a strange shading in the picture and it would then require a very long antibiotic treatment.  However, the vet thought now that no more antibiotics is needed.  Great!

This morning I took Bailey for a brisk walk.  It was very cold and windy but we went on and Bailey was enjoying it.  He was limping a bit but walked 30 minutes and was ravenous when we got back home.

I will get a second opinion and I will keep you posted.  You know, it is SO nice to have you there as a support - dishing out a load of common sence and words of wisdom and experience.  I never had a dog before and sometimes I just don't know what to do. So, thank you.

Speak to you soon.

Tuuli & Bailey
 

[Penel]

Hi Tuuli,
I'm really pleased you have taken on board the advice - and I really hope that the second opinion might give you more positive news.  You should be able to take the x-rays from your own vets with you to show the 2nd opinion vet - saves them having to re-do them.
15mg pred is not a lot for a cocker spaniel, Saffy was on 50mg at one point to suppress her immune system.  50mg is a huge dose - so don' t worry too much about the doses Bailey has been on, he'll be ok as long as you wean him off really really slowly like you said.
I've just read your thread on the facial twitching - I see they did a spinal tap, no doubt to check for meningitis. It's good that was ruled out.
If Bailey is insured I would be inclined to ask the vet to refer you back to Cambridge, I can't help wondering if all this is connected.
 

[PennyB]

If Bailey is insured I would be inclined to ask the vet to refer you back to Cambridge, I can't help wondering if all this is connected.

I'd agree with this as when Wilf's lymph nodes came up for no reason and won't go down my vet is keen to send me back to Cambridge just as a 2nd opinion, but then he's the sort that would rather admit defeat and find the best care for my pet as quickly as possible (rather than faffing around).

Sometimes if you treat things in isolation then you might not get anywhere as there may be a bigger picture out there (you're vet is basically like a GP here unless they have their own specialism). Cambridge have access to all the different research and practitioners (I think the same biopsies were seen by about 6 different pathologists when I took Wilf there and they were still following it up long after he'd gone!). True they still may come to the same conclusion that your vet did (mine said he could've done the surgery that Wilf had in the end but hadn't felt confident to come to that conclusion).

[Sheryl]

Just seen this thread and thought I would stick my nose in too!  I am sorry but I think that the idea of the steroids stopping antibiotics working is ridiculous.  Chloe has been on steroids (high doses and now low dose maintenance) for 6 years plus.  She gets infections at least every month and gets antibiotics which work perfectly well.  She just had an infection up her nose (of all places ) which didn't clear up but that was because there were three different bacteria and she needed two types of antibiotic to clear it.  Poor Bailey.  Chloe sends lots of sympathy and slobbery kisses.  

[Tuuli]

Gosh - this sometimes feels like a never ending story.

  Bailey was convinced that there was something interesting under the fridge. He started to scratch the fridge to get access to what ever it was supposed to be. AND his poorly paw started to bleed.  Took him to vet.  He does not want to operate.  He thinks that it is a strange calcium deposit and it is gradually bursting through his paw.  Apparently it is very unusual to have such a deposit in the paw.  They are usually under the skin.I

He also said that Bailey's nervous system does not seem to be in balance!  Right.
The vet actually is also a homeopathic practitioner and has suggested that maybe we should try some homeopathic treatments.  Well, I'm sorry but I think that it is a bit... How shall I put it?  Naff.  

I was really interested in reading that other cockers have steroids and antibiotics and that both medicines seem to be effective.  

In defence of the vet - he is very caring and genuinely interested in Bailey's problems.  He tells me that Bailey's symptoms as a whole are really rare and weird as there are no previous similar cases in UK, possily in the world!

He has not charged me for last two visits and he wants to see Bailey again next Thursday.

I have my own chair in the waiting room!

So, what now?  Homeopathy - is it worth trying?

Tuuli & Bailey

[suzysu]

Tuuli - Sorry no experience to advise, but sorry to hear little Bailey is still having problems, it must be so difficult for you.  

Sending you lots of love and positive thoughts and a big hug for Bailey x  

[bluegirl]

High doses of corticosteroids can lead to Cushing Syndrome so I can see how your vet may have made a link to the Cushings, but on withdrawal of the steroids the cushings Syndrome is usually reversible.
The Xray results however were interesting and a infection, especially one tracking into the bone does need sorting out. I would imagine that surgery to remove and flush out the infection would be done and strong antibiotics would be given.
Homeopathy can be very useful, but I would be inclined to go with the treatment offered by the second opinion vet in this case.
From Karen

[PennyB]

Gosh - this sometimes feels like a never ending story.

  Bailey was convinced that there was something interesting under the fridge. He started to scratch the fridge to get access to what ever it was supposed to be. AND his poorly paw started to bleed.  Took him to vet.  He does not want to operate.  He thinks that it is a strange calcium deposit and it is gradually bursting through his paw.  Apparently it is very unusual to have such a deposit in the paw.  They are usually under the skin.I

He also said that Bailey's nervous system does not seem to be in balance!  Right.
The vet actually is also a homeopathic practitioner and has suggested that maybe we should try some homeopathic treatments.  Well, I'm sorry but I think that it is a bit... How shall I put it?  Naff.  

I was really interested in reading that other cockers have steroids and antibiotics and that both medicines seem to be effective.  

In defence of the vet - he is very caring and genuinely interested in Bailey's problems.  He tells me that Bailey's symptoms as a whole are really rare and weird as there are no previous similar cases in UK, possily in the world!

He has not charged me for last two visits and he wants to see Bailey again next Thursday.

I have my own chair in the waiting room!

So, what now?  Homeopathy - is it worth trying?

Tuuli & Bailey

Wouldn't it be better finding out what the problem is 1st though rather than just treating the symptoms. This may be of interest to Cambridge if only to add to what they already know about Bailey and something they may know of. Depends on how uptodate your vet is.

Wilf and I have our own seat in the waiting room of our vet. Wilf had  an extremely rare malignancy (everyone says histicytomas are always benign but Wilfs was malignant and again no reports of it in research papers). My vet will only treat Wilf so much (he occasionally still presents with odd symptoms) and would rather refer him on as he knows its rare and Cambridge have more people at their disposal to help out (plus am pleased my vet doesn't want to go alone in this).