August 7th 2007 2:20 am
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I want to thank many of you for your messages of support in the past months, they made me warm and fuzzy. I haven't been able to update everyone on my hair-loss condition because I got really sick all of a sudden in June (for hair-loss diagnosis skip to paragraph 3).
One day I woke up and couldn't move anymore. Every time I tried to get up, I would lose balance and fall. I couldn't even go to the bathroom without toppling over. Few days later, I got even worse and stopped using my right leg. My parents took me all over in the 60 mile radius to see Vets and specialists. Many of them didn't know why I was ill, because labs & X-rays showed nothing. One of them scared my Mom to tears when he said I may have terminal cancer. Luckily, that vet was full of doo doo...Finally, a neurologist ran a MRI and found that I have spine degeneration and disc protrusion, pressing on my nerves and debilitating my mobility. I am too small and old for surgery, so the Neuro ordered me meds and rehab. He warned us that recovery may be slow, if at all. Mommy and Daddy cleared their calendar to take care of me with lots of TLC. I saw how stressed and sad they were and decided that I have gotS to get STRONGER. So I did! in just 3 weeks (to everyone's surprise). The docs now say I need to be very careful from here on with my aging spine, so no more wild beach parties with young puppies for me. I guess I am geriatrics now.
Good news is, because of my debilitating stint, the 5 different vets/specialists ran every possible panel, test, ultrasound, MRI, xray possible. Daddy, who is a human MD decided to send all results to a University of Tennesee Doc who's done alot of research in Alopecia X and Cushings, since the Melatonin treatment our previous Derm put me on was not working and my hairloss was getting worse. The Tennesee specialist suggested we go to another local derm to run an ACTH STIMULATION test, because she disagrees that we should rule out Cushings. She was right, the ACTH and sex hormone panel ran by the 2nd derm confirmed Cushings. The smart 2nd Derm told us that Alopecia X is really a catch-all phrase that many vets use when hairloss is due to hormones other than Cortisol, but they cannot figure out why. Cushings (from Cortisol) has actual health impact and is beyond mere esthetic issue. So now, I am on a Trilastine treatment to control my raging Cortisol hormones and monitoring progress with monthly ACTH blood panel. It's been 1 month of Trilastine and my hormones are in check. However, my hair hasn't grown back much and the skin on my back thigh is still dark. I will continue to update everyone on progress. You will for sure hear from me when my hair mojo comes back!
My mom is so happy that she took me to the beach again this past weekend against the doc's advice. She took many pictures of me this past week and posted a new slideshow. Yes, I look a little scraggly than usual but I am just happy to be healthy again.
Thank you all again for caring and listening. Please sign my new guestbook!
Technical Details on Cushings Diagnosis
(WARNING: too Complicated for our little brains, read only if you have to)
For those of you who have written me and concerned about your own hairloss, you can take these steps to find proper diagnosis.
1. skin biopsy & thyroid blood test
-Initial screening can be taken by general vets
-these will not give specific info to make a diagnosis, but will rule out
mange or thyroid conditions.
2. urine cortisol test
- many veterinarian articles site this as a good screening test to rule out
Cushing’s, but it can be negative and make you think you don’t have it
when you do (such in our case), so I'd skip this and go to step 3 if you want
to definitively rule out Cushings
-try melatonin medicine for diagnosis of Alopecia X (hairloss & skin
3.ACTH stimulation test
-this tells you that you have Cushing’s syndrome which is increased
cortisol horomone, but it does not tell you the source of the high cortisol
4.Sex hormone panel
-can be ordered by your vet which is sent to University of Tennessee,
where they research on alopecia X and give you reading of the various sex
-Technically, you can only be diagnosed as Alopecia X if you have
abnormal sex hormone levels with a normal cortisone level. (becareful of
docs who use this as a catch-all phrase!)
Cushing’s symptoms: high cortisol hormone which causes increased thirst, loss of hair, pigmentation of skin, liver damage, and various other problems later.
The high cortisol can come from various sources:
-from medication given to you by doctor’s
-from the adrenal gland (a tumor)
-from the pituitary gland (this gland controls the production of cortisol which is made in the adrenal gland. It often comes from a small tumor called a microtumor)
85% of Cushing’s in dogs is from the pituitary gland microtumor. To determine if the source is the pituitary gland or adrenal gland, you can do various tests:
-abdominal ultrasound to look at the adrenal glands. If both glands are slightly enlarged, this is consistent with a pituitary gland causing the increased production. If there is one enlarged adrenal gland, this is usually indicative of an adrenal gland tumor which can be malignant
-low dose dexamethasone test (this is a specialized blood test that will distinguish if it’s a pituitary cause or an adrenal gland cause of the Cushing’s)
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