Cushings Disease & Immune-Mediated Hemolytic Anemia

I have the greatest dog-ter (daughter of the canine persuasion).  She is an Old English Mastiff that I rescued from the pound in August of 2000 when she was about 18 to 24 months old, so she's approximately 10 1/2 or 11 years old now.  She was prolapsed when I got her, but had no other health issues until November of 2007, when she was diagnosed with Immune-Mediated Hemolytic Anemia.  This horrible monster of a disease nearly took my baby girl, but through about 2 weeks of hospitalization, 7 blood transfusions, two weeks of cyclosporin, 9 months of prednisone, tons of love and about $8,000 in vet bills she pulled through.

15 months after the Immune-Mediated Hemolytic Anemia diagnosis we moved.  The day of the move, she ate a whole vegetarian pizza that the movers left out.  The next day she could barely get up, her stomach was very distended, she couldn't climb the stairs at all and panted heavily.

I took her to the vet and had the whole battery of tests run, then to the specialist for an ultrasound.  The ultrasound showed there was not a mass, but there was a large amount of fluid around her liver.  The vet believes she has Cushings Disease.  The good news is the blood work, fluid sample, ultrasound and other tests all tested negative for cancer cells and no tumors were found.

Thinking back, she has had a distended belly off an on for several years.  I always thought it was just weight fluctuation, as she is a very, very good eater.  She has also had sebaceous cysts since before her bout with Immune-Mediated Hemolytic Anemia, but about the time she got this disease they started opening and had a difficult time healing.  She also urinated frequently prior to the illness.

My questions are:
1. Could she have had Cushings Disease prior to coming down with Immune-Mediated Hemolytic Anemia and gone all this time without treatment.
2. Could Cushings have caused her Immune-Mediated Hemolytic Anemia
3. If she had Immune-Mediated Hemolytic Anemia and the Prednisone caused Cushings, why did it take over 6 months after Prednisone was discontinued for Cushings to develop
4. Will she get her strength back and cease to have these cysts open after treatment begins
5. Does Cushings that developed from Prednisone carry the same 2 year remaining life expectancy as the tumor caused version of the disease
6. Is it common for Prednisone caused Cushings to require treatment so long after the Prednisone was eliminated.

Any thoughts and input are greatly appreciated.

[Sandra_G]

Hiya,
My mini poodle had Pancreatitis..she woke up in the AM & than went back to sleep all day...she wouldn't eat food.  She got up at 5 pm...kept drinking water & kept vomiting a bile like substance...not food...kept repeating it for hours. I thought it was a cold or virus. Than out of nowhere she had a seizure. My little baby was thrashing on her side & knew no-one for 5 min.. I just about had a heart attack myself.
We rushed her to the ER Vet & they kept her for 4 days. No food at all...just IV fluids & IV meds & lots of tests & scans & xrays. They were wonderful to her & to me too. They thought it might be from table food or something else, they couldn't be sure.
I think they were right ..I had given her fresh ham all week, left over from Christmas. I had also cut off all the fat. OMG I am so upset for what I did to her.

Julie recovered & went home on a strict diet....Hills KD food & I cooked boiled chicken & rice too. She had antibiotics & Pepsid & pills for her Liver.  She didn't need pain meds once she got home.
2 wks. later I was told she has kidney disease. I was devastated for her. Than a week later she tested positive for Cushings Disease. When I think back, she also had all the symptoms of Cushings (pot belly look for a long time, overly thirsty, always hungry, urinating constantly, not interested in doing what she used to do, sleeping alot) all this was before the Pancreatitis attack, which I had no idea what any of these diseases were. I was told that all this is interrelated.

Now my Julie is on a drug for Cushings disease..Trilostane.
My vet thinks this will work to get her back to herself. It will take months of treatment & $$$$ but she is worth it to us. Today, was $265.00 for the 1hr. ACTH blood test....to make sure her numbers are in line. it is 8.7, too high still. I must increase the Trilostane to 15 mg from 7.5 mg.  I will have to keep her on it for the rest of her life.
I was told that the Cushings may be causing the kidneys to enlarge & it may "go away" once the Cushings is under control. I pray thats true.


As for your dog, I bet that the Cushings was there from the beginning, & not caused by Prednisone & was probably overlooked.  Cushings causes a whole host of problems & reeks havock on thier organs. (Don't give your dog foods with protein, Cushings produces way to much of it)
I makes it look like the other organs (liver, kidneys etc.) are affected & they may NOT be. I opted to treat my Julie with Trilostane. It was just released in the U.S. in February.
It is the choice that I made after months of research. .
Lysodren,  is the other treatment & it has too many deaths in dogs just from the treatment. It is NOT reversable.
Trilostane is much safer & if any bad side effects arise, it is completely reversable.
So far, my Julie tolerates it well, with low doses to begin with.

Try to stay calm, I know thats hard to do yet once six months or less go by, your dog should be back to himself, with proper treatment.

Use this internet to look up everything that you can. It's great info.
Please keep in touch & let me know your dogs progress. Best of luck.
Sandy