Smidgen is a 15 year old Dachshund who has been a patient of Winslow Animal Hospital since she was a puppy. In 2011 Smidgen was having issues with her right front leg and shoulder pain. Smidgen began receiving acupuncture treatments and our physical therapist, Linda Franzini, began treating her with the cold laser. Initially Smidgen received treatments every two weeks. Eventually we were able to reduce the frequency of her treatments to once a month.
Her shoulder issue completely resolved, but along the way, Smidgen developed some issues with her back, as many Dachshunds do. She was having some weakness of her hind limbs, wobbliness to her gait when she walked, as well as some knuckling or dragging of her hind feet. These clinical signs are usually consistent with Intervertebral disc disease (IVDD).
Dogs with IVDD may have several bulging discs in their thoracic and lumbar spine that are pressing on their spinal cord and causing the neurologic abnormality and pain. Linda and I began treating Smidgen for the back problem with acupuncture and the laser. Additionally, a Chinese herbal formula called Bu Yang Huan Wu was prescribed. Her back problem has completely resolved.
In November 2012, Smidgen’s owner brought her to see Dr. Coudrai at Winslow Animal Hospital for her wellness exam. Her bloodwork revealed an elevated Alkaline phosphatase(ALP) level. This elevation in older dogs frequently indicates an endocrine condition known as hyperadrenocorticism or Cushing’s Disease. Clinical signs of this condition are typically excessive water drinking and urination. Dr. Coudrai recommended a special test for Smidgen called a Low Dose Dexamethasone Suppression (LDDS) test to confirm the diagnosis. Smidgen tested positive for Cushing’s, and Dr. Coudrai prescribed Trilostane – the current treatment of choice for Cushing’s disease. There are two forms of Cushing’s disease in dogs, Pituitary dependant hyperadrenocorticism (PDH) and adrenal tumors. In small breed dogs, the more common form to see is PDH. There is no cure for PDH as the tumor is growing on the pituitary gland, which is located at the base of the brain and therefore inoperable. This means that typically these animals require Trilostane the rest of their lives.
With the Cushing’s diagnosis, Smidgen’s herbal formula was changed to Rehmannia 14. In February 2013, Dr. Coudrai ran another test on Smidgen called an Adrenocortiocotropine hormone (ACTH) stimulation to monitor her response to the Trilostane. Smidgen’s test results revealed such low numbers, Dr. Coudrai discontinued the Trilostane.
Smidgen’s clinical signs of Cushing’s Disease have not returned. She continues to receive monthly “tune up” treatments of acupuncture and laser and is still on Rehmannia 14.
Smidgen is a very good example of how Alternative Medicine can help our older patients live the best quality of life possible!
Amy Hinze, VMD
Winslow Animal Hospital
640 Sicklerville Road
Sicklerville, New Jersey 08081