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Apoligies for another endocrine case

Lily presented 2 years ago with facial paralysis which I treated and settled.
She had bilateral total hip replacement 5 years ago.
Over the last year she has been diagnosed with Hyperadrenocorticism. Finding the correct dose has been a challenge and Lily has had chronic bowel issues/ skin issues. Her gait has always been quite odd because no formal rehab had been done after the surgery 5 years ago . The pelvic angle seems all odd to me, there is no gluteal musculature and she is now having the lack of muscle and pot belly due to Cushing as well.

3 weeks ago she presented with a complete stiff hind limb gait. extremely stilted and patella reflexes are muted due to the muscle rigidity. I advised xray to eliminate implant issues. The Radiographs show no implant failures. response to acupuncture and mobilising was poor after initial consult.
Her bloods show reasonable good control of her Cushing disease, she lost some abdominal distention, she is less pu/pd. Has anyone any experience with pseudo myotonia as a complication of Cushing disease. Drug wise / supplement wise/ physio wise, literally any help would be welcome.
Thank you

There are some studies out there that correlate with what you are finding:Send to

J Am Vet Med Assoc. 1979 Jun 15;174(12):1310-5.
Myopathy associated with hyperadrenocorticism in the dog.
Greene CE, Lorenz MD, Munnell JF, Prasse KW, White NA, Bowen JM.
Abstract
Naturally occurring or iatrogenic hyperadrenocorticism was associated with myopathy in six dogs. One dog had muscle weakness and muscle atrophy but normal electromyographic findings. Five dogs had muscle stiffness, proximal appendicular muscle enlargement, and myotonic discharges on electromyography. Histologic, electron microscopic, and histochemical findings in the musculature of dogs that were examined were characteristic of noninflammatory degenerative myopathy. Clinical signs of the myopathy improved to varying degrees in five dogs that were treated for the hyperadrenocorticism.
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There are a few others that pop up with the search terms Myotonia & Cushings when I tap into PubMed, but they are all of the same 'vintage'.

So, while you can continue to pursue general conditioning, my GUESS would be that the medical management needs to be better regulated (traditional medicine, perhaps with homeopathic/naturopathic augmentation).

I know from personal experience they are frustrating from a 'purely' rehab perspective. Totally cases that need all eyes working in the best interest of the patient!

Laurie

Laurie,
Have you had much success with muscle stim for hind end weakness in these cases? I'll be assessing a dog (vet reports Cushings is stable) and the owner is very interested in whether purchasing a muscle stim unit would be worthwhile (live an hour and a half way so he is looking at self-management options).
Thanks.

I think your success will be 'marginal' with e-stim. I don't think you'd make gains beyond regular exercise.
We've had some come in to rehab from cruciate surgery, and they are difficult to build muscle in - even with e-stim.
Do your best, but I have found it's best to be 'realistic' with your expectations.
Cheers,
Laurie