Q & A with Dr. Feldman- very interesting article

[addy]

http://veterinarynews.dvm360.com/dvm/Medicine/Cushings-disease-and-other-adrenal-gland-disorders/ArticleStandard/Article/detail/672663

I thought this interview with Dr. Feldman was extremely interesting so wanted to share it.

Addy

[Harley PoMMom]

Thanks Addy :) as we do have that article, it can be found in our Helpful Resources for Owners of Cushing's Dogs here: http://www.k9cushings.com/forum/showthread.php?t=2231

Love and hugs,
Lori

[frijole]

I need to say something about that article. That very week is when Annie had the ultrasound done in Omaha. I went back to my vet and he said he and the vet in Omaha discussed the situation and what they would do if it were their dog and because she does not have any signs of cushings, they would not treat.

My point is that - we all know that there is more to cushings than excessive drinking and peeing. I am 100% positive that he had just read that article the day we met. I am confident that was not the intent of Feldman.

So - out of curiousity - what symptoms do YOU think warrant treatment of cushings?

[addy]

I think it is a hard call and a decision that has to be made by each person in conjunction with their vet. Do you treat early when symptoms are mild or wait for them to get worse? It is an agonizing decision becuase there is always the doubt is the diagnosis real?

I feel the biggest point is that are we sure of the diagnosis? That was what I took away from the article and that we need to think about treating the symptoms not the diagnosis. If you have a diagnosis and slight symptoms, some may decide not to treat their dog or wait until the picture is clearer to them.

His point about not being in a hurry to treat is important. My first vet was picking out a drug and scaring me to death based on a UC:CR test. That was just wrong.

I do not think anyone should take the article as a negative, I did not.

Addy

[lulusmom]

So - out of curiousity - what symptoms do YOU think warrant treatment of cushings?

You've only heard this a thousand time but cushing's is a very graded disease so there is really no need to start treatment as long as the symptoms are mild. An honest answer and one that a lot of experienced vets will go with is that you opt to treat when the pet owner can no longer live with the symptoms, such as extreme hunger which drives them to counter surf and get into the trash; panting constantly which keeps everybody up all night and the big one is a dog that is peeing all over the house because of pu/pd.

Then there are the dermatologists who see things a bit differently. As Dr. Bruyette puts it, dermatologists' main goal in treatment is to grow hair. :eek: I thought that was a bit harsh but he's probably right in that derm vets are trying to get to the bottom of skin and coat issues. Our little foster, Mabel, was diagnosed by a derm vet. Her only symptoms were severe skin and coat issues. She had ringworm and then demodectic mange which adult dogs just don't get unless something is compromising their immune system. Mabel was put on Trilostane despite not having all the usual symptoms we're used to seeing around here. She wasn't a big drinker, never panted, never had accidents and compared to my dogs, her appetite was totally normal.

That probably didn't really answer your question but I feel better getting all of that off my chest. :D:p:D

[addy]

i wish i could get things off my chest, it is getting too big!:eek::eek::eek:

thought we needed alittle humor, things are getting too heavy.:confused:

Addy