newly diagnosed-vet is 90% sure he has Cushings.

[Lucy]

Hello,
I have just found out that my 8 yr old male dachshund, Diego, most likely has Cushing's. I know he needs to be treated but my funds are extremely limited. I'm not sure what the best and most affordable treatment options there are. It is very sad to see him all bloated and not feeling well. He has all of the symptoms.
I would greatly appreciate any advice. Thank you, Lucy

[addy]

Hi Lucy,

I am so glad you found us but am sorry to hear of the possible Cushings daignosis. The moderators will all be along soon and will want information, like what tests where done and what were the results.

If you look through our Resource section, it will help get you started on your Cushings Learning Tutorial :)

I know we had posted on another thread information on Care Credit and other financial avenues. I am sure you will be supplied that information as well.

Hold tight, try to breathe, you are no longer alone.

Hugs,
Addy

[Lucy]

Thanks Addy,
I've just begun to explore this very helpful site and your kind words mean alot to me. I have felt overwhelmed and so sad for my ''Diggy''.

[Casey's Mom]

Hi Lucy and welcome to our family!

What testing has been done to confirm your pup's diagnosis? I know the other more experienced members will ask if you could please post tests and results and they will be able to help you get all sorted out.

My dog has been treated with Lysodren for a year and a half and I believe it is less expensive than Trilostane however your vet does need to be comfortable and experienced no matter which drug is prescribed.

You are no longer alone, we are all here to help and make sure you just keep asking questions okay?

Hugs,

[Harley PoMMom]

Hi Lucy,

Welcome to you and your precious Diego from me and my boy Harley. I, too, am sorry for the circumstances that brought you here but glad you found this forum, we will help you in any way we can.

Addy and Ellen are correct, we do ask alot of questions from our new members. This is not because we are being nosey but the more we know about your pup the better our feedback will be and that is the best way to help you help Diego, ok?

So are you ready for my questions :eek::)
What symptoms led you or your vet to test Diego for cushing's in the first place?
What test/s were done to confirm Diego's cushing's?
Does Diego suffer from any other health problems?
Is Diego taking any herbs/supplements/medications?
How much does he weigh?
Was a CBC/Chemistry blood panel done, and if so, could you post anything on there that is marked abnormal with the reference ranges and the units of measurments.
Was an ultrasound done?

Cushing's is so hard to diagnose and that's why it is so very important to get a proper diagnosis. Usually the diagnostic phase is the most expensive part. With my boys I use Care Credit...love that card, and I will provide a link for it below.

The good news is that Cushing’s is a treatable disease. Delivery of competent and humane medical care by a skilled GP and/or specialist experienced in the diagnosis and management of Cushing’s has a significant impact on a pup's survival and well-being. With proper medical management, close monitoring and owner observation, most Cushingoid pets can live to their full life expectancy, with complete or partial resolution of clinical signs, and good quality of life!

Remember you are not alone on this journey, we are here for you and Diego so ask all the questions you want and we will answer them the best we can.

Love and hugs,
Lori

The Links:

Financial Resources to help with Vet bills
http://www.k9cushings.com/forum/showthread.php?t=212

Care Credit for Veterinary care
http://www.carecredit.com/vetmed/whycc.html

Links to Cushings Websites (especially helpful for new members!)
http://www.k9cushings.com/forum/showthread.php?t=180

Helpful Resources for Owners of Cushing's Dogs
http://www.k9cushings.com/forum/forumdisplay.php?f=10

[Lucy]

Thank you all for your responses.
It's a comfort to know I'm not alone. I knew nothing about Cushing's until a week ago.
I took Diego to the vet because of the followng symtoms(which I later discovered listed under canine Cushing's disease):

• increased/excessive water consumption
• increased/excessive urination
• urinary accidents in previously housetrained dogs
• increased/excessive appetite
• appearance of food stealing/guarding,trash dumping
• sagging, bloated, pot-bellied appearance
• massive weight gain-he was 22lbs, now he is43lbs!
• lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• seeking cool surfaces to rest on
• thinning hair
• other coat changes like dullness, dryness
• darkly pigmented skin patches and scabs on his belly

They did a blood panel as well as fecal exam. results:
no worms
no signs of renal failure
ruled out diabetes
all the blood levels fell w.in the normal range except:
Creatin- slightly low- 0.5 mg/dl [normal is 0.5-1.8]
Cholesterol- a bit high- 480 mg/dl [normal range is110-320]

the most alarming result was:
ALKP was off the charts- over 2000! normal range is 23-212 U/L

The vet said he was 90% sure it was Cushings and that I needed to have an ACTH test to confirm. This alone would be $472.00 and then other tests and tests every six months as well as the cost of medicine. I haven't done any further blood work or ultra sound yet.

The expense is mind bogling!: I know he needs to be treated but I am trying to discover the most economical way to go. Until I can afford to proceed, I am also wondering if there are any suggestions(besides finding another vet) as to diet or other measures that might alleviate some of the symptoms and make him more comfortable. Many thanks, Lucy

[Sabre's Mum]

Hi Lucy

I am in NZ and others in the US may want to comment but $472 does seem to be on the steep side for an ACTH stim. Firstly, is your vet experienced with treating cushings? Another question ... are there other vets or IMS in your area which you could consider changing to?

To keep costs to a minimum ... I would definitely get an ACTH and then an ultrasound. Others may want to comment on this.

For us ... we had already spent a fortune on treating our Vizsla for pyoderma ... doesn't sound like much but it was nearly $2000 just for this! Money was really low and all his symptoms, along with a biopsy which showed calcinosis (lots of areas were developing on his skin), pointed to cushings .... we only performed an ACTH. For us ... Lysodren was the only option as Sabre also had a heart murmur and therefore we wanted the flexibility that if he required heart meds we would not have any contraindications. In hindsight ... I really wish we could have squeezed the additional money from somewhere ... maybe that money tree that has yet to be invented :D

The costs vary once you start treating for cushings - dependent on the drug chosen. Did your vet indicate what drug he used to treat cushings?

All the best
Angela and Flynn (the naughty Vizsla!)

[Harley PoMMom]

Hi Lucy,

That $472 for an ACTH test sounds really steep to me too. What stimulation agent does your vet use? Is it cortrosyn? Is your vet charging you for the whole vial? If so he should not!


It has been shown that 5 mcg/kg achieves maximal adrenal stimulation when given intravenously. The typical 250 mcg vial would be adequate for a 50 kg dog.

http://www.veterinarypracticenews.com/vet-practice-news-columns/abstract/acth-stimulation-testing.aspx

How many dogs has your vet treated with Cushing's disease? This disease takes a vet/IMS and an owner that can be team players. The vet/IMS has to be willing to work and listen to YOU because YOU are Diego's only voice, his advocate. So are YOU comfortable with your vet?

Now, it does seem that Diego has so many of the Cushing symptoms. Usually an ultrasound and a LDDS or ACTH test is recommended to confirm a Cushing's diagnosis even if strong symptoms are being displayed by the pup.

Lucy we all really do understand the financial hardship of it all but still, I would recommend an ACTH stim test.

The treatment drugs usually rx'd are Trilostane/Vetoryl or Mitotane/Lysodren. Now, to cut costs you can get these compounded and it is alot cheaper.

Also, the ACTH testing to monitor; here is a cost-saving stratey that we will pass along...once Diego's Cushing's is controlled you only need to get a post draw done as long as he is not displaying any ill or adverse signs.

We are here for you and Diego.

Love and hugs,
Lori

[frijole]

WOW. I pay $125 for an acth. I agree - that is way high. It is common to see $200-250. Kim

[sunimist]

Hi Lucy and welcome to our cush house!

I agree with the others that the cost for an ACTH is extreme and it does sound like your vet is overcharging you for one test. I know prices vary across the states, but I never paid over $125 for an ACTH.

Poor Diego certainly seems to have all the symptoms of a cushpup, and until you get the cortisol regulated, they won't resolve. I know of no diet that will alleviate the hunger your boy has. It is just one of the exaggerated symptoms caused from overproduction of cortisol.

I can relate to the financial issues. I could not have made it without a credit card. I got a separate one to use only for my girl's vet bills and paid it out over a period of time. After the initial cost of diagnosing and getting the cortisol lowered, the maintenance cost is not too bad from then on, providing there are no complications. Would this be an option for you?

Hoping for a solution to your dilemma, and be assured that we do understand and care.:) Please keep us posted.

Shelba and Suni~~

[mytil]

Hi and welcome from me too.

It has been a while, but I never paid over $150.00 for my test.

Here is another test that can be performed to Rule Out Cushings - UC:CR. It is not very expensive at all.


Urine Cortisol/Creatinine Ratio Test: Considered a screening test, this cannot diagnose Cushing's, but it can rule it out. A urine sample is examined for the relative amounts of cortisol versus a normally excreted protein metabolite, creatinine (the latter is used to control for the degree of dilution of the urine). The greater the ratio, the higher the cortisol level. High cortisol in urine is suggestive of high cortisol in the bloodstream. Many conditions other than Cushing's disease can cause false positives, so this test is not considered diagnostic. Nonetheless, if the cortisol/creatinine ratio is okay, the dog is not likely to be Cushingoid, so this is a good screening test.

Terry

[makita1996]

Hello...... I am in Canada and my ACTH test was around $300. By the time you pay taxes etc. it was a bit more. Thankfully, I had signed up with Petcare Insurance for Makita approx. 10 years ago... All of the test's and medications are covered 80% (used to be 100 % but she is over 8) and a VISA of course helped as well.

[Lucy]

Dear friends,
Again I am so very grateful for all of your helpful replies! It is very comforting for me to know that there are such kind, understanding and caring people out there. Your support and the resources on this site are helping me to move closer to a game plan because before I was overwhelmed and ''grief stricken'' by Diego's probable diagnosis and the costs of tests and treatment. (last week I couldn't stop crying but now I am feeling encouraged and optimistic. Thank you!) I just want my sweet dog to feel better!

My game plan: This week I will try to
1. find a new and competant vet with reasonable prices.
2. determine what tests are essential.
3. persue the best courses of treatment asap.
4. explore financial remedies

I live in McLean which is in northern Virginia. If anyone knows of a good vet nearby please let me know as well as the most definatve blood test(s).
Many thanks and hugs, Lucy- "Diggy's mom"

[Casey's Mom]

As Mytil stated the first test you need is a urine test - UR:CR test. Inexpensive - I think it cost me about $35 and this test will rule out cushings and there will be no need for any other cushings tests.

It is the first test my vet did for me - hope this helps.

Hugs,

[sunimist]

Atta girl Lucy! And just remember, we are here for you and Deigo! :)

((HUGS))

Shelba and Suni~~

[Franklin'sMum]

Hi Lucy and a belated welcome to you and Diego,

You've received some great advice, and I just wanted to give you a link for searching for a vet/IMS in your area.

http://http://www.k9cushings.com/forum/showthread.php?t=182
that will take you to a page with a couple of links on it to help you with your search.
Hope that helps,

Jane, Franklin and Bailey xxx

[apollo6]

Dear Lucy
Welcome I am Apollo's mom. Apollo is a 12 year old mini dachshund.
You have come to the right place.

[apollo6]

Dear Lucy
Welcome. Sorry about the double post. I am so sorry to hear about your sweet Diggy.
In your profile under User-left side upper right , would like you to download picture of Diggy. Also where you are from. It helps us with giving you resources.
I am Apollo's mom. Apollo is a 12 year mini dachshund. He had all of the symptoms you are talking about.
Below is a website, listing Vet specialist in your area. You just look up your state, then there is a list of vets, you click on the one closest to you see the information on them and go from there.

http://www.acvim.org/websites/acvim/index.php?p=3
I went through the same with Apollo. Just a suggestion ask what the test costs before and see if you can get a reduced price. The price you were quoted seems awfully high. Unless there were other tests included. I am in San Diego and paid a lot less. We will be asking a lot of questions. Unfortunately Cushing Disease is not that uncommon in dachie's. My other dachshund, Karma, does not have this awful disease.
We have a few dachshunds on the forum with it. Please make sure you know which cushing , Diggy has.
Below is a website that gives a quick run down on cushing.
http://www.kateconnick.com/library/cushingsdisease.html
This shows pictures also of cushing dogs.
Hugs Sonja and Apollo