Treat or not? Quality of Life Question

[Paws]

Hello, my name is Jennifer. Paws is my 14 year old Lab/English Springer mix. She's been treated for a thyroid condition for the past two years, but it seemed to get worse recently. When I googled her symptoms, they seemed to strongly suggest she has Cushings.

Is it worth it to get her diagnosed and start her on medication? Will her quality of life her improved enough to justify the expenditure?

I love her so much. I've had her since I was 8 years old, and I'm 22 now. She's my sweet, sweet girl. She is, however, fairly old for a dog.

[Harley PoMMom]

Hi Jennifer!

Welcome to you and your girl, Paws! So sorry for the circumstances that brought you here but very glad you found us.

Cushing's is one of the most difficult diseases to get a confirmed diagnosis because not one test is 100% accurate at diagnosing Cushing's and many other illnesses share the same symptoms of Cushing's. Strong symptoms are a huge part of the diagnosis, what symptoms does Paws display?

Cushing's disease is not a death sentence, and when properly treated, dogs can live out their normal life spans.

Could you get copies of any/all test/s that were done on Paws and post the results here. The more we know about your girl the better our feedback will be, ok?

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[StarDeb55]

Jennifer, welcome to you & Paws! I know it's a very difficult decision to make about treatment when you have a senior pup. I faced the same decision about 3 years ago with my, then, 13 1/2 year old Shih Tzu, Harley. What made me decide to treat was Harley was having some serious issues with a recurring corneal ulcer that was difficult to heal, an episode of kennel cough, & one or 2 other infections. Repeated infections that are difficult to cure is one of the symptoms of Cushing's as Cushing's depresses the pup's immune system. I will tell you that Harley did well on lysodren for a little over 2 years before we discovered what was probably a malignant bone tumor in his jaw that had already spread to his lungs. Harley wasn't my first cushpup. My Barkley was diagnosed at about 7 yrs. old, & was successfully treated with lysodren for nearly 8 years with a great quality of life.

When you say her symptoms strongly suggest Cushing's, could you please tell us more about those symptoms? A lot of times treatment goals are to make the pup more comfortable, & to help alleviate some of the troublesome symptoms for the parent, such as the constant hunger & foraging for food, drinking gallons & peeing buckets.

If no Cushing's testing has been done as of yet, there is a simple test that will absolutely rule out Cushing's called a urine cortisol/creatinine ratio. A negative test means that you aren't dealing with Cushing's, positive means that Cushing's is possible, further testing required. You can even collect the urine sample at home, preferably the first AM "pee", before eating or any medication.

As Lori has already indicated, if Paws has had any recent general labwork such as a senior wellness panel or super chemistry panel, we would very much like to see any abnormal results from those panels. When you post, please include the normal ranges & reporting units. There are abnormalities on general labwork that are common in our pups, & may point a vet toward looking at Cushing's

Again, welcome! We are here to help in any way we can.

Debbie

[Paws]

Thank you for your quick and caring responses. I feel so lucky to have found such wonderful, thoughtful people!

Paws hasn't had any lab test recently, except for a thyroid blood test, but it sounds like I'll be taking her in ASAP to get the urine test.

Symptoms are:

- constant panting
- excessive drinking/urination
- hair loss
- dry, flaky skin
- fatigue/difficulty exercising
- Weight gain
- Weak hind quarters
- excessive mooching (begging) - I've put the chubby Paws on a diet to ease the symptoms of her arthritis, but I've noticed that she doesn't finish her food. She's begging more, but eating less dog food. This might be a sign that the dry dog food is to hard for her to eat.


Several things make it hard to get a clear "reading" of her symptoms, though.

1) My mother left our family and took Paws when I was a sophomore in college two years ago, so I've been seeing Paws inconsistently since then. Since I only see her once a year, I might only be seeing the deterioration of old age (though I don't think so - I know my dog well.)

2) Second, my mother doesn't give her the thyroid medication she's supposed to be on, so every time I visit I have to start the medication anew. My observations of her symptoms are based on a lifetime of knowing her and seeing the differences in her behavior, but

I'm off of school for a month and living with my mom and Paws during that time, so I want to get all of Paws' health problems worked out in the short time that I have with her.

Thank you so much for your compassion and advice. With these symptoms, does it sound like she's suffering?

[Harley PoMMom]

Many of Paws symptoms can be attributed to a thyroid issue. Before doing any kind of testing, even an UC:CR, I would make sure that the thyroid problem is under control.

Any non-adrenal illness will cause the cortisol to be elevated and thus can skew all Cushing tests.

[StarDeb55]

I know it may be hard to do, but if I were in your shoes, I would have a chat with my Mom, explaining the importance of Paws getting her thyroid meds as prescribed. Once she is back on her thyroid meds, I suspect that a lot of these symptoms may ease up, if not totally disappear. If the symptoms don't disappear after her thyroid is regulated, I would then re-visit Cushing's.

Debbie

[Snoopy&Rummer_Mom]

Jennifer, my 14 yr. old Cocker Spaniel presented some of the Cushings symptoms about 5 yrs. ago and we thought it was Cushings. Turns out it was his thyroid. Once we got that under control the symptoms associated with Cushings started to disappear including his pot belly. Thyroid is one thing that your mom will have to stay on top of. Believe me, I've been in your shoes on that one every time I go on deployments and leave him with mom. But she us getting better about being a doggie grandma. :-)

Maria

[labblab]

Jennifer, if Paws hasn't yet started back on her thyroid medication, one other diagnostic possibility is to redo her thyroid testing, but this time with a "full" thyroid panel rather than just a single test of her T4 level. Low thyroid function can be a primary disease in and of itself, or it can also be secondary to certain other conditions -- Cushing's being one such condition. When that is the case, treatment of the underlying condition may also eliminate the thyroid deficiency as well. A full thyroid panel cannot identify the underlying condition itself, but the results can give you an indication as to whether "something else" is at play in addition to the hypothyroidism. Blood can be drawn by your vet, and then sent off to a specialized lab for analysis of the full thyroid panel.

If Paws has already started back on her thyroid medication, then this testing may be a moot point for the moment because her thyroid levels will be skewed. But if she has not yet started back, this is just a thought so as to give you a really comprehensive picture of her thyroid function.

Marianne