11 1/2 y.o. Cocker possibly Atypical Cushings, Is it treatable?

[Cocker's Mom in FL]

Hello all! after reading many, many posts decided to ask this:

I have a female cocker spaniel who is 11 1/2. 6 months ago she started peeing the house. Then the panting came, along with: excessive hunger and wanting to eat all the time, drinking copious amounts of water and peeing every hour. Two vets saw her and thought she possibly had Cushing's. A month ago I had blood work done. First the senior wellness panel, this suggested that yes, she had Cushing's. Did the low-dose dex suppression test and that came back negative. The vet said at this point the next step would be to do the test for the adrenal type, but the test would probably cost about $425 and it had to be sent to Univ. of Tenn. ( I live in Orlando Florida). Those blood tests ran around $420.

Here is the question: I am struggling with how to deal with her. While I love this dog dearly, she has some other issues. She will be 12 in October. The changes in my life have made this extremely stressful for me. I now live in a second story condo and have to take her down a very steep flight of stairs to go potty. At night I am taking her down every hour. This goes on until midnight. She then wakes me around 5 - 5:30 AM for food and potty. I am 63, and still working. I am not getting enough sleep, find I am exhausted all the time. I am struggling with a new job and my health ( I have type 2 diabetes which is not doing well).

Additionally, Faith has a history of seizures. At first I thought she had epilepsy, but the most recent vet thought it was probably caused by a tumor probably in her brain. I cannot afford to go the route of MRI's and surgery, and given her age she isn't going to live much longer anyway. Is this treatable without surgery? Do I put her down? Sometimes she acts her normal self, then other days she doesn't look so hot. I find that in the evening she pants a lot, I notice that her body temperature goes up and that is when she is drinking almost 1/2 a bucket of water.

At first I thought: withhold water, then she won't pee so much. Then I realized, she needed the water, so drink she does and I take her downstairs often. She likes to lie on the ceramic tile floor - it is nice and cool. She is a spoiled house dog and I keep the temperature 73 or 74 inside. I don't mean this to sound cold and heartless, but I have to be realistic. I have very limited resources and while I have taken excellent care of my dogs, I can't afford endless vet bills. Both our lives are being severely affected by this and I don't know how much longer I can take this. I would happily rehome this dog, but I can't imagine who would be willing to take on a dog with issues like these.

HELP!!

[mytil]

Hi and welcome to our site, I am so sorry you and your girl are going through this.

When you get the chance, post the results of the low dose test - that way we can see these numbers. As well as any other test results. Take a look at this link that describes more on Atypical http://www.k9cushings.com/forum/showthread.php?t=198&highlight=atypical

I am glad you decided against withholding water as it is not good to have them dehydrated.

I know others with diagnosed Atypical cushing's will pop in shortly - I do not have direct experience in this.

During all this testing did your vet test for diabetes or possibly thyroid problems? Both of these mimic a lot of same symptoms as Cushing's.

Keep us posted and know we are all here to help.
Terry

[Squirt's Mom]

Hi and welcome to you and your baby girl! :)

Atypical is the easiest and least expensive to treat, in my experience here. My Squirt has this form and has been on treatment for it since '08 and doing well. The UTK panel, the test to be sent to Tennessee, is the test you need to have done to determine if this is the form she has. This is the only test that will show the hormones involved in Atypical that I know of and UTK is the only place that does this testing.

However...the initial treatment for Atypical is very benign - meaning you can start treatment with very little concern for adverse effects to see if it helps her. Atypical is treated using two supplements - lignans and melatonin. Both can be bought in local stores like Whole Foods or other organic stores, and some places like GNC have them, tho I've not had luck finding them at GNC myself.

The lignans can be from flax or spruce and the melatonin must be the plain type - not time released, extended, etc - just plain old melatonin. The dosages are explained in the following link (if you need help determining, just let us know) -

Treatment Option Sheet
http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201107.pdf


Here are some other links about Atypical for you to read as well -

(Atypical Cushing's involves the following hormones - Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone – an elevation in one, all, or any combination of these hormones, without elevated cortisol determines a diagnosis of Atypical.)

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=485128&sk=&date=&pageID=1

Beware of false positives, negatives in canine hyperadrenocorticism testing
http://www.vetcontact.com/en/art.php?a=132&t

17-Hydroxyprogesterone
http://en.wikipedia.org/wiki/17-Hydroxyprogesterone

UTK Panel
Explanation of hormones
http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php


That should keep you occupied for a few minutes. :p

Please keep talking and we will do our best to help you and your sweet girl through this. Ask any questions you may have - there are no such things as dumb questions here. ;)

I'm glad you found us and look forward to learning more about the both of you as time passes.

Hugs,
Leslie and the gang

[molly muffin]

It is sooo hard to know what to do in these situations and you have to consider other things as well.
You mentioned she has other health problems?

One thing I will suggest, is starting her on the doggie pads. You can't take her in and out all night and day, down two flights of stairs, with your health, her health and all the other factors. So, try teaching her to go on the pads, during the night and during the day if you aren't there. I've had friends who live in condos, etc, who have used this. You still would take her out as much as you can, but she need not feel awful about peeing in the house, when she has no control over it. Use them in a place with tile, or other suitable flooring. Just a suggestion.

As far as the cushings treatment or suggestion, I'll leave that to those who are way more knowledgable than myself on the subject.

Hugs and don't worry, it Will all work out and we are all here for you both.

Sharlene (and molly muffin too)

[Cocker's Mom in FL]

I was under the impression that the only way to treat the adrenal type of Cushings was surgery.??

Last night was a bad one. Faith was VERY hot all evening. Lots of panting, I took a wet washcloth and draped it over her neck, back, and belly to help cool her down. She woke me up at 2:00, 4:00, 5:30, I was ready to kill her! Today she is better. It seems the hot-ness comes on in the evening. Kind of like hot flashes!

I do have a deck that she will pee on. I tried the potty pads, and for some reason she wouldn't pee on them. She will pee on newspaper though, so I spread those out and she will go on that. I let her do that in the middle of the night. Unfortunately I can't leave the door open, it is too hot outside right now. So if I hear her brush against the plastic verticals, it wakes me up and I can let her out. The other problem is my deck/porch is screened in, and there is really no way to hose it off. I don't want it to smell like dog urine. I am renting this place. After she wets the paper, I will pick it up, pour some water down and try and sweep it under the screen. Challenging to say the least.

She has had seizures for about 5-6 years now. It does not appear to be epilepsy. (I thought it was until recently) The vet thinks she probably has a tumor somewhere. She also has had a bulging disc in her back. Same disc about 3 times so I want to be careful of her going up and down these steep stairs. Other than that, she's fine! :)

I could live with the back and the seizures, but this peeing is making me crazy!

She did have a UTI when her bloodwork / urine sample was taken and was treated for that. Rather than post the entire 4 page results, I will post the High results (everything else was in the normal range) and the Dexamethasone test:

Blood:
Alk Phosphatase 1174 (very high)
BUN Creatinine ratio 26
Phosphorus 5.4
Sodium 150
Potassium 5.4000
Cholesterol 279
Platelet Count 611 (high)
Neutrophils 77
Eosinophils 1 (low)
Absolute Bands 0
Absolute Monocytes 976 (high)

URINE:
Ph 7.5

CORTISOL SERIAL 3
Time 1 pre
Time 2 4 hr
TIme 3 8 hr

Cortisol Sample 1 - 2.9
Cortisol 2 - 3.1
Cortisol 3 - 2.0

I don't think she has diabetes, or thyroid problems. I think those have been addresses. After reading so many posts, I understand that this is really hard to diagnose, and there are many other problems that can appear like Cushings.

Does the test from UT run any less than $475 anywhere? What if I took her to UT? My concern is, spend the $475, then what? if she does test positive then they are going to want to do an MRI or CT scan, then what? surgery? you are now talking about $2000. I am just not going to spend that kind of money, I don't have it. If I were made of money, yes, I would do it but that isn't my position now.

[Squirt's Mom]

Hi,

Atypical and the adrenal based form of Cushing's are two different forms.

From my first post -


(Atypical Cushing's involves the following hormones - Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone – an elevation in one, all, or any combination of these hormones, without elevated cortisol determines a diagnosis of Atypical.)

The links I provided will explain what Atypical is and the test involved. Taking her to UT will not reduce the cost of the testing but would add to your expenses for traveling there.

If the pup has the adrenal form, meaning there is a tumor on one or both of the adrenal glands, then surgery is an OPTION, not the only way to treat it. The same drugs used to treat the pituitary form (PDH - when the tumor is on the pituitary gland) are used to treat the adrenal form (ADH). Atypical is a different animal which may or may not involve a pituitary tumor.

So, just FYI - Atypical and ADH are not the same thing and are not treated the same way.

Hugs,
Leslie and the gang

[Cocker's Mom in FL]

OHHHH... I didn't realize that. I did read your message when you wrote it, just haven't had a chance to reply.

Nothing has changed, Faith is still peeing, drinking and panting and I notice that her skin on her neck is turning very dark. She will be 12 in a month and a half. I am taking her to the vet on Sunday to check on prognosis. I can't take this anymore. I am exhausted. She peed in the house (I am renting) four days ago. I noticed the odor when I came home from work, it STANK! I had the carpets cleaned the next day. Kept the dog in the puppy play pen for the night. Took her out to go potty at 4:30, went back to sleep, and when I got up at 6:45 there was a wet spot on the carpet!!! I was so mad! She didn't even try to wake me up to let her out. If I were living in a house and could just open the door I think I could live with this a little longer, but I notice her shaking now when we walk, and she stumbles. Sometimes she can't get up the stairs. Poor puppy...

A neighbor just told me about supraglan. Has anyone used this successfully? I am not giving Faith anything at this point.

Not sure which way to go at this point. I know she won't live a whole lot longer, but I don't want to take her life prematurely.:(

[Squirt's Mom]

Hi,

Supraglan, Cushex, all of those are nothing but snake oil and contain things that are not good for cush pups at all. These products claim to treat BOTH Cushing's and Addison's diseases which are polar opposite diseases; one product cannot treat two opposite conditions. These products do nothing but put money in the manufacturers pocket, give pet parents false hope and pose potential risk and harm to the dogs. Don't waste your money.

Faith cannot help herself when it comes to peeing, she is not doing this to make you mad - she is sick. Without treatment, this is going to continue. Has she been seen by the vet since your first post? Is there any possibility the UTI is back? Urine with an infection will have a strong odor and darker color. Cush pups cannot concentrate their urine so it is usually very dilute unless there is an infection present. If that hasn't been checked since July, I would have that done for sure.

Here are some links that may provide you with info to help with the costs of testing and treatment -

Financial resources
http://www.k9cushings.com/forum/showthread.php?t=212

How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing
http://endocrinevet.blogspot.com/2012/03/how-to-dilute-and-store-cortrosyn-for.html

Let us hear from you! and keep your chin up!
Hugs,
Leslie and the gang

[molly muffin]

You could also get a Little Green Bissel cleaning machine. It's hand held, and with the odor control formula, it sucks urine out of the carpet spot really well. Seriously, you can't even tell that there was an accident there. Believe me it is cheaper than having the carpets cleaned professionally all the time.

Yep, the UTI is a possibility if there is a strong odor.

Unfortunately, the experts I have read agree that the two items metioned above are a hoax to get peoples money. What is even more disturbing is how they go about getting people to buy it by writing up false "reviews". An animal lover, just wants what is best for their beloved pups and this kind of thing play into their emotions to do what is best. If we ever heard of it working, you know we would be on the train big time as that is our main focus here, trying to keep and get our babies well.

Hugs,
Sharlene

[Cocker's Mom in FL]

Well the vet didn't think she was that bad, I was ready to have her put down. Her peeing though is making me crazy!! Had the carpet cleaner back after only a few days, they didn't get one area up very well, and discovered she had peed about 3 times in a different spot!

Vet suggested I increase the proin she was taking to 1 tablet twice a day. She didn't think she had a UTI, at least didn't suggest doing a test for it. Vet also suggested running a test to determine where the cushings was and gave me an estimate. The medicine (gel) I purchase separately is around $30 and will do 2-3 tests, and they charge $141 for the ACTH stimulation test.

Told me to stop giving her Comfortis (for fleas), I didn't realize it wasn't recommended for dogs with seizures.

Sure enough, she had a seizure the next day! this was one was pretty mild. Gave me a prescription for (can't find the prescription, was a valium type drug, I'll look for it and post later)

I have reservations about doing the ACTH stimulation test due to expense involved, and then what? put her on a drug which is also expensive and requires more blood test, it seems like an endless $$$ merry-go-round you get on with this! Bottom line is, this isn't curable is it? what good does the medication do?

I am going to look into doggy diapers, that may help with the peeing in the house which I can't take anymore! anyone have success with those? what type to use?

[Steph n' Ella]

I think you owe it to your dog to at least figure out if she has cushings or not. If she has cushings, she cannot control her water intake and cannot control her need to go potty. Diapers, pee pads, new flooring are a part of cushings but, IMHO, not a humane solution.

Have you had an ultra sound done? If the imaging shows a tumor on the adrenal gland, cushings can be cured if the tumor is removed during surgery. If it is determined that your dog has pituitary cushings, you can only control the urge to eat/drink excessively through medication to manage your dog's cortisol levels.