My poor Oscar

[janarmenta]

Oscar is an 11 yr. old rescued Bijon. He was in supposed perfect health last June at his checkup. We noticed in Sept. he was gaining weight. By Oct. he had gained 50% of his original body weight. He had insatiable thirst,and infected gums. His blood test was good. After a urine test and a baseline blood test he has been diagnosed with Cushings. He is so uncomfortable, cannot jump onto the bed, can hardly walk due to his weight, very frequent urination and moans and cries a lot.. he has also lost some of his vision. He has been on 30 mg of vetoryl for 2 weeks and I see no changes. Tomorrow is his next blood test. I am finding the treatment cost prohibitive as i have been told he will need several blood tests on top of the cost of the medecine. I wonder if he will ever regain his old life and what is the best way to proceed. Any input would be welcome.
Janis

[frijole]

Janis, we will be asking alot of questions - we will want to know all symptoms, all tests done to come up with the diagnosis, the results of the tests (get them if you don't have them)... in order to best help you.

Have you ruled out diabetes? Have you ruled out SARDS? (see link here: http://www.k9cushings.com/forum/showthread.php?t=213) The weight gain and eyesight loss make me wonder if it's something other than cushings.

Cushings is very often misdiagnosed and so that is why we like to look at all the test results to see if perhaps that is the case.

In order to know if the dosage is right we need to know how much Oscar weighs.

Hang in there - tell us the whole story and get test results! We'll help you! Kim

[janarmenta]

I will ask vet tomorrow for test results. Diabetes and thyroid were ruled out. Oscar weighed 13 lbs, now weighs 19.8 lbs. He seems to have a lot of the symptoms of Cushings. Hopefully I will find out more tomorrow.

[frijole]

The test you are doing tomorrow is the acth test and it is to measure the results of the trilostane. Since you haven't seen any changes the chances are that it will come back as still high. The goal of treatment is to reduce cortisol which will then result in appetite/thirst issues resolving and then yes Oscar can have a very normal life.

The key is to get the dose right. At that weight you might have started at 20 mgs so 30 mgs is not out of line. It just might not be enough. As time consuming and painful as it is to have to tweek the dosage it is better to start off low and work your way up then it is to start to high as that is where dogs get into trouble.

Did you do an ultrasound or the low dose dex suppression test (LDDS) to diagnose? Please do take the time to read a bit on SARDS just to be safe. It is my understanding that most of these dogs are misdiagnosed as having cushings and can quickly go blind if it isn't caught. Most SARDS dogs do not even have cushings but they have cushings symptoms. I just want to be safe when I mention it.

Just also wanted you to know that should Oscar have cushings - this s the tough part and once the cortisol is under control from the meds you can both live a very happy and normal life! My dog Haley lived with cushings for 4 1/2 yrs and passed at the age of 16 1/2 of old age. Hang in there. Kim

[JoannH]

I'll be praying for you and Oscar. When my Daisy was first sick, it cost an arm and a leg to figure out what was going on. Now that she's on meds and things seem more stable, the cost is basically the medication (which is still a lot) and a blood test every few months.

Hang in there. This is a great forum with some amazing people who will help every step of the way.

[molly muffin]

Hello and welcome to the forum.
How did his ACTH test come out?

Sharlene and Molly Muffin

[janarmenta]

The results of the test showed some success for Oscar. The vet has decided to increase the Vetoryl from 30 to 40 g. per day. I have noticed Oscar has less discomfort- not as thirsty, more energy. She said his loss of sight is due to cataracts and he still has very limited vision.
I feel comfortable with the Cushings diagnosis as Oscar has demonstrated almost every symptom of the disease I have read about. I think the vet was thorough in the testing, 3 blood tests and 2 urine tests ruling out other possibiliites.
He will be going to be re-tested in 2 weeks so I will see how that goes, and I will read up on SARDS.
Thanks for all your support.
Janis

[lulusmom]

Hi Janis,

I just want to repeat what Kim has already told you about some dogs with SARDS having natural occurring cushing's but most do not. You mention that you are sure your vet correctly diagnosed Oscar because Oscar has demonstrated almost all symptoms associated with cushing's. Symptoms are a huge component of a cushing's diagnosis; however, dogs with SARDS also have identical symptoms. The reason for this is that almost most, if not all, dogs with SARDS have elevated adrenal sex hormones and these hormones cause the same symptoms, changes in affected organs on imaging, and blood and urine abnormalities as those found in dogs with pituitary or adrenal cushing's.

Have you taken Oscar to see a veterinary opthamologist? If not, I would recommend that you get a referral from your vet. An Opthamologist can correctly diagnose SARDS and I truly think you need to know what you are dealing with.

In your first post you mentioned that your vet diagnosed Oscar based on a urine test and a baseline blood test and now you mention that he actually did three blood tests and two urine tests. I realize you trust that your vet has properly diagnosed Oscar but it would still be great if you could please round up copies of all testing and let us know which tests those were and post the results? Can you also post the results of the recent acth stimulation test?

Have you taken Oscar to see a veterinary opthamologist? If not, I would recommend that you get a referral from your vet. An Opthamologist can correctly diagnose SARDS and I truly think you need to know what you are dealing with. If it is SARDS, there is a good possibility that Oscar does not have cushing's, meaning he does not have a tumor on his pituitary or adrenal gland. Did your vet do an abdominal ultrasound to determine if Oscar has pituitary or adrental dependent cushing's? Most general practitioner vets have never dealt with SARDS so please ask your vet if he has any experience with it.

We will be looking forward to seeing the test results.

Glynda

P.S. Vetoryl can and usually does continue to reduce cortisol in the first 30 days so vets highly experienced with the disease and the drug don't make any dosing changes after the first two weeks, unless it is very apparent that the dog is showing no improvements and the post stimulated cortisol is well above the therapeutic range. Was Oscar showing any improvements on 30mg?