New here, elderly dog with new cushings dx

[Hailey's Mom]

Hi there, stumbled on this page while researching my old girl's new cushings dx. Hailey is 15, lab hound mix. Until about 6 months ago she was the picture of health, no one believed she was so old. Now she is classic cushings, boney head, bald patches, pot bellied, and most recently weakness in her hind legs. In retrospect this has probably been building for a little over a year. My normally well mannered dog was counter surfing and getting into the garbage. She seemed constantly starving. Also she could no longer wear her collar because it would rub her fur out. Her labs had ast of 1100, low thyroid, and low dose dex test was positive. Simple huh? Not so much. Her calcium was also up and the dex test was inconclusive for the origin of the disease, pituitary or adrenal. Vet is worried about cancer and referred for an ultrasound which is another 500 dollars on top of the work up already done, and recent treatment for ear infection and today cellulitis in her hind paw. Chest X-ray today was negative for obvious metastatic disease.
So as of now hailey is doped up on tramadol and on antibiotics. I'm well over 1000 dollars into this with possible US to come and we've yet to treat her. I hate to even think about dollars but just had acl repair on my mastiff so it is an issue. I can do the US next week but was wondering, what is the point? If she has cancer I will opt to just keep her comfy as long as I can, no treatment, if it show adrenal cushings is still treat her the same as pituitary with trilostane. And I can't fix old age. To be blunt, her symptoms are seriously impacting her quality of life. I am considering asking the vet to just write the script, treat for cushings and hope for the best. Understanding that if there is malignancy getting rid of the excess cortisol will hasten her death. But cushings is the only thing that could be treated and make a difference in her quality of life. IDK, reasonable risk? Spending 200 a month on treatment that will make her potentially her old self is worth it to me, treating cancer not so much, thanks for listening! Any thought appreciated.

[Roxee's Dad]

Hi Hailey's Mom and welcome to you and Hailey :)

Many will be by to welcome you and help you and Hailey through this.

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[Budsters Mom]

Hello and welcome from me too. :)
I am sorry for the reason that brought you here, but so glad you found us. You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help. Others will be popping in to welcome you also. So again welcome to you and Your sweet Hailey.:)

Hugs,
Kathy

[Roxee's Dad]

Dear Hailey's mom,
I am so sorry for what you and Hailey are going through. I really don't have an answer, if not an Ultrasound, maybe I would do an ACTH test to see what her cortisol levels are. If they are high, Try a lower dose of the trilostane and recheck in about 10 days. Also be aware that if Hailey does have cushings, treating the cushings is lowering her cortisol which is most probably helping with her arthritis and other joint pains. But maybe we can get her to a comfortable level somewhere between the high and the low.

[frijole]

Please post the results from the blood panel that was done. Give us everything that was out of range (high or low) as well as what the normal range for each is. That way we can take a look. If it's more than cushing's we should be able to tell if other enzymes are out of whack. And we'll read it over for free. No we aren't vets but we see alot of these things.

Why is your dog on tramadol? I've used it and it is some strong opiate like stuff and will make your dog drowsy.

Silly questions but does your dog have a pot belly and is the urine clear or yellow?

Kim

[molly muffin]

Hello and welcome from me too.

Hugs, I know this is hard and can be very confusing. Like Kim said if you can post the abnormal labs with the normal range next to it, that could be very helpful.
We'll do all we can to help you. This is just a tough spot to be in and when they are 15, you want to just give them the best quality of life that is possible. So, lets first see if we can determine what is going on via those blood test results and urinalysis too if you have the results of one.

Sharlene and Molly Muffin

[Hailey's Mom]

A little more info. Hailey is on tramadol due to the new cellulitis in her left back leg. It is swollen, weeping and painful, so we are keeping her as comfortable as possible while the antibiotics have a chance to work. This is her third infection since starting the Cushing work up. The cushings is causing major immune system issues.
I don't have her LDDS test results but vet said as expected it was positive but inconclusive for source. I can get the results and will post.
She has every symptom, extreme hunger and thirst, pot belly, boney head, and losing more hair every day in patches. Now she is having one infection after another. Lately she has significant muscle weakness. this oddly enough is not an arthritic oldster, 6 months ago she was running and jumping like a pup. She has always been super healthy, never needed more than routine yearly vet visits. Last year her labs were perfect, this year her chemistry was typical cushings.
I don't have those handy either but ALT was 1100, other liver enzymes normal, T4 was low, glucose low, renal stuff normal,
WBC high, but she had ear infection. Hemoglobin and hematocrit was actually high, surprising with the amount she drinks. The cancer concern is due to elevated calcium, only about a point off but apparently a big deal.
We did CXR today just to see if there was obvious metastatic disease and it was negative.
I don't question the dx, that is pretty clear just confused about the relevance of the cause. Its the same med. I'd rather spend the $$s treating the one thing that may improve her quality of life and even extend her life if we luck out and it's pituitary driven. Surgery isn't an option for a 15 year old, and if its cancer with her current symptoms she is pretty end stage, can't fix old age either. Vet seems resistant to treating without the US. I don't think we have much to lose at this point and its worth the risk. Have a consult appointment to talk to the vet about these thoughts next week. Hopefully hailey will be over the cellulitis and they will agree to start treating cushings. I guess I would like opinions from those of you have had been there if I am being reasonable or is a 500 dollar US the better way to go?
Also I read here that some use diamondback compounding pharmacy for trilostane. It is over a 100 dollar savings on the 175 dollar per month cost the vet quoted. They are willing to write a script if we go that route so interested to here experiences with this pharmacy.
Thanks so much and I will stop by the vet to get test results tomorrow and post.

[Roxee's Dad]

Also I read here that some use diamondback compounding pharmacy for trilostane. It is over a 100 dollar savings on the 175 dollar per month cost the vet quoted. They are willing to write a script if we go that route so interested to here experiences with this pharmacy.

Quite a few including myself have used Diamondback, I have had a great experience with them as they are willing to take your calls and answer questions. I have heard no complaints to date.

[Budsters Mom]

Yes, Diamondback all the way!!!!!!!! I use them, I love them, they are wonderful! :D:D:):) If you call with the milligrams ahead of time, they will tell you the cheapest route to go. I order 60 count 20 mg Trilostane at a time. It costs only four dollars more to get 60 than it does to order 30. If you know this ahead of time, you can tell your vet. That way, they can call in the prescription for the larger amount.:D. Diamondback's service is phenomenal! You get your prescription within two or three days of ordering. I did a lot of research before I went with them. They have many awards,certifications, and excellent service. They are also the most affordable.:):o

PS. I don't buy any meds from my vet. They are far more expensive! If it's a regular prescription like an antibiotic or something like that, I get written script and take it to Walmart or Costco. Walmart and Costco do not carry Trilostane as of yet.

Hugs,
Kathy

[Hailey's Mom]

So went ahead with the ultrasound and both adrenals are swollen so we are pituitary driven, and no cancer found in the abd. Organs or chest X-ray. Should be simple right? But no, ionized calcium is 1.6 (high normal is 1.46) so we sent of PHT test and malignancy panel to hopefully rule out lymphoma. So another 700 in diagnostics and still no decision on treatment. If its lymphoma the cushings may be actually helping her so treating would be a bad choice.
I'm wondering if anyone has had a dog that had abnormally high calcium levels with cushings? The vet said there is a very small chance her parathyroid is reacting to low calcium common in cushings and raising her level But more likely she has worse case lymphoma, or best hyper parathyroid along with the cushings.
I am happy that the referral internal med vet is not intimidated by hailey's 15 years and finds it reasonable to treat barring lymphoma dx.

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about ultrasound results into Hailey’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!

[goldengirl88]

Welcome:
I am so sorry for your Hailey's situation. My precious Tipper is a Cushings dog also. It seem to come out of nowhere for her too. I hope you have good luck with treating the Cushings, if in fact you are 100% positive it is Cushings. Just a few tips, keep a daily diary on your Hailey's happenings, make sure you are hooked up with a professional that understands this disease. If you use the name brand Vetoryl, call Dechra and start a file on your dog, there are vets on staff there to help you. 1-866-933-2472 in the number. Blessings
Patti

[Hailey's Mom]

Thanks! We are 100 percent sure of the cushings dx, just not sure what else is going on, hyperparathyroid or lymphoma. Hopefully this latest blood test will give us the answers. I'm hopeful it will r/o lymphoma, since untreated dogs tupically don't survive more than a few months and we are about 4 months into testing.
I know in people hyperparathyroid can be secondary to renal failure so curious if anyone had a similar situation with their cushings dog?
The only treatment for it is surgery and that is risky in a 15 yr old. Of course I didn't think to ask the vet if there is some relationship between both issues was just so relieved to hear no cancer in her chest or belly!

[Budsters Mom]

Thank you so much for coming back and updating us on Hailey.:) I'm glad you went ahead and got the ultrasound done. That helps you develop a plan of action of what to do next. Due to Hailey's advanced age, I'm sure that you want to make her as comfortable as possible for as long as possible. Please continue to keep us informed and we will do all we can to help. And yes, go ahead and continue to post your questions, because somebody on here may just have the answer you're seeking.
Hugs,
Kathy

[Concernedmom]

I am so sorry for the declining health of your Hailey. It's heartbreaking to watch when they can't tell you what's wrong.
I have a 13 year old with cushings and have been treating with homeopathic remedies for 4 months. He's doing very well so far and just wanted to pass along a study that was done on the remedies I am using.
http://www.bahvs.com/wp-content/uploads/2012/11/Cushings-Research.pdf
This way of treatment is not for everyone but it may be another option for you. I did not do this on my own it was prescribed by a holistic vet. I hope Hailey starts to feel better and hugs to her Mom

[Hailey's Mom]

Still waiting for results from the hypercalcemia of malignancy panel. It seems like each test just leads to more questions and more tests. This is a very long and frustrating journey. If we get answers I will post all of her results and a summary of the process in hopes it will help someone else.
The toughest symptom is the muscle weakness. She is really distressed when she can't get up. I hate seeing her struggle to get up and worry that I won't be home to help her and she will be stressed. I know this is common in old big dogs but not something hailey had issues with. Just ordered her traction socks to help.

[goldengirl88]

Hoping and praying everything comes out ok for your baby. Blessings
Patti

[Simba's Mom]

Hello and welcome to you and Hailey, sounds like lots of tests have been done already, that's the worst part I think, the not knowing.....anyways, my dog Simba has had high calcium numbers too, when his cushings is not controlled, since meds started his numbers went down, so hang in there, I treat Simba with Trilostane and it keeps him happy and his symptoms down....sending hugs!!!

[Hailey's Mom]

Thanks so much simba s mom. The vets have indicated high calcium is almost always a malignancy so your post gives me hope while I wait for the latest results.

[Hailey's Mom]

Latest test results in and my girl has hyperparathyroid and cushings. Both treatable but the question is how? IM vet suggests treating the parathyroid first, either with surgery or fosamax then tackle the cushings. I'm hesitant to do surgery on such an old dog. Just seems life is a very delicate balance at her age and I sure don't want to nudge her in the wrong direction. So fosamax monitor for results and if successful trilostane. Both reversible treatments, just in case she is better off doing nothing, which was also presented as a reasonable alternative.

Will get all the test results together and post just in case our journey will help someone else

[maria]

Hi,

Sorry you and Hayley are having these problems. It is hard to see them age and have medical issues on top of it. My 8 year-old Beagle has been symptomatic for Cushings since she was 2-4 yrs old. We just got a diagnoses last month of atypical Cushings. Her calcium has also been consistently high. I understand the even a little over normal usually means a problem. I believe the reference range normal was 11 and hers was 12. something. I don't recall the units they measured them in. The vet wanted to check for cancer but I did not do anything about that. She had an abdominal ultrasound last month and no malignancy was found there.

It seems like we could spend ourselves into the poorhouse pursuing things that they might have. If the dog has cancer and treating it could make it worse, then I guess you need to find out. At that age, you just want to make them comfortable for whatever time they have left which the Cushings treatment will do. I always try to think if I do these expensive/invasive tests what am I going to do with the information. When they wanted to do a biopsy on my Beagle for hepatitis to see if it was the autoimmune type, I asked what the treatment would be. I was told it was cortisone. So I asked the vet if we could just treat her with the cortisone, if it works, we will know it is autoimmune, if not, then we will know it was not. The treatment worked and she was spared having a biopsy. I don't recommend anyone follow my example because I am not a vet but it worked for me.

[Hailey's Mom]

Sounds like we have had the same journey. My thought were similar, if trilostane was the treatment why not just do it? And 1000s of dollars later that is where we will end up. I am happy with the IM vet. My regular vet said things like you could spend this money and it probably won't get you a year. Duh, I'm not an idiot, she's 15 getting another year would be amazing even without the medical issues. The IM vet seems to get that it is about quality, which if we are constantly battling infections due to cushings and dealing with the muscle weakness she just doesn't have. If she can feel better than it is worth giving the treatment a shot, but like you I won't put her through invasive tests and surgeries.

[Trixie]

So glad lymphoma was ruled out for Hailey! That's good news and I'm sure quite a relief for you. At least now you know what you're dealing with and have some choices of treatment.
Sounds like your plan-no surgery-makes the most sense. Like you said both treatments are reversible if doing nothing is better quality of life. I do hope Hailey feels better soon.
Barbara

[Budsters Mom]

No lymphoma, that is great!:) Sounds like you have a good plan to help Hailey feel as comfortable as possible for as long as possible. Isn't that what we all want? Hugs,
Kathy

[goldengirl88]

Glad to hear the good news regarding no lymphoma. I too believe in the quality of life. Do what your heart tells you. No one loves this baby like you, so you will make the best decisions. Blessings
Patti