dmariehill
09-24-2013, 04:45 PM
Cora is a rescued 12 year old pug. We rescued her 2 1/2 years ago at age 9 when her previous owners wanted to put her to sleep because of her arthritis. She's a sweet, demanding, sometimes b*tchy, princess of a pug, exactly as she should be.
I only heard the word Cushing's for the first time on Friday. We're in the middle of the diagnostic testing right now, so we don't officially have a diagnosis and it's still possible that it could end up negative. I'm trying to make sure I have as much information as possible to have the right conversation with the vet if the diagnosis is Cushings.
Okay - so first off - the reason we're even looking at Cushings. She has somewhat elevated liver levels (which could have been caused by the Deramaxx she used to take for severe arthritis). In the last 6 months, we have been battling multiple recurrent infections - eyes, ears and UTI. She's drinking much more than before (she's emptying the water jug every two days instead of once a week or so). She's struggling with frequent urination (she even pees in her sleep and has been for more than 6 months). She is either antsy - pacing and panting around the living room, or she's passed out on her bed napping much more than usual. There's not much in between.
Additionally, her arthritis is being managed with Tramadol right now when I can get her to take it. Several years ago, tramadol was not enough. She still has some bad days with the arthritis: dragging her back legs and falling when she tries to get up. She really only uses one of the back legs for weight bearing and the other is just for balance and she rarely puts much weight on it. We can't put her back on Deramaxx as her liver level was already elevated enough to prohibit that drug.
So Friday, we were back in to the Vet with the eye and concerned about another UTI. Because these infections keep happening, and the elevated liver level, along with the symptoms above they mentioned the C word and started talking about testing. We did the urinalysis to confirm the UTI and started treating the eye infection and the UTI. And we did a Urine/Creatine ratio test. It came back suggestive of Cushings. The vet said they look for 34 or more and Cora was at 51. So on Monday, they did the LDDS test over 8 hours. We're still waiting for those results (they had to send them off).
My concern is that if this is Cushings, it's possible that the reason her arthritis is doing as well as it is now is because of the cortisol from Cushing’s. If she were 9 or 10 with no arthritis, I wouldn't hesitate to do treatment if we get the diagnosis. However, at 12, with severe arthritis (she was in an arthritis study at 8.5 to 9 and had it confirmed with xrays, it's really bad), I'm not sure if treatment is in her best interests especially if it increases the arthritis pain and further decreases her mobility.
What I've seen so far in my research is that treatment doesn't really extend life, it's intent is to improve quality of life (ie, a pugs expected life span is 12 to 14 years, at this point the disease doesn’t shorten or lengthen that). So with that in mind, has anyone on here chosen not to pursue treatment and just kept your baby as comfortable as possible? If so, why did you make that choice? Do you still think it was the right choice? If you have an older dog with other medical issues and chose treatment anyway, are you glad you did?
What questions do I need to be prepared to ask my vet as we discuss Cora in particular and what is going to make her the most comfortable in the time she is still here? And what other tests do we need to run?
I'm not as freaked out after reading on this site as I was before I got here. Now, I'm just trying to be proactive.
I only heard the word Cushing's for the first time on Friday. We're in the middle of the diagnostic testing right now, so we don't officially have a diagnosis and it's still possible that it could end up negative. I'm trying to make sure I have as much information as possible to have the right conversation with the vet if the diagnosis is Cushings.
Okay - so first off - the reason we're even looking at Cushings. She has somewhat elevated liver levels (which could have been caused by the Deramaxx she used to take for severe arthritis). In the last 6 months, we have been battling multiple recurrent infections - eyes, ears and UTI. She's drinking much more than before (she's emptying the water jug every two days instead of once a week or so). She's struggling with frequent urination (she even pees in her sleep and has been for more than 6 months). She is either antsy - pacing and panting around the living room, or she's passed out on her bed napping much more than usual. There's not much in between.
Additionally, her arthritis is being managed with Tramadol right now when I can get her to take it. Several years ago, tramadol was not enough. She still has some bad days with the arthritis: dragging her back legs and falling when she tries to get up. She really only uses one of the back legs for weight bearing and the other is just for balance and she rarely puts much weight on it. We can't put her back on Deramaxx as her liver level was already elevated enough to prohibit that drug.
So Friday, we were back in to the Vet with the eye and concerned about another UTI. Because these infections keep happening, and the elevated liver level, along with the symptoms above they mentioned the C word and started talking about testing. We did the urinalysis to confirm the UTI and started treating the eye infection and the UTI. And we did a Urine/Creatine ratio test. It came back suggestive of Cushings. The vet said they look for 34 or more and Cora was at 51. So on Monday, they did the LDDS test over 8 hours. We're still waiting for those results (they had to send them off).
My concern is that if this is Cushings, it's possible that the reason her arthritis is doing as well as it is now is because of the cortisol from Cushing’s. If she were 9 or 10 with no arthritis, I wouldn't hesitate to do treatment if we get the diagnosis. However, at 12, with severe arthritis (she was in an arthritis study at 8.5 to 9 and had it confirmed with xrays, it's really bad), I'm not sure if treatment is in her best interests especially if it increases the arthritis pain and further decreases her mobility.
What I've seen so far in my research is that treatment doesn't really extend life, it's intent is to improve quality of life (ie, a pugs expected life span is 12 to 14 years, at this point the disease doesn’t shorten or lengthen that). So with that in mind, has anyone on here chosen not to pursue treatment and just kept your baby as comfortable as possible? If so, why did you make that choice? Do you still think it was the right choice? If you have an older dog with other medical issues and chose treatment anyway, are you glad you did?
What questions do I need to be prepared to ask my vet as we discuss Cora in particular and what is going to make her the most comfortable in the time she is still here? And what other tests do we need to run?
I'm not as freaked out after reading on this site as I was before I got here. Now, I'm just trying to be proactive.