Help! rabies vaccine in undiagnosed Cushing's?

[Kobester]

I am a new to the forum. My beautiful 14 year old Shiba Inu Kobe likely has Cushing's disease. She was completely healthy until 2 years ago when she had a front leg amputated for sarcoma. It took a month for Kobe to recover fully from the surgery but we were really happy to give her a few more years of good quality of life. She developed canine vestibular syndrome about 8 months ago that was especially difficult because of her amputation. But my resilient little girl recovered from it. Over the past year, she gradually slowed down a lot (mostly sitting around, unable to climb up a single step to the point where we had to build her a ramp for her to get onto the porch, etc). We noticed that she was drinking WAY too much water over the past 6 months. Her appetite is voracious. She is always panting. It sounds like Cushing's, but we were not aware of how common it is in dogs. Unfortunately, last month we took her to the vet for a rabies shot. She didn't look good afterward. A few days later she had a very severe case of vestibular syndrome and was not able to stand on her own for a month. Now she still can't walk more than a few steps on her own without falling down. She has urinary incontinence a few times a day because of her immobility, so the frequent urination really shocked me. We were devastated because we've raised her since she was a puppy and have never seen her like this. We almost euthanized her until I started to read about Cushing's in dogs on your forum yesterday. It made me wonder if her condition is potentially reversible. Now I suspect that Kobe had undiagnosed Cushing's disease for a long time and her recent symptoms might have been triggered by the rabies vaccine. I want to take her to a good vet for diagnosis. We've taken Kobe to the vet a few times this month but never to specifically ask about Cushing's. Has anyone seen the effects of rabies vaccine on a dog with untreated Cushing's? Also, how much did it cost to establish the Cushing's diagnosis, including visits and labs? We want to figure this out in the next few days to see if we can help Kobe recover her mobility. Thanks!!

[goldengirl88]

Welcome to the group. My Tipper also had vestibular disease. I do not get her any vaccinations any more. Unfortunately you did not know and I guess that is why the reaction. It really varies how much diagnosis can cost. I can tell you one thing I have learned. Got to a Dr. that is familiar with this disease. It will save time, money and heartache. The initial part is the most costly, it does get more reasonable after that. Just get a good Dr., do all the testing to make sure of the diagnosis, LDDS, ACTH, urine, blood panel and Ultra Sound to start off. I will not lie to you it is not cheap to begin with, but as I said it does go way down after diagnosis. Keep a daily doggy diary, and measure the water consumption. the two drugs used are Trilostane ( Vetoryl) and Lysodren. There are no other remedies natural or otherwise, so save you money. You can purchase the Vetoryl cheaper online than what the vets charge. We all have to try and save money where we can. If you are vigilant about watching your dog, he will do fine. I know it is scary, we have all been there, so when you need help we are all here. We will want to see the abnormal results of the testing done so please always get copies for yourself. It will be ok, so try not to worry. Blessings
Patti

[Harley PoMMom]

Hi and welcome to you and Kobe,

Oh my goodness your sweet girl has been through a lot. My boy, Bear, had to have one of his front legs amputated due to cancer, his vet agreed with me that he would no longer be vaccinated, this included rabies in which she would give a waiver for.

Cushing's can be difficult to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing Cushing's and other non-adrenal illnesses can create false positive results on all tests for Cushing's. Other heath issues do share many of the same symptoms as Cushing's, such as diabetes and thyroid problems, and should be ruled out, have these been checked and ruled out?

If you could get copies of all tests that were done on Kobe and post any abnormalities that are listed, that would be of great help to us.

If the diagnosis of Cushing's is confirmed in Kobe, I want you to know that Cushing's is a treatable disease however, success depends on a vet/IMS that is very knowledgeable and skilled in the treatment of Cushing's plus that knows the proper protocols for Cushing's.

We are here for you both and we will help in any way we can.

Hugs, Lori

[molly muffin]

Hello and welcome to the forum. Poor baby, so much going on. Yes, definitely rule out thyroid and Diabetes and a UTI first. A UTI if the urine's specific gravity is low, can only be determined by a culture.
If you look at your lab work, and anything that is high/low could be posted here, for example: ALKP 785ug range 50 - 300ug, that would be very helpful for us to give you feed back.

Cost differs depending up on location. You can check out the Poll Section, where people have filled in how much different test cost in their area.
The link is http://www.k9cushings.com/forum/forumdisplay.php?f=28

Also our Helpful Resource section has quite a bit of information link here:

http://www.k9cushings.com/forum/forumdisplay.php?f=10

Of course we will answer any questions also.

This should get you started. :) Lets hope it is something that we can get figured out and see if your baby can be helped to get a good quality of life back.

Sharlene and Molly Muffin

[Kobester]

Thanks for the kind words, Tipper's Mom and Lori! Can you give me a ballpark estimate of what the labs/diagnostic tests costs for the diagnosis? We've spent a fortunate on vet bills recently, but amazingly the vets did not perform a single blood test or mention Cushing's when we mentioned the excessive drinking etc. Thank goodness I found your forum when I searched for dogs with excessive thirst. We have shed lots of tears in the past month and it gives us a lot of hope to think she may have a treatable condition. If we think we can improve Kobe's life, we definitely are willing to spend the $$. Also, how do I find a good vet with experience diagnosing and treating Cushing's? We live the in SF Bay Area and I was thinking about taking the two hour drive to UC Davis Vet School next week if I can get time off work.

[molly muffin]

UC Davis is an excellent vet school, when it comes to cushings and many other types of ailments. If I had the option to go there, I certainly would do so. We had one member that drove 4 hours each way to go there. We might have some others in the area that know of a local vet too, as the member I mention is currently not checking in every day.

Did you check out the link I provided to the poll of rates for the different tests?
This link will take you to a graph of the various costs.
http://www.k9cushings.com/forum/showthread.php?t=1512

Oh and if you don't have it already, look into Care Credit. http://www.carecredit.com/
Many of our members use this for their vet bills.

I'm in Canada so not sure that my rates would help you much.


Sharlene and Molly Muffin

[doxiesrock912]

From what I've heard, it is well worth going to UC Davis. We're in CT and we go to Cornell University to see an IMS specialist. I'm sure that UC Davis can set up an appointment with one. From there, they can likely recommend someone close to home who is just as qualified.

[Harley PoMMom]

With Cushing's the initial expense is during the diagnostic phase. Since there isn't one test that is 100% accurate at diagnosing Cushing's usually multiple tests need to be done to validate a Cushing's diagnosis. These tests include; ACTH stimulation test, this test is expensive because of the stimulating agent, it usually runs between $150. 00 - $300.00, the LDDS test (low-dose dexamethasone suppression), cost is between $100.00 - $200.00, an abdominal ultrasound, this runs between $300.00 - -$400.00.

The tests I would recommend for diagnosing Cushing's, depending on the dog, are either the ACTH or LDDS test along with an ultrasound.

UC Davis is a prestigious vet school. To find an IMS in your area search here: Finding an Internal Medicine Specialist Vet (ACVIM) (N. America and other countries) (http://www.k9cushings.com/forum/showthread.php?t=182) You need to only type in your State and click search.

[goldengirl88]

I would definitely make the drive to UC Davis. it is well worth the trip. They are revered as one of the best veterinary schools in the U.S. If you do get a Cushings diagnosis, treating with one of the drugs mentioned will certainly help improve Kobe's quality of life. As I told others my Tipper would not be here if not for this drug. You are on the right path and have a wonderful school to go to so I would take full advantage of that. Blessings
Patti

[spdd]

Just wanting to welcome you to the forum. Your pup has certainly been through a lot.

Hang in there, everyone on here is terrific and will go way above anything you'd expect anywhere in helping you and Kobe.

[goldengirl88]

Hope you have decided to drive to UC Davis. Let us know how things progress. Blessings
Patti

[Kobester]

Thanks to all those who responded! We are grateful to have your support!! We took Kobe for initial screening labs at our local clinic. Her ALT was high at 201 (twice the upper limit of normal), but this was the only liver abnormality. I have been reading about elevated ALP, but that was completely normal. Her glucose and cholesterol were normal. Her urine specific gravity was 1.023. We are driving her to UC Davis on Monday to see the internal medicine doctor. She continues to drink a lot (almost 2 liters a day). She eats a ton and pants all the time. What do you folks think? Is this consistent with Cushing's?

[molly muffin]

Symptoms could be consistent with cushings, however, usually it is the ALKP that goes first, but not necessarily. Her urine is dilute, which is strange if she is drinking that much water, you'd think it would be lower specific gravity.
The problem with cushings is that nothing is written in stone. Many things are consistent with cushings, but part of diagnosing cushings, is first ruling out every other possibility. That makes it one of the hardest diseases to diagnose.
I'm glad that you are going to Davis, they do have a good reputation and have been one of the leading schools in cushing research. If it isn't cushings, then I would think they could perhaps figure out what IS going on and get you on track to deal with it.

Sharlene and Molly Muffin

[goldengirl88]

Glad you are going to UC Davis. Some of the things do sound consistent with Cushings and some don't. I am sure you will get answers where you are going. They have an excellent reputation. Blessings
Patti

[Kobester]

First, we want to thank all of the wonderful people on this forum for answering our questions and providing us support! On Monday we took Kobe to UCDavis vet school to see the internal medicine vet and neurologist. They examined Kobe and reviewed her labs. Unfortunately, they concluded that her clinical picture did not appear to be consistent with Cushing's or any other endocrine disorder that could be reversible. The neurologist thought that most likely she has a brain tumor causing her neurologic symptoms. The internal medicine vet stated that many older dogs have behavioral issues with excessive water drinking (rather than biological disease), which can explain Kobe's only major symptom pointing to Cushing's. We plan to euthanize Kobe this weekend. My husband and I are devastated because we have raised her for 14.5 years and she is the only "child" we ever had! We have been crying every day and having nightmares every night for the past month. Thank you for giving us a little hope and making us feel that we are not alone in this world! We encounter a lot of people who can't understand the degree of sadness we are experiencing with Kobe's illness and her impending end of life. Best of luck to all of you! Your dogs are lucky to have you!

[Squirt's Mom]

Oh, no. :( I am just so sorry to hear this sad news. Kobe has fought hard and won so many battles and I hoped this would be one more he could beat. Kobe is so incredibly lucky to have ya'll as his mom and dad. You have stood by him through thick and thin, giving him your all. Now that no more can be done to improve his life, you give him the greatest gift of all - freedom from a failing vessel.

We are here any time should you wish to talk. Many of us have walked where you do today and understand your anguish.
Our thoughts and prayers are with you all,
Leslie and the gang

[Roxee's Dad]

I am so very sorry, my heart hurts for you. A good friend of this forum once said their is not a more unselfish gift you can give than taking their pain away and making it yours.

All of our angels will be at the Rainbow Bridge waiting to welcome Kobe....

[Trish]

Gosh, what a hard week this is going to be for you. It sounds like you have tried everything to help him and now you have to make that decision none of us want to make but we do it because of love for them is bigger than our own need to keep them with us when they are uncomfortable. I know you know this, but it doesn't make it any easier. Your boy is lucky to leave this life in your loving arms and I am sending you big hugs and strength to get though it xxxxx

[molly muffin]

I am so very sorry to hear this news. We always hope for the best and try to prepare for the worst but it is never really something one can be ready for. Not ever. I know your heart is broken.
Just spend everyone not with Kobe
Love after all is the great equalizer in this world.
Hugs
Sharlene and Molly muffin

[goldengirl88]

I am so very sorry to hear all of this. I know you are heartbroken, and rightly so. This is such a heart wrenching decision to have to make especially when you have had your baby this long. I am praying for you and your baby that you can get thru this. Again I am so sorry. Blessings
Patti

[Squirt's Mom]

You are all in my thoughts this morning.
Hugs,
Leslie and the gang

[goldengirl88]

God Bless you all today and every day there after.
Patti

[Kobester]

We have been wavering back and forth on this decision for more than a month. Unlike many of you, we prayed that it was Cushing's disease causing her symptoms. It was our last hope. We look at her now and she is only 1% of the dog that she was even two years ago. In our hearts we know the time is near. We spoil her with food and treats everyday. But it kills me to think whether we can give her another week or one or two more days. How do you know when the "right" day comes?

[Trish]

You will see it in her eyes when she looks into your soul to tell you that she is ready to fly. So sorry you have to make this decision, one that tears at your heart when you have to release your friend who has given you so much pleasure over the years. Big Hugs... xxxx

[molly muffin]

Like Trish said, they do let you know. It doesn't make it easier so much, as just you say to yourself, it is time. The quality of life is not there, the eyes don't hold that same gleam, the tail doesn't do the happy dance much if at all. (okay, my golden was wagging her tail, even when she couldn't stand up, but that is a golden for you) :)
Sending you big hugs. I know this is so very hard to go through.

Sharlene and Molly Muffin