New here, have questions about my dog's diagnosis.

[Grace's Dad]

First off, I'm happy to find a forum dedicated to Cushings in Dogs. Please excuse what is bound to turn into a long post.

A call from the Vet today confirmed a diagnosis of Cushings in Grace (she's a 12yr old Aussie Cattle Dog/Blue Heeler). She displayed a poster child like list of symptoms for cushings, all had been chalked up to a pet growing old. So we were the poster child owners of a cushings dog too. As I was getting ready to take her to the vet last week, she developed a terrible nose bleed, something I'd never seen with her. My wife had given her some small doses of aspirin for her hip pain, and that coupled with the high blood pressure must have caused this, as she hasn't had another since.

I do not have the actual results from the test just yet, but the Doc told me over the phone that the ACHT test showed no difference from the baseline in the 4hour and 6hour readings.

Symptoms were/are;
Drinking massive amounts of water, and thus urinating often.
High blood pressure.
Hip pain/soreness.
Ravenous appetite.
Fat re-distribution.
Panting.
Seeking cool place to lay down.
Calcium deposits on the chest and abdominal area.

The only symptom she really hasn't shown is hair loss or skin problems.

My vet isn't insistent on medicating her just yet. The reason for taking her in was pain in the hip area, and Tramadol has helped that greatly. She is also on a blood pressure med now as well, temporary until we got test results back.

So, I'm here exploring options. Grace has a pretty non-existent medical history. She has been a very healthy dog her entire life. She spent the early portions of her life working a bit. Certainly not everyday, but enough that she took a few kicks from cows. Nothing that did any significant damage, but enough to make her sore for a few days afterward. Aside from that she's been a healthy dog, requiring only routine maintenance.

So here I am, and here is Grace. We have been thrown a curveball late in her life, and need some sound advice on how to best proceed. My vet is not outwardly advocating treatment, as her age falls into the average life expectancy for her breed, and with the meds she is now on, she is doing much better day-to-day. We have discussed treatment, and Vetoryl is his go-to. We have not pinned down the location of the tumor to the pituitary or the adrenal, he claims Vetoryl would be the treatment either way. He told me the recommended dosage was 60mg of Vetoryl, but would start her on 30mg, then build up as test results required.

I read the list of possible side effects of Vetoryl, and the list seems worst than the symptoms she exhibits now. But I definitely understand that not all dogs show all side effects too. I was almost ready to order her some Cushex Drops until I found this forum and saw the negative views towards it.

I guess I should summarize my thoughts here, as I am rambling. While I can afford the treatment and a few rounds of ACTH testing before Grace depletes my available surplus income, I am naturally concerned about her quality of life in the end. Right now, she is doing OK. She's no spring chicken, but she isn't doing bad either. Her life consists of being a house dog, not particularly active, but we do make sure she gets exercise as well.


Please help me understand any options in treatment, diet, or any other area I might explore to help Grace enjoy a little more quality time with us before she chases the big cow in the sky. This is all new to me, the disease, so no information would be considered redundant or insignificant to me.

Thank You very much,

Jay (and Grace)

[doxiesrock912]

Welcome Jay and Grace,

I have a 10yr old miniature dachshund, Daisy Mae who was diagnosed in May. They did an LDDS test and the IMS vet performed an ACTH test and an ultrasound to view her organs. Xrays will not show enough so don't bother if one is suggested.

First, I encourage you to get the results of Grace's tests and the type of test done along with any other health conditions that she has and post them here asap. We have several members who are experienced in interpreting the test results in terms that are understandable.

Since your vet suggests Vetoryl (we use compounded Trilostane for Daisy), I'll start by giving you some pointers there. It is best to start at the low end of the spectrum with dosage because every dog responds differently. Daisy weighed 11.5 lbs when we began treatment. Her vet suggested 20mg once a day which turned out to be much to high in one dose. She became lethargic, had diarrhea, and refused food. Please familiarize yourself with the symptoms of Addisons disease located under the helpful resources portion of this forum because these symptoms will indicate that Grace needs a lower dosage.

Once a day dosing was too much for Daisy to tolerate. She remained on the same strength split into two doses which she tolerated very well.

Daisy had many of the symptoms that Grace has with the addition of skin problems that she never had before. The skin issues are what prompted us to a vet visit and the Cushings was discovered. Tests are not 100% conclusive. Rather, the combination of what the tests indicate and clinical symptoms together make the diagnosis.

Diagnosing and treatment are more costly in the beginning because dose adjustments are almost always called for until they determine what is best for Grace. Cushings is very individualized. Once the correct dose is found, testing occurs less frequently and that is where the cost lowers.

Left untreated, the high levels of Cortisol wreak havoc on their immune systems and they become prone to skin infections, UTIs, and organ damage.

Rarely will a dog die from Cushings. Most live out the remainder of their life expectancy with treatment.

My best advice to you is too familiarize yourself with treatment options via the helpful resources section and write down questions for your vet. Unfortunately, too many vets are no as educated with Cushings as we think that they are. The information I obtained here helped me to weed out two inexperienced vets. Had I not done the research, I wouldn't have realized that they didn't know enough and that would have had dire consequences.

Well be waiting for those tests :)

[Harley PoMMom]

Hi Jay,

Welcome to you and Grace! I am sorry for the reasons that brought you to us but so glad you found your way here.

The medications for Cushing's will not cure it, they are given to help with the symptoms by lowering the elevated cortisol. Deciding whether to treat/not treat an elder dog can be a very difficult decision. One of our Administrators, Marianne, wrote a post to a member whose elder dog was just diagnosed with Cushing's and I believe what Marianne wrote may help:
Hi Fred,

I surely understand why you are struggling with a treatment decision for your girl, especially if your family vet does not feel optimistic. Do you know how many Cushing's dogs he has worked with, and which medication/s he has used? I would never mislead you by saying that Cushing's is a "snap," and that we have never experienced treatment failures or difficulties among our members. But we also have witnessed many, many success stories, as well, which allowed dogs to live out their normal lifespans with an excellent quality of life. So perhaps your vet has had the bad luck to have encountered a smaller group of dogs that have had special problems that interfered with their ability to respond favorably to treatment. In that vein, I hate to say it, but calcinosis cutis *is* a special problem that afflicts a smaller subset of Cushpups. If your dog really does have calcinosis cutis, that may have a huge impact on your treatment decision.

Setting that aside for a moment, here are a few personal thoughts from me. Other members may think differently, but for a dog who is already approaching the end of his/her normal lifespan, I would base a treatment decision largely on quality of life issues. We do know that untreated Cushing's has the potential to cause slow, systemic damage over the course of time. So for younger dogs, I have equal concern about halting the chronic damage that does, indeed, have the potential to shorten their lives. But for an older dog, my concern shifts more to comfort. As you say, balancing the need for medication, tests, and vet visits vs. the quality of the dog's life for their remaining time. However, sometimes that question is itself a no-brainer. For instance, prior to treatment, my own Cushpup was so miserable from overt symptoms that I could not imagine withholding medication if it would help (panting, ravenous hunger, excessive thirst/urination, hindleg weakness that increased to the point he could not negotiatie stairs or jump onto the couch or in the car). And the good news is that effective treatment really DOES help resolve those symptoms -- some of them very quickly. So that's where I differ from your vet. At any age, I would not hesitate to consider treatment if I was able to afford it and if my dog was uncomfortably symptomatic. But for an older dog, if symptoms were minimal and quality of life was still good "as is," I might be more likely to hold off.

However, for your girl, the calcinosis cutis may be the deciding factor as to her quality of life. If she truly suffers from it, I'm afraid that you must gain control of the circulating cortisol in order to have hopes of containing it. It is an uncommon condition, but we have had sufferers in the past and currently have some dogs who are currently afflicted. I am not an expert and have no first-hand knowledge, but my impression is that it will worsen and spread in the absence of treatment. And it is a condition that can absolutely make a dog miserable. I am not telling you this to force you into treatment. But instead to let you know as to the importance of making that diagnosis in a timely fashion so that you know what you are facing. If there is any doubt about it and if it is at all possible, you may try to see a veterinary dermatologist. As I say, ultimately the treatment decision will still be up to you. But if you do want to try to gain the upper hand on that disorder, it is best not to wait.

I see I've written a book, so I will close. But I am truly glad you've found us. And I'm certain other folks here will also share their own perspectives.

Marianne

We do have a Helpful Resource Thread that has a wealth of information regarding Cushing's, here's a handy link: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10) If you have any questions please do ask them. ;)

Hugs. Lori

[Trixie]

Hi Jay,
My mini schnauzer is 9 and was diagnosed last March with Cushings. We started on a very low dose of Trilostane/Vetoryl and we gradually increased the dose as needed after acth tests to check her levels.
My dog had the same list of symptoms as your Grace does and we a did not have the fur or skin issue either.
It took awhile to get to the right dose but the medication has helped my dog a great deal. We have had zero side effects so far...(I'm knocking wood..don't want to jinx anything). The constant drinking/urinating finally let up..still maybe a tad more than normal but nothing like it was. She seems much more comfortable in general and we are so relieved to know that cortisol is not wreaking havoc on her organs.
I know the side effect list can be scary but if your dog's dose is conservative you could see those symptoms abate and I can tell you that was such a good feeling for us.
I hope whatever you decide that Grace will feel good and enjoy life.

Barbara

[goldengirl88]

Welcome to the forum:
I am so sorry you baby is having troubles. It is hard and everyone wrestles with the situation of to treat or not. I can only tell you my situation. My Tipper just turned 12, she had such severe symptoms that I feel she would not be here today if it weren't for Vetoryl. Each dog reacts differently to it. It has given my dog back a decent quality of life, and has allowed me to be with her for a longer period of time. Those two things are the most important factors in my life. Everyone feels differently. Just get educated on this disease before deciding. I know you are afraid of the Vetoryl, but the consequences of not treating can be devastating also. If you a vigilant and watch your dog carefully, you and your dog should do fine. It is when people do not pay attention to warning signs that things go down hill. It seems your vet is educated on this drug, as I always tell everyone start low and gradually move up. You dog stands less of a chance of problems that way. This is what your vet advised and I applaud him for that. A lot of these vets have been blasting these dogs with really high doses and there are problems from it. You will make the decision that is best for you and your baby, and we will support you in it. My Tipper has been on Vetoryl for 13 months now. I cherish every day with her as it is a blessing. Good Luck and God Bless you both
Patti

[Grace's Dad]

Thanks to everyone for the words of wisdom and encouragement.

I am more inclined to begin the treatment of Vetoryl now that I've gotten some real world feedback.

I will keep as active as possible here on the forum, and keep everyone interested updated of Grace's condition.

Thanks again, it is nice to have a support group like this with caring and educated people to bounce ideas off of.

Jay

[Trixie]

Good Luck with treating...low and slow is the way to go in my opinion. We also do a split dose..morning and night. All dogs are different but this has worked well for us. I also like the idea of my dog getting small doses twice a day rather than the full dose all at one time...but that protocol may not be optimum for every dog. Just saying what has worked for us. The low dose did not change the symptoms very much at the start but I think maybe increasing very slowly after testing got the dog used to the drug...(I'm no scientist..just noting our experience) and so maybe that has something to do with not seeing any adverse effects over the last 8 months of medicating.
My dog weighs about 16 pounds and we are now at 14mg twice a day...we started at 6mg twice a day so it was months of tweaking the dose, eventually it worked and controlled all the symptoms.
Hope you have good results with Grace. :)

Barbara