Cushings in my mini Dauchsund

[Dukes Mom]

Hi
I just received a diagnosis of Cushings disease on my 9 year old mini dauchshund.
Problems started back in October of 2013. He had a nasal infection, we treated with prednisone, and antibiotics. November, He had severe pneumonia and we almost lost him, More antibiotics, and prednisone. We lost his partner in april. December he was diagnosed with diabetes, and another nasal infection. Started low dose insulin, and antibiotic. Blood testing is a real problem with him, he hates needles, and the only place I can get blood for testing is from the ear.
Last week we had to increase his insulin to 7 units, and he has another infection.
Vet suspected cushings, so we did the 8 hour test. Test results came back today. Last vet bill was $500. How do you keep doing these test and buy medicine. Vet wants to start treating this week.
His only current symptoms, He wants to eat and drink continuously, and he pees a lot.

any suggestions :confused:

[Harley PoMMom]

Hi and welcome to you and your boy! I am sorry for the circumstances that brought you to us but glad you found your way here.

We have a sister site that deals with canine diabetes and I urge you to join there also, here's their link: http://www.k9diabetes.com/forum/ The wonderful people there are very knowledgeable about diabetes and they are really supportive.

Cushing's can be a difficult disease to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing it and other non-adrenal illnesses can create false positive test results.

It sounds like the vet performed the low-dose dexamethasone suppression (LDDS) test, which does take 8 hours. The LDDS test can create a false positive result when a dog has uncontrolled diabetes. The ACTH stimulation test is preferred when a diabetic dog is suspected of Cushing's.

Many members do have their dog's Cushing's medication compounded, which is a cost savings, Diamondback is one pharmacy that has a reputable reputation: http://www.diamondbackdrugs.com/home-mobile/

With Cushing's the initial expense is during the diagnostic phase, when a dog becomes stabilized with treatment the cost does drop considerably. Dogs that are on Cushing's medication do need to be monitored closely with the ACTH stimulation test. The ACTH test is expensive because of the stimulating agent. A renown Cushing's expert, Dr. Peterson, has written in his blog on how to save money with the ACTH stimulation test, here's a link to his article: How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing (http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html)

The diabetes should take priority over the Cushing's, no tests for Cushing's should be done until the Diabetes is controlled. Dr Peterson has written on his blog about this also and here is an excerpt from his blog:
The problem with diabetic dogs is that it's very difficult to make a diagnosis of Cushing's with certainty unless we see cutaneous changes. PU/PD, polyphagia, and high liver values all could be secondary to the diabetes. False-positive test results on a LDDST are very common in dogs with nonadrenal illness, such as diabetes (1-3). The full artcile can be found here: Q & A: Diagnosing Cushing's Disease in Dogs with Diabetes Mellitus (http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html)

We are here to help in any way we can so do not hesitate to ask all the questions you want.

Hugs, Lori

[Dukes Mom]

I am meeting with the vet on Wednesday, and will get copies of all test results. There have been many. Thank you for the information. I will hold off on cushings treatment until I have more information. The glucose levels seem to elevate with infections. Thank you for the cost information also.

[doxiesrock912]

Care Credit makes a credit card especially for vet bills. They often run interest free specials if you pay off the bill within a specific amount of time.

[Dukes Mom]

Today I met with my Vet. She is really good. She ran an 8 hour acth test for the cushings. The diabetes is under control at 7 units twice a day. Duke weights 13 lbs. He is quite active, and the messes around the house have come to an end. We will start treatment for the cushings at 12 mg once a day of trilostane. The vet contacted an endocrinologist to come up with this dose. I am a
Biology teacher, I have a weeks vacation coming up and we will start treatment then. My husband has parkinsons, and is in the later stages, so I do not think I have an option not to treat. I am a little nervous about what to expect, but I will also have prednisone on hand. The vet thinks that the cushings is aggravating the diabetes, and as we treat I will have to closely watch his glucose levels.

The cost is more than I think I can afford, but I guess I will have to go without a few luxuries so I can keep my baby around.

It is good to have someplace to talk about all of this. It has been a stressful week. :confused:

[molly muffin]

Oh lordy that is a stressful week for you! I am so happy that your vet spoke with an endocrinologist, because that is right at the dose you want to be at when you start. (always start small and work up) The care credit that Valarie mentioned can be very helpful for the vet bills.
I'm glad that the diabetes is controlled that helps alot.
Deep breaths. We have a great support group here, available whenever we are needed.

Sharlene and molly muffin