Very old gal and just found out about cushing's...please help

[fattycakes]

Hi all, I'm hoping someone here may be of help. I have a 15yr old staffordshire terrier gal (rescued her when she was just a pup) that hasn't been "diagnosed" yet but has these symptoms: insatiable thirst&hunger, pot belly/overweight, hair loss, very loose skin, wobbly legs & stands oddly, blackheads on feet&belly, rashes on elbows, leaky anal glands, elevated alkaline phosphatase level, panting & sometimes labored breathing, and sleeps constantly when not foraging for food or urinating on the floor. At first, my vet was attributing most of the earlier symptoms to old age. But of course she kept having me come back to treat for arthritis, occasional uti's, $pecial diet/dog food, $kin allergies, you name it. But never cushing's. After chasing these symptoms that became worse and worse over the last 18-24monthes, I switched vets. The new vet did basic blood panel & saw the elevated alkaline phosphatase level. Now they want to do an abdominal ultrasound to check for cushing's. (I guess all the symptoms aren't enough to make a diagnosis as they have to be sure, I understand this). But because of the original vet, I'm so far in debt now that I can barely afford to pay my electric bill. I have some $ saved to be able to do an in-home euthanasia, and an individual cremation when the time comes (just being realistic, she's 15yrs old and 75 lbs). I would be willing to dip into that saved $ to do the abdominal ultrasound if I thought it would be the only test they would need to do. But unfortunately from what I've read, it seems like this would be just the beginning of plenty more tests to come. Then if diagnosed finally, it would just be the beginning of the new vet trying to find the proper med, and dose, which seems to be almost experimental at best, and extremely time and money consuming (which isn't exactly on my old gal's side). Anyone ever hear of a really old dog's cushings turning itself around immediately following abdominal ultra sound diagnosis and the very first Rx prescribed? It looks like all the hollistic options available seem to be purely snake oil at best (i.e. cushex, supraglan, etc.), but would a raw food diet and supplements be helpful at all at this stage? If the answers are "no" to both questions, is there any type of major pain medication that would ensure she was very comfortable for the time she has left? I'm sorry I sound like a jerk probably, I'm just so frustrated the original vet never mentioned cushing's. I just want the time my baby has left to be as pain-free as possible. And if it isn't possible at all, I will start preparing to make the dreaded appointment... Any answers are very appreciated, but please be kind, I'm typing this with a face full of tears. Thank You

[goldengirl88]

Welcome to you and your baby girl. I know what you mean a face full of tears. We have all been there. As far as the money lost on the other vet, I am so sorry that happened, but a lot of us have that experience. There are very few vets that are educated on, and understand this disease. Many chalk it up to old age. Unfortunately because Cushing's is such a hard disease to diagnose, that is why all the testing must be done. These are powerful drugs used to manage this disease and you do not want to give them to a dog that does not have Cushing's. There are other diseases that have similar symptoms. Has your dog been tested for thyroid disease, and diabetes? The testing up front is where most of the money is spent, after that it does become a lot less expensive. You named a lot of Cushing's symptoms that your dog is having, so it may well be she has Cushing's. Did you have any of the following done urine creatinine test, LDDS, ACTH ? When diagnosing Cushing's it is not one particular test that you diagnose by. It is a combination of symptoms, testing, ultra sound, blood work. All this is taken into consideration. The ultra sound is worth the money only if it is done on a high definition machine in my opinion. I paid for several at my vets that weren't worth a Nicole. By getting an ultra sound you can identify done other problems in the abdomen , and identify what type of Cushing's your dog has.There is adrenal, and pituitary. The Adrenal can be removed with an operation if readable, the pituitary is usually done with radiation. Most people choose to manage the disease with Lysodren, or Trilostane name brand Vetoryl. There is no cure for this disease unless it is removed, there is the drugs mentioned to manage the symptoms. Once your dog gets on one of the drugs your cost will go down substantially. You will just be buying the drugs, and after the initialACTH 30 day period in which you would have 2 ACTH tests, one at 15 days and one at 30 days, you would be monitoring the disease with an ACTH every three months, and at dosage changes. A dog can live out it's natural life if managed correctly on these drugs, so it is not a death sentence. I always caution someone new about the starting dosage of trilostane. We have seen time and time again when you start your dog on a low dosage, the dog does well after adjusting to the drug and the cortisol lowering, but we have seen dogs struggle, and some get in trouble by starting too high. Lysodren is different as there is a loading phase with it. Usually it is the older dogs that get this disease. I know you are thinking about the age of your dog, and I can understand that. You are right the natural products offered do not manage this disease or there would be no need for this forum, or these drugs. If you have had any of the testing mentioned, we will want you to post the abnormal numbers along with the reference for normals given by the lab as they are all different. We can better see what is going on with your dog and help you that way. You are not alone, and the thought of you sitting there typing this and crying, brings me back to my beginnings here. We are here for you to listen and support and go thru this journey with you so please do not feel alone any more. You will be your dogs only advocate so read all you can about this disease to bring yourself up to speed, as that will be your biggest asset. Keep a daily journal on your dog and what is going on, you will need it to refer back to. We are here with a friendly shoulder if you need one to cry on. Blessings
Patti

[Squirt's Mom]

Hi Fattycakes :p, welcome!

As Patti said, we do understand all you have gone through, are going through and will go through. And you now have a new family that will be by your side the whole way no matter which course you choose to take.

First, 15 is a GREAT age for any pup to reach but especially so for a larger breed like a Staffordshire! That speaks volumes about the TLC you have given her. Second, in your shoes I would not put her through all the testing nor the treatment but would do my utmost to continue making her every day as wonderful as possible and enjoy every moment you have with her. Treatment will not cure the disease, only help control the signs like the hunger. And it is a lifetime treatment - once started it continues for most pups.

You can do things like give her green beans, carrots, apples, bananas, and many other fresh fruits and veggies to help her feel fuller. Supplements like salmon oil, Glucosamine, condroitin, etc can help a little bit with arthritic pain. If you think she is in great pain a lot of the time, talk to the vet about something to help her with that. As for feeding a raw diet, unless she has been on raw previously, I would not switch to raw at this stage of her life....tho the raw feeders and supporters here are going to tell you differently. ;)

I am glad you found us and hope to hear more about your sweet girl. We are here anytime you need to talk for any reason and never hesitate to ask questions.
Hugs,
Leslie and the gang

[fattycakes]

Awww...thnks sooo much for your kind words Patti. Its nice to know when you're not alone, thank you.... I'm not "angry" at the old vet, I know she really did care, but just wasn't educated enough obviously (as much as I wish vet's were, I know they aren't psychic). And unfortunately, the only thing that has been done so far concerning the cushing's possibility is exactly what I posted, a basic blood panel. She just went to the new vet for the first time yesterday morning, and that's the first time I've ever heard the word "cushings". Its been a long 24hrs reading online. That's why I was asking if anyone has ever heard of a very old dog being "diagnosed" after the very first abdominal ultrasound and then getting relief from the very first Rx? I appreciate your wealth of technical knowledge (not sure if they use a high-def ultrasound, but I can find out if that would make the difference needed: diagnosis after that one test). As I stated in my post, I would just barely be able to afford the very first test and possibly the first Rx, but without a doubt no way I could afford even a second test, much less a third, or various drugs to find which one works best. As I stated in my post, I'm trying to keep the lights in my apartment on. I sold my car 3 monthes ago to settle up with my old vet. I have a coin collection from when I was a kid that I'm listing on craigslist now, but that's not $ I have in my pocket currently. Altho I'm on a strictly ramen noodle diet myself, I have $ for her "diet". As I was asking in my original posting, do you or anyone else here know if maybe a fully raw organic diet would ease her symptoms in any way? If not, is there something I can ask the vet for medication-wise to ensure that she is as comfortable as absolutely possible for the amount of time she has left? Again, she's a 15yr old dog with a 12yr average lifespan. Even if I could afford every last test and medication they want to try on her, I don't know if she would want her remaining time spent in that manner. I'm trying not to be morbid, but definately realistic. When my mother had cancer for the last 18 monthes of her life, they gave her medication to make sure she was comfortable. I know cushing's isnt cancer, but do they not do that for our furbabies during their twilight? I just want my baby to be comfortable for however long she has left. I'm so sorry I'm rambling, and thank you again for your kind words Patti. I'm sure I'm just asking questions that have answers that I don't want to hear, if that makes any sense...

[Renee]

I am a proponent of raw diets for dogs - but, even I would not recommend it for a dog of that age, not unless that was her regular diet throughout her life anyway. A raw diet can be a game changer for some dogs, but as they age, it can be harder to digest.

A good quality kibble or canned food, maybe with a vitamin supplement added, would be my suggestion.

As for the testing, etc - I understand where you are coming from. It is quite expensive. No way around that.

[fattycakes]

Thank You Leslie! I didnt see your reply while I was typing Patti's...You guys are soooo kind, THANK YOU! I've been doing the carrots&apples her whole life (Ive always called her my lil horsie:)...so they come in handy with her appetite. I quit giving her her regular mealtimes a while back, just so that she can sorta "graze" every couple hours and still keep her from gaining anymore weight. And yes, she has definately been a spoiled girl her whole life. The vet told me to add some padding to her bed for her joints and I just laughed, as she has never not slept in my bed, I'm lucky I don't have to sleep on the doggie bed with her nitetime sprawl. I know Ive given her an amazing life, especially compared with where she was rescued from as a puppy. That's why, unless I thought it would buy her a couple more years, I couldn't bare to put her thru all the testing, trial periods of meds, etc. (even if I could afford it). I will ask the new vet about something for her "old, achy joints&bones", but she really seems adamant about doing the ultrasound before anything else. I'm afraid that when I tell her I don't want to go that route, she might not be so quick to address her simple comfort level. I'm sure Im just being a bit jaded and shouldn't assume anything until I tell her. Again, thanks soo much you guys, I can't tell you how much better you guys are making this. Thank you!

[molly muffin]

Hello and welcome.
I agree with Leslie. An operation would cost thousands and I probably would not put a 15 year old staffy through that. I am sure the vet wants to do an ultrasound, but you have to be frank with the vet and say, I can't afford the ultrasound and I won't be doing an operation (if that is your choice) and I want to make sure that she is as comfortable as it is possible for her to be for the time she has left.
Save the money you have set aside for the purpose you saved it for and concentrate on just making her comfortable and as happy as she can be. It doesn't mean that things end tomorrow or the next day, it just means that the rest of the time, is her time to be her doggie self.

I hope that helps. We do understand that this is very hard and it is heart breaking too, and all you want to do is what is best.

Sharlene and molly muffin

[fattycakes]

thnks renee, thats good to hear from someone that's for the raw or BARF type diet. I'll just stick with the raw fruits&veggies (mainly just carrots&apples, & a bite or two of banana evey now&then), and her normal wet food she's been on. She had some skin allergies about ten yrs ago and it took me awhile to find a food that agreed with so I didnt really want to mess with her diet unless it was going to really possibly be beneficial. As far as supplements, Ive just been doing the glucosamine&standard vita thing for a while.

thanks Sharlene, I think that's about what Ive decided to do. The only reason I would've been willing to dip into the in-home euth $ is because I think sometimes thats almost more for my comfort than hers. I know she wouldnt want to do that at the vets office, but I don't know how much being individually cremated is going to help HER and not just me, ya know? Regardless, it doesn't seem like doing the ultrasound only would extend her time. As for her comfort, I don't want her to be "out of it" completely, but I want to give her something to really be sure she's comfortable. Ive had broken bones& knee surgery in the past, and I know what its like when they give you the "good stuff", I just want her to have that warm&fuzzy feeling, ya know. The vet prescribed tramadol for her, but I haven't noticed any difference in her either way. I also have some anti-inflammatory meds for her arthritis (Rimidol?), but I stopped giving it to her because the new vet said she's not even sure she has arthritis to begin with. There must be something to "ensure" she's feeling good in the aches&pains department. It probably just comes down to whether or not the vet wants to prescribe it. Thanks again you guys, seriously, thank all of you, Ive feel ten times better since seeing your replies. And I think its making my old gal feel a lil better since she knows when I'm down, we've been through alot together over the years and she knows if I'm sad.

[goldengirl88]

Do what your heart tells you. Keep your baby comfortable and with you and just love her every minute you have with her. At her age it would be very hard to go thru all the testing. I think it might be easier on you and money wise too to get a good kibble and add to it as suggested. Please let us know how she is getting along, and take care of yourself. Again I wish I had a magic wand to make things
better? Blessings
Patti

[Harley PoMMom]

Hi and welcome to you and your girl!

Sorry for the reasons that brought you here but glad you found us as we will help in any way we can.

Cushing's is when a dog's system produces excessive amounts of cortisol either from a tumor of the pituitary or a tumor on the adrenal gland/s. This plethora amount of cortisol has anti-inflammatory properties and kinda is like a "feel good" drug to dogs with Cushing's disease.

This excessive cortisol does make some of the internal organs work harder such as the liver and kidneys. Since the liver is being taxed by the cortisol if this were me I would not use Rimadyl as this drug can cause some ill effects on the liver. Also with this extra cortisol the kidneys produce a lot more urine so a dog with Cushing's has to drink loads of water to keep up with the output from the kidneys, for this reason a dog with Cushing's should never have their water restricted.

I'm providing a quote from one of our Administrators who had posted to a member's thread regarding treating an elder dog:

Cushing's is typically a slowly progressive disease but it does have the potential to cause systemic damage over time (from high blood pressure, vulnerability to pancreatitis and infections, high cholesterol, kidney damage, liver inflammation, etc.). So for a younger dog, I'd certainly recommend effective treatment so as to eliminate some of these risks, improve longterm quality of life, and allow the dog to live out his/her normal lifespan. However, for a dog of Pepper's age, immediate quality of life issues seem of paramount importance to me. And there are some trade-offs to treatment, especially for an arthritic dog since the arthritis may actually worsen as the cortisol level drops, necessitating the introduction of additional drugs to better manage the discomfort. Also, especially at the beginning, there can be numerous vet visits and blood draws which can be less than pleasant for a dog who's nervous at the vet (and also hard on the owner's pocketbook :o).

I don't tell you any of this to dissuade you from treating if you and your vet agree this is the best path forward for Pepper. But I do think you are the best judge as to how uncomfortable her current symptoms are to you both, and if they are not bothering Pepper all that much -- as I say, you may want to hold off on treating for the time being.


Marianne

Hugs, Lori

[fattycakes]

thanks Patti, your kind words are sooo appreciated. I've decided that I'll probably stick with the same diet she's been on. As I mentioned in my reply to renee, she had some skin allergies about ten years ago and it took me awhile to get the diet combination of wet food&fruits/veggies that seemed to clear it up. It's posted in the reply to renee above if you wanted to check it out and/or have any suggestions of anything that might be worth adding that could possibly be beneficial in easing any symptoms. (she doesn't have any allergy "rashes" like she used to get, so I'd be able to tell right away if she had an allergic reaction to anything new as long as I try new foods/supplements one at a time). thnks again for the support, it really has been helpful in such a trying time.

[fattycakes]

Thanks for reposting that for me Lori! The "immediate quality of life of most importance" part definately rings true for my old gal. And I for sure won't be giving her the Rimadyl anymore, especially since the original arthritis diagnosis is in question at this point anyways. I am still giving her the tramadol because I want to do anything for I can for her aches&pains. And because I was thinking I probably don't need to be super concerned about her being on anything for too long term, do you think that with just the excess cortisol being produced, it is the very best that she can possibly feel? It's making her feel better than ANY pain medication the vet could possibly prescribe? I just want to be sure she feels as good as she can under the circumstances. And again, thanks so much you guys!

[Harley PoMMom]

And I for sure won't be giving her the Rimadyl anymore, especially since the original arthritis diagnosis is in question at this point anyways. I am still giving her the tramadol because I want to do anything for I can for her aches&pains.

I'm glad to read that you have stopped the Rimadyl because when a dog's body is producing excessive amounts of cortisol and is given Rimadyl the chances of gastrointestinal side effects are greater.

Tramadol, I believe, is a great option.



do you think that with just the excess cortisol being produced, it is the very best that she can possibly feel? It's making her feel better than ANY pain medication the vet could possibly prescribe? I just want to be sure she feels as good as she can under the circumstances. And again, thanks so much you guys!

I really don't know if the excess cortisol can be better that any other pain medication. What I do know is that for some dogs when treatment is started and the cortisol is lowered that the pain from arthritis becomes unmasked.

I know you will do the very best for your girl, your deep love for her will guide you.

Hugs, Lori

[pansywags]

I'm sorry you and your girl are going through this - it's clear you want nothing but the best for her. My heart goes out to you - I cried so many tears (and I still cry every day even though it's been over a month since Pansy died).

I wonder if there might be some non-rx therapies that could help your dog's comfort level. Veterinary rehab facilities are doing some impressive things with acupuncture, acupressure and laser therapies. The one that Pansy went to for a year had a non profit fund that provided grants for pets from low income households, shelter animals and military and police service dogs/assistance animals.

[fattycakes]

thanks lori, for your words of support and for the confirmation on ending the rimadyl and keeping the tramadol. Ive read some conflicting stuff on the tramadol, but Ive already given it to her for two days now, and my gal hasnt shown any signs of harsh side effects. The only thing that might concern me is if I should maybe taper down her dose before I run out. I only have about 45 days worth. I think it's an opioid, and I wouldn't want her going thru any type of mild withdrawal when it's all gone.

thanks pansywags, those are good suggestions...It gave me the great idea to look up youtube vids for diy massage treatments. Not sure if they're helping any "symptoms", but my gal loves it and thats really all that counts at this point, so thanks, I wouldn't have thought of it without your post. Also, there are actually two different programs in my area for financial assistance with pets. I've applied with one about a month ago (heven't heard anything back, even after a few emails), and the other one doesn't give assistance to animals this far past their their average lifespan. I thought it sounded a bit harsh at first, but with the limited resources they have, I can undertand that they want to use them for younger pets that could benefit from those funds for a much longer time. And since I'm not going to do the conventional treatment (abdominal ultrasound+everything el$e), I might be able to swing one or two accupuncture sessions by next month. I'm not opposed to nonconventional approaches, as long as they aren't filled with the unscrupulous claims of the "snake oil" type companies. And I was actually thinking of maybe trying a small amount of dandelion just because I already have some. Has anyone heard of any adverse reactions to dandelion? I understand that it might not help, I just want to be sure that it won't hurt trying a very small amount to start. I've also read some ppl have seen slight results from melatonin. Anybody use any herbs and see any improvements?

[goldengirl88]

Hope you and your gal are doing well today. Just take it one day at a time. Sometimes I have to take it one hour at a time! Blessings
Patti

[Squirt's Mom]

About the Dandelion - do you have flower, leaf or root on hand? In what form - dried herb, alcohol tincture, etc.?

Dandelion has several actions, one of which is as a diuretic. What are you hoping to achieve by using the Dandelion? We may be able to find another option or two knowing what your goal(s) is / are.

Those allergic to or that have a sensitivity to plants in the Aster family, may have a reaction to Dandelion. I'll have to check to see what, if any, other cautions accompany this plant and get back to you.

Melatonin and lignans, from either flax or spruce, are used to treat a form of Cushing's called Atypical in which the cortisol is normal but other hormones called the Intermediate, or sex, hormones are elevated. You might try them with your baby girl but bear in mind - it takes at least 4 months for this treatment to show any improvements if it works. If you wish to try this, we can help you figure out the dose she would need of each.

Hugs,
Leslie and the gang

[fattycakes]

thanks Patti, that's great advice and so sweet of you. I hope you are having a good day as well!

Hi Leslie, I think I've decided to skip the dandelion altogether, (unless you think the positive effects outweigh the diaretic side effect?). I had some dried root on hand and figured since I already have it maybe I should look into it, but I bought it bulk from the natural foods store awhile back and I really can't say how old it is exactly. And although she shows many signs of cushings (insatiable thirst&hunger, pot belly/overweight, hair loss, very loose, thin skin, wobbly legs & stands oddly, major muscle loss on back legs, blackheads on feet&belly, rashes on elbows, leaky anal glands, elevated alkaline phosphatase level, panting, fatty type lumps on her lower back, small fat hump btwn her shoulders, and severe incontinence, and a few others), I don't have a diagnosis. It would be hard to see how it couldn't, but because I'm not a vet, I just have to keep telling myself there still could be a possibility that maybe its not cushings somehow. Because I want to know what she has sooo bad, it's really hard to believe it's not. But the bottom line is: I don't have an official diagnosis from a trained&certified professional no matter how many giant billboard type signs point to cushings, so I need to keep that in mind ....As far as what my "goals" are, pretty much the same as everyone I guess: do anything I possibly can to make my baby feel as well as she possibly can. If there's anything I can get, especially for a fraction of what conventional diagnosis&treatment costs (and that would help even just one of her many symptoms), I want to get it. But with that being said, I'm not willing to risk her feeling worse to try something. Even if I could afford every last test and Rx they want to try on her, I wouldn't do that to her at her extremely old age.... I've read some great things about dandelion helping the immune system in general, but if it is a diaretic, wouldn't that make her have to pee more? She doesn't need that. Do you know if the positive effects of dandelion make the diaretic side effect "worth it"? I've only known melatonin as a sleep aid, and my old gal doesn't need any help in that department either. I know it's probably a silly question, but maybe there are herbs that would possibly help without the risk of her feeling worse? Again, the goal is to alleviate, even if just slightly, any one or more of the twenty or so signs of cushings that she exhibits, and do anything I can to make her feel as well as I possibly can at her age....
And thank you again, to all of you. Seriously, I don't know where my head would be had I not found you guys. I have never seen such a compassionate group of ppl anywhere on the web...I get choked up just thinkin' about it. THANKS YOU GUYS!

[molly muffin]

I think the dandelion might make her pee more, which you don't want.

Leslie Might have some ideas of herbs that could help. All I can think of is the joint health support with perna canaliculus (green lipped) mussel might help. I get mine from amazon, cosequin.

sharlene and molly muffin

[fattycakes]

thanks sharlene, thats what made me think to steer clear of the dandelion, because leslie pointed out that it is a diaretic. My baby definately doesn't need to pee more. Just wondering about any herbs because it looks like maybe some might get slight relief of certain signs/symptoms with them. I understand none will lower cortisol levels (or if that's even the problem with my baby). We have an amazing natural co-op where I live that sells thousands of different bulk herbs by weight, so I'll look to see if I can find green lipped mussel. (I guess I should make sure she doesn't have a reaction to it before I buy the minimum 180 capsules from amazon, even tho its probably much cheaper there in the long run). Thanks again you guys!

[goldengirl88]

Just wanted to mention since you wanted the green lipped mussel, Tipper takes Glycoflex lll and it is in this product. I think the cheapest place for it is on Amazon. Blessings
Patti

[Harley PoMMom]

The only thing that might concern me is if I should maybe taper down her dose before I run out. I only have about 45 days worth. I think it's an opioid, and I wouldn't want her going thru any type of mild withdrawal when it's all gone.


I really don't think she will have any withdrawls from the tramadol.


Strangely, in the dog, tramadol is not metabolized into an opioid and how tramadol is able to effect pain relief in pets remains somewhat of a mystery.


Found that quote here:Tramadol (http://www.marvistavet.com/html/body_tramadol.html)

Hugs, Lori

[goldengirl88]

How is your girl doing? I hope everything is good. I was just thinking about you two, and wondering what was going on. Blessings
Patti